Barriers of Institutional Delivery in an Urban–Slum of Delhi

Dr Manoj Kr Dhingra; Dr Preeti Adhav; Dr Renu Dhingra; Brig (Dr) Ajoy Mehan; Dr B S Deswal

Volume : VIII, Issue : V, May - 2019

Barriers of Institutional Delivery in an Urban–Slum of Delhi

Dr Manoj Kr Dhingra, Dr Preeti Adhav, Dr Renu Dhingra, Brig Dr Ajoy Mehan, Dr B S Deswal

Abstract :

Decreasing maternal mortality and morbidity in India is one of the most important and neglected public health goals of Indian health care system. This is mainly attributed to the fragmented maternal care delivery system in India which is rather dependent on co–axial interplay of both government and private health care systems for high quality maternal care. The trend in maternal mortality ratio (MMR) from a high of about 254 in 2004–06; 212 in 2007–09; 178 in 2010–12; 167 in 2011–13 and 130 in 2014–16 is a welcome trend. 2, however, a MMR of 130 per lakh live births is still too high as per international standards even today. What ails the maternal care in India and lack of universal institutional delivery is analyzed in this article as barriers still exists for universal institutional delivery even today. Of an estimated 287,000 maternal deaths that occurred globally in 2010, India accounted for 56,000, or 19% of the global maternal mortality ratio. India has a high and stagnating MMR which needs urgent action. Strategies to decrease MMR should include a Universal Institutional Delivery system and needs strengthening the Indian Maternal Health care delivery system. It is high time that Institutional Deliveries should be made universal and comprehensive in India.Further, evidence–based biomarkers for pre–empting the diagnosis of pre–eclampsia have emerged globally as a result of intensive research and these have not been used as a community screening tool in routine antenatal care in India. Therefore, there is an urgent need to use these evidence–based biomarkers such as (Soluble fms–like tyrosine kinase–1), VEGR (Vascular endothelial growth factor), PlGF (Placental Growth factor), for community screening of suspected pregnant mothers having pre–eclampsia, as they can pre–empt the diagnosis of PE and lead to gain in the lead time of diagnosis of PE, thereby leading to rapid diagnosis and improved management strategies