Life-saving Intervention

Through a systems approach focused on purpose, inter-departmental coordination, community engagement, and multipronged innovations, Meghalaya's Rescue Mission has managed to tackle the state's alarming maternal mortality rate

- Anil Swarup

In mid-2020, an unexpected problem came to light as the administration in Meghalaya conducted weekly reviews to monitor the situation of the COVID-19 pandemic in the state: a high number of maternal deaths. In FY 2020-21, the state reported a high MMR (number of maternal deaths per 1,00,000 live births) of 289 against a national average of 97.

There were many factors that caused Meghalaya's high maternal mortality. Fear and anxiety about contracting the SARS-CoV-2 virus had led to a decline in pregnant women coming to health facilities to seek necessary antenatal care.

Meghalaya's geographic challenges further compounded the problem. Around 30 percent of the state's nearly 7,000 villages were hard-to-reach. This meant that they were either inaccessible by motorable roads, or were inaccessible during monsoons. GIS mapping of health facilities by the state government showed that residents of 49 percent of the state's villages could not reach a health facility within thirty minutes by vehicle. Providing healthcare services to the state's population became a challenge in such circumstances.

Most importantly, there was a lack of purpose or urgency within the health system for prevention of maternal deaths. High maternal deaths were seen as inevitable, and not as a problem that could be solved.

Faced with such challenges, the state's leadership realized the importance of taking a systems approach to solve the problem of high maternal mortality.