Non-medical Determinants of Maternal Death in India

Abstract

A study was carried out to explore non-medical factors responsible for the persistently high maternal mortality in India showed that most deaths occurred at home and during the postnatal period. Most 'death cases' belonged to high-risk age groups, had high parity (3+), were socially disadvantaged, had not received prenatal care and advice to go to hospital as compared to women with complications. Consequently, they either had not gone to hospital or had gone too late. Delay in care was also because of lack of transport facilities, inappropriate referrals or poor emergency preparedness of referral facilities. Data suggested that about balf the deaths could have been avoided if the health system had been alert and accessible. The critical determinants of avoidable death were families' awareness about complications, emergency transport and preparedness of referral facilities. The study highlighted the need for health workers to stress on health education, care during the third trimester and postnatal period, and referral to appropriate and accessible facilities, even bypassing the hierarchical referral system if necessary.