INSTITUTIONAL OVERSIGHT

Though hospital births have seen a record rise in the past 15 years, maternal and infant mortality rates remain high

- TARAN DEOL

AT THE maternal care ward in Madhya Pradesh's Tikamgarh District Hospital, 19-year-old Sarita (name changed) is in distress. “I have no idea how my one-week-old son is doing,” she says. Her baby was born severely underweight and puking, and was admitted to the Sick Newborn Care Unit (SNCU). The young mother admits she did not come in for any antenatal care (ANC) checkups prior to delivery. The World Health Organization (WHO) mandates at least four ANC checkups during pregnancy to monitor the mother and child's health.

Sarita is one of 28 new mothers in the maternal care ward, which is most of the time filled to capacity. About half of the 200 beds at the Tikamgarh District Hospital are allocated for expectant and new mothers. As per the "Indian Public Health Standards", a set of guidelines under the National Rural Health Mission, district hospitals seeing more than 75 childbirths a month need one senior doctor and one staff nurse for the postnatal care unit, while those with over 100 childbirths a month need nine nurses for ante- and postnatal care. The Tikamgarh District Hospital meets these standards, with four senior doctors, nine medical students and around 20 nurses in the maternal and child care units. However, with the staff working in eight-hour shifts and the hospital conducting 30-40 deliveries on average daily, resources are stretched. "Ideally, a mother should stay in the facility for 48-72 hours after a normal delivery. But we are not always able to accommodate them. So in case of a normal delivery, we discharge her within a day," says a nurse on condition of anonymity.