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Delivery of perinatal care in India: priorities and policies
Insights
Improving perinatal care is crucial in developing nations to reduce high maternal, perinatal, and neonatal mortality rates. Addressing preventable deaths, like those from birth asphyxia and low birth weight, is key to achieving "health for all" goals.
Area of Science:
- Public Health
- Obstetrics & Gynecology
- Neonatology
Background:
- High maternal, perinatal, and neonatal mortality rates persist in developing countries.
- Perinatal mortality rates in India range significantly, with many centers reporting 70-90/1000.
- Preventable factors contribute to a large proportion of perinatal deaths in India.
Purpose of the Study:
- To highlight the urgent need for appropriate perinatal care delivery at all levels.
- To underscore the importance of reducing perinatal mortality for national health goals.
Main Methods:
- Review of WHO reports on perinatal morbidity and mortality.
- Analysis of existing studies on perinatal mortality causes and contributing factors in India.
Main Results:
- Intranatal asphyxia, pulmonary conditions, birth trauma, and infections are leading causes of perinatal death.
- Low birth weight is a significant factor in perinatal and neonatal mortality.
- High fetal and childhood mortality negatively impacts family planning acceptance.
Conclusions:
- Effective perinatal care is essential for India's national health objectives.
- Addressing preventable perinatal deaths is critical for improving maternal and child survival.
- Integrating comprehensive perinatal care is vital for achieving "health for all" targets.
Abstract:
Delivery of appropriate perinatal care at primary, secondary and tertiary levels is becoming an urgent and important issue in countries of the Third World where maternal, perinatal and neonatal mortality rates remain at an unacceptably high level. A recent WHO report on perinatal morbidity and mortality in the South-east Asian region (Table I) shows the current state of the problem in this region (1). In India, the perinatal mortality rate (PNMR) varies from 12.5 to 147.2/1000 (2), with most centres reporting rates of 70-90/1000 (Table II) (2-5). Ghosh et al. (6) have reported intranatal asphyxia, pulmonary conditions, cerebral birth trauma and neonatal infections as the leading necropsy causes of perinatal death. Several studies have also documented low birth weight as a major contributory factor in perinatal and neonatal mortality. In India a large proportion of perinatal deaths are preventable. High fetal and childhood mortality adversely affect the acceptance of family planning (7). Therefore, perinatal care is important for India and must form an integral part of national goals of "health for all" by 2000 AD.