A case of maternal mortality in Mangabeli village of Bicchiya Block of Mandla District

In Mangabeli village of Kanranjia Panchayat of Bichhiya block of Mandla district a women “Babli” wife of Mr. Vinay died after delivery in Community Health Centre Bichhiya in January 2010.

ASHA, Ms. Kamla Jharia, reported that Babli (age 16-17 yrs.) was first taken to SHC, Rajo, (5 Km. from village) for delivery and after keeping for one day ANM, Ms. Reeta Shyam referred her to CHC (20 Km. from Mangabeli village) because of anaemia. From Rajo family members returned her back to village and then take her to CHC by bus. Mother-in-law Sivratia Bai, and Husband, Vinay reported that they tried to call Janani Express but it could not came because it went to bring another women and if they hire other private vehicle to take Babli to hospital it will take 600-700 Rs. and health institution will not provide money for transportation if transported by private vehicle or two wheeler and moved walking. The economic condition of the family was very poor and they were unable to arrange any other vehicle. ASHA also accompanied them to CHC. In CHC she had normal delivery and delivered a low birth weight (2 Kg.) male baby. After delivery placenta also came out and Babli drink tea with biscuits. ASHA returned back to her home. Babli’s mother went to clean clothes and mother-in-law take baby to give him sunlight, as doctor prescribed. From window of the room her mother-in-law started talking with Babli and after few moments Babli died without any complaint.

Baby of Babli they named him “Nishant”, as remembrance of Babli, was 5 months old and received all the vaccines. Vinay showed his Jachcha Bachcha card also. It was an UIP card and from this card it was noticed that Babli received 3 ANC, IFA tablets and 2 TT vaccines during her pregnancy. But Nishant could not be weighed by AWW as AWW not visited their house to weigh him. We contacted AWW also but she was out of station then we contact her son and she provide weighing machine and growth chart of AWC. We weighed Nishant and found that his weight was only 3 Kg. and falls in IV^th grade of malnutrition. We advised his father to take him to Nutrition Rehabilitation Centre Mandla and also make arrangement for his movement.

For further inquiry ANM of Rajo SHC Ms. Reeta Shyam was also contacted. She reported that Babli was atrisk due to many reasons:

1. Less than 18 yrs. of age.
2. Primy para
3. Short structured
4. Low BP with acclampsia
5. Anaemia

In CHC there was no gynecologist was posted and there was only one doctor Dr. Taksande, BMO was on duty. He has to serve 1,54,815 population and his absence there was no other technical person available.

India has committed “To achieve Goal-5 of MDG, i.e., India should reduce maternal mortality (MMR) from 437 deaths per 100,000 live births in 1991 to 109 by 2015.” How any one can expect to reduce maternal mortality in such circumstances?