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Losing a young mother due to poor access to emergency obstetric care in a remote tribal village in India

A ritual of playing drums at the death of a tribal woman who died after a difficult labor and child birth in a remote hilly area of India.

Photo of Maninder Manihani
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During my visit to a  tribal district in India, it took us nearly 3 hours of driving from the nearest town (over rough hilly terrain and the last leg of the journey over a non existent road) to reach a remote village to assess the health services available to the people and to assess the time taken to access the nearest health facility. 

When we reached, a celebration was going on in the village with the playing of drums and people singing. I just happened to ask what was going on. I was told that a baby boy has been born and it is an occasion to celebrate. 

We then proceeded to the local health facility which was supposed to be a sub-centre with facilities for institutional delivery under the care of an Auxillary Nurse Midwife (ANM). It turned out to be an old dilapidated structure with bare minimum infrastructure. There was no running water or electricity in the sub centre. I wondered if the baby just delivered had been delivered at home. when I asked the ANM accompanying us, she told us that the lady had a prolonged and difficult labor and by the time they could make arrangements to take her to the nearest hospital, she gave birth to the baby and died of post-partum bleeding. I was stunned. Her family was celebrating the arrival of the baby while getting the mother ready for cremation.

The ANM shared that the tribals sometimes take the patients and pregnant women on makeshift stretchers and beds to the nearest motorable road and then have to arrange a vehicle to take them to the nearest hospital.

What is a provocation or insight that might inspire others during this challenge?

All pregnancies are not high-risk pregnancies and trained ANMs can conduct normal deliveries safely. We need to screen the pregnant women and those with high risk pregnancies should be prioritised by the health system and transferred to the health facilities well in time. We need to track the data collected during each pregnancy and also keep the previous obstetric history handy.

How does this research relate to our use cases and personas?

The under-resourced mom, the healthcare providers and the unusual suspects are all the key stakeholders in this particular incident. Maybe we need a platform connecting all three to find a collaborative solution to these challenges.

Tell us about yourself:

A medical doctor with specialisation in Public health and a sexual and reproductive health specialists from India. An MBA student, a budding social entrepreneur, passionate about social innovations

Are you currently an employee of Sutter Health or UCB Pharmaceuticals?

  • No

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Photo of Bettina Fliegel

Hi Maninder. Thanks for sharing this story. Your ideas to use tech to maintain a health record that can be shared with appropriate medical providers is interesting. Do you know if the woman in the story had prenatal care? Is there any record keeping currently in the subcenters that you mention?

Are you familiar with the work being done in the developing world by Family Care International in the area of maternal and newborn health?
Mission and general info:http://www.familycareintl.org/en/about/31
Strengthening Midwifery http://www.familycareintl.org/en/about/31

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