Maternal Health Research and Interventions

By Divya Ramamurthy, Research Analyst – ICTPH

The Millennium Development Goal to improve maternal health reinforces the importance of focusing on safe motherhood and preventive maternal care. In line with this, maternal health is a crucial aspect of the health interventions that ICTPH is planning in the Thanjavur district in Tamil Nadu (TN). While the Public Health Centres (PHCs) in the state of TN offer tremendously good care and support to mothers during the time of delivery, it is limited to this. There is not much follow-up care offered during the periods of preconception, prenatal and postnatal periods for both mother and child. While the system accounts for the safe delivery of the baby (which we acknowledge as extremely important), we also recognise the importance of nutritional support and care before, during and after pregnancy. ICTPH, through its maternal care interventions, attempts to fill these gaps by provisioning preventive and promotive care for mothers-to-be and pregnant women, in order to ensure a healthy baby and a healthy mother.

Through our discussions in Thanjavur on maternal health care, we came to realise just how vast the topic of discussion was. It became necessary to be very specific about the target population that a potential intervention would reach out to. We chalked out the need to plan out an intervention that would target women across an eighteen month period that spanned across pre-birth, pregnancy, and post-birth. This included three months of preconception, the nine months of pregnancy, and the immediate six months after the birth of the child. This crucial eighteen month period is necessary as it is the period of time where the mother’s health will directly impact the health of her child, and any nutritional deficiencies can be corrected easily during these periods.

Our baseline survey had revealed a highly anaemic population in our areas, specifically with regard to women and children. This also pertained to pregnant women, and we found from our sample size that more than 40% of pregnant women were found to be anaemic. What is puzzling here is that iron tablets are offered for free by the local PHC to pregnant women and mothers. It is not the fact that these iron tablets are unavailable or inaccessible, but rather that the delivery mechanism might need to be changed in order for women to avail use of these tablets which the government is so readily offering to them. Our hope is that we can intervene to bring down the rate of anaemia in our populations by working with the PHC to improve the delivery mechanism of these iron folic acid tablets. Our SughaVazhvu guides are the best way to improve the compliance rates of women as they will be able to go door-to-door with iron supplementation, as well as follow-up to ensure proper use and consumption of these tablets.

While iron folic acid is essential for pregnant mothers, we also discussed the importance of vital vitamins such as vitamin A and D, as well as the importance of breastfeeding as recommended by the WHO. Neonatal care for the mother and child is also extremely important as the child is most vulnerable at birth. With the consensus on the importance of iron folic acid, we will now proceed to making this a reality on the field, while also keeping in mind the need to focus on other aspects of maternal health care. Stay tuned as we make important decisions regarding ongoing research and implementation on the same.

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Nachiket Mor
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6 years 11 months ago
Dear Divya, I want to draw your attention to this article that was recently shared with us by Lindsey: http://www.bloomberg.com/news/2010-11-07/india-s-deadly-diabetes-scourge-cuts-down-millions-rising-to-middle-class.html. I am hoping that your work on pre-pregnancy “Marriage Package” will have a signficant impact on this issue in the longer term. The Dr. Caroline Fall study in Mumbai that they refer to is a joint effort with the ICICI Centre for Child Health and Nutrition (www.icchn.org.in) — please see this link: http://www.icchn.org.in/html/ourwork/ourwork_4_project_saras.html. If you need to know more about this please write to Anuska Kalita or send her your intervention design paper for review. While your work will have… Read more »
Divya Ramamurthy
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Divya Ramamurthy
6 years 11 months ago
Dear Nachiket, Thanks for drawing attention to this article. It highlights the notion that the time has now come to move towards the next frontier in maternal and child health care, by focusing on prevention during the pre-pregnancy period. There is much research now that shows the importance of interventions during this period of time. In fact with particular relevance to this article on diabetes, CDC has also recorded that diabetes management before pregnancy, substantially reduces the threefold increase in prevalence of birth defects among infants of diabetic women. I think that focusing on this period of time will enhance… Read more »
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