Postpartum haemorrhage (PPH) is a dangerous complication that occurs after childbirth, marked by heavy and persistent bleeding. This can lead to a rapid decrease in blood pressure and in extreme cases, it can even be fatal. One tool that has proven instrumental in managing PPH is the Non-pneumatic Anti-Shock garment (NASG).
The NASG is a critical instrument designed to control blood loss from PPH, effectively eliminating a life-threatening risk for new mothers. The garment works by applying pressure to the lower body and abdomen. This forces the blood that was amassing in the pelvic area to reroute to other vital parts of the body. By quickly stabilizing the patient, the NASG buys enough time for doctors to intervene.
The Sahara Initiative: Implementing NASG in Ahmedabad, Gujarat
Recognising the potential of NASG, Arun Mahesh Babu, the district’s development officer of Ahmedabad in Gujarat, introduced this approach as part of a local initiative aptly named Sahara. This initiative began in November 2018 and has demonstrated significant success since its implementation.
Before Sahara, the district recorded eight maternal deaths due to PPH between January and November 2018. However, following the implementation of the Sahara initiative, no such deaths have been reported. This is partly attributed to the fact that many mothers in Ahmedabad are anaemic due to poor nutrition, which exacerbates the effect of sudden and excessive bleeding.
The Impact of Distance and Timing on Maternal Deaths
Maternal health in rural areas presents additional challenges, particularly when there are complications such as PPH. Women who give birth in these areas are often far from district hospitals where any complications can be attended to. According to data, around 30% of maternal deaths in the state were attributed to PPH. Alarmingly, these fatality incidents often occurred within the first four to twenty-four hours following childbirth.
Government Investment in NASG Suit Allocation
Following the success of the Sahara initiative, the government has made substantial investment in NASGs. Currently, 40 Primary Health Care Centres (PHCs) in Ahmedabad are equipped with an NASG suit each. These suits can each be used up to 140 times, and the government has invested Rs 14,500 per suit under the Janani Shishu Suraksha Karyakaram (JSSK).
Implementation of the JSSK Initiative
The Government of India launched the Janani Shishu Suraksha Karyakaram (JSSK) on June 1, 2011. The aim of this initiative is to provide free and cashless services to pregnant women and newborns (up to 30 days after birth). The scheme covers normal deliveries and caesarean operations in government health institutions in both rural and urban areas. The expectation is that the JSSK will encourage those who traditionally opt for home births to choose institutional deliveries.
Key Facts
| Fact | Value | | --- | --- | | NASG Suits Per PHC | 1 | | Uses Per NASG Suit | 140 | | Cost Per NASG Suit (In INR) | 14,500 | | Maternal Deaths Between Jan and Nov 2018 | 8 | | Maternal Deaths After Sahara Initiative | 0 |
Gujarat’s IMR and MMR Rates Against National Averages
According to data from the Sample Registration System results of 2016-17, Gujarat’s Infant Mortality Rate (IMR) was 30 per 1,000 live births and the Maternal Mortality Rate (MMR) was 91 per 100,000 live births. Although these figures are better than the national averages, they are still high for a state known for its relative prosperity.
