Strategies adopted by the Department of Health, Guna under the able leadership of the District Collector Dr. G. K. Sarswat IAS have been multi-prolonged. As the district has had high MMR, IMR and high malnutrition rate among 0-5 yrs of children so the initiatives taken to improve existing delivery of services are numerous and are being attempted at all levels. Major areas of thrust are health, education, water and sanitation and women and child development issues.
1. MATERNAL MORTALITY REDUCTION STRATEGY BY STRENGTHENING DELIVERY INSTITUTIONS ACROSS DISTRICT-GUNA
1. Key Interventions
For improving and strengthening of institutional delivery system in the district which alone can make lots of differences, a number of initiatives have been taken.-
i. Initiation of Community Mobile Health Services in all five blocks of the district. That has been the glaring example of community participation in the process of development.. Five mobile vans were purchased with the local community support. CM of the state honorable Mr.Shivraaj Singh came to Guna to launch the programme on 27 th May,07 and handed over vans to local community. These vans are used to carry doctors and their teams along with medicines to far flung areas to provide emergency services. to people. So far, 65 thousand people have been benefited from its access since last one and half year.
ii. Strengthening of Institutional Delivery Centers- Reducing maternal mortality requires strengthening of the health care system. One strategic entry point is provision and improvement of EmOC. A crucial part of EmOC is the availability of skilled attendants at birth and this requires long term planning. The overall effectiveness of skilled attendants depends, however, on the immediate access to life saving EmOC. Thus, reducing maternal mortality needs a strong and functioning health system. District administration has been assisting and supporting department of health Guna for setting priorities that strengthen health systems, i.e., provision of 24-hour quality EmOC should be a top priority. So far, 26 delivery centers have been identified and giving services. Two years back, District reported only 35 percent of institutional births and now the figure has gone upto 95 percent.
iii. Opening of 24 hours call center-A call center with TOLL-FREE NUMBER -102 at the premise of District hospital was opened five months back. The call center has all informations about pregnant women. Everyone has the access of free mobile vans for the transport of pregnant mothers. The results have been very phenomenal. Institutional deliveries have improved.
iii. Mother and Child Protection camps: Every pregnant woman faces risk of developing obstetric complications during pregnancy, during and after childbirth.. Basic education and literacy are among the most important determinants of family planning. Because an educated girl is likely to get married later, she reduces her risk of developing infection and dying during childbirth. Her babies are also more likely to survive the first year of life. An educated mother tends to be healthier and raise her family accordingly. Considering the importance of this, department of health has been organizing regular MCP camps at sector levels.
v. Maternal mortality audit – providing evidence for action
The five methods promoted by District are: verbal autopsy, facility-based death reviews, confidential enquiries into maternal deaths, near- misses review, and clinical audit. The five steps are identification of deaths, confidential data collection, anonymous analysis, recommendations for action and guidelines, and evaluation and refinement.
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