Assam's steady steps to ensure safe motherhood

Minjuara Begum religiously visits a medical unit in Assam's Kamrup (Metro) district on the ninth day of each month with the hope that she delivers a healthy child in six months.
Minjuara, 23, had three spontaneous abortions and now carrying her fourth child, she is taking no chances.
"My mother-in-law drags me to quacks and occultists but I would rather go to doctors who would help me become a mother of a healthy child," she told PTI.
And so Minjuara makes it a point to visit the First Referral Unit (FRU) at Dhirenpara. Under the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), special ante-natal care checkups are done on the ninth day of each month for high-risk pregnancy cases like hers.

PMSMA was launched on June 9 last year across the country with the objective of ensuring safe motherhood and providing assured, comprehensive and quality antenatal care on the ninth of every month.
Assam has the dubious distinction of having the country's highest Maternal Mortality Rate (MMR) of 300 per one lakh live birth as against the national average of 167 per one lakh live birth and has taken up the implementation of PMSMA in right earnest.

"The emphasis of the scheme is to target high-risk pregnancies, left-out and drop-out cases among the underprivileged women and provide them with the best possible antenatal care," says Senior Medical and Health Officer (SMHO) Dr J B Sarmah.

A salient feature of the scheme is requisitioning the services of private doctors as volunteers but there is no dearth of gynaecologists and obstetricians engaged in the government sector in the state, he points out.
According to statistics provided by the state National Health Mission (NHM), 62 private doctors have registered under PMSMA in Assam as against Madhya Pradesh with the highest number of 625 volunteers.
Kamrup (Metro) has the highest number of 18 volunteers followed by Sivasagar with 11 and Kamrup (Rural) with six while the other districts have one or two each.
"This is, however, not a matter of concern for us as we have enough gynaecologists at the district level. We are very happy with the progress made so far having served 1.48 lakh women since its launch in June last year to March," maternal health consultant Dr Pankaj Suthar says.

The focus of the scheme is on detection of high-risk pregnancies which include mostly anaemic women, hypertension, multiple pregnancy, ectopic pregnancy and any woman below 18 years of age, he says.
Dr Eva Devi Goswami, who works in a private nursing home, has volunteered to serve under the scheme.
Besides, special ANC checkups in addition to routine ANC and preparation of list of eligible women and mobilising by ASHA and ANM workers are also included, she adds.
The services provide free of cost blood and urine test, height and weight measurement, blood-pressure measurement, ante-natal check-ups and also transport facilities to pregnant women, says SMHO of Pandu Referral Unit Dr Pranita Deka.

The applicable diagnostic services also include ultra sonography.
Though most district level hospitals have USG machines, yet in many cases due to lack of manpower, patients are sent to private or other government hospitals for tests.
Besides, most of the district hospitals have no blood banks though in most cases, there are blood storage facilities.
Expecting mothers are generally satisfied with the ANC care with most of the tests being conducted at the same place and medicines, particularly iron folic tablets, being provided to them.
"A particular day for the check-up help us to plan and come to the hospital though it will be better if ultrasonography is also done at the same centre," points out 24-year-old Riva Boro.