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Stillbirths: Some measures

stillckThe Karnataka State Commission for Protection of Child Rights headed by Dr Kripa Amar Alva, has recommended short term measures to reduce perinatal mortality and has written to U T Khader, Minister for Health & Family Welfare and Atul Kumar Tiwari, Principal Secretary to Government Health & Family Welfare Dept and PS Vastrad, Commissioner, Health & Family Welfare Services, and Sowjanya, Mission Director, National Health Mission.
This action comes in the wake of an article that appeared in a newspaper fortnight ago about the rate of ‘Stillbirths’ in Karnataka, where the State ranks 1st in the chart of stillbirths.
Short term measures that have been recommended are:
* Strengthening of the labor theaters
* Provide more nurses/ trained ANMs dedicated to all the hospitals conducting large number of deliveries based on statistics of the hospital to address work load of deliveries.
*Appointing clerical staff to carry out administrative work ( presently nurses are burdened with this instead of patient care)
* Appoint 3 or more MBBS doctors to assist the obstetrician to every labor theatre
* Provide more untied funds or to give GO to utilize the funds as “need based” with justification and proof
* To provide yearly maintenance fund to LT for good housekeeping. (this is nonexistent)
* Replenish old outdated equipments with new one of high quality along with simplifying the procedure of condemning the old equipments
* Administrative reforms: Most administrators in the hospitals have poor administrative knowledge and are appointed by virtue of seniority. Large amount of funds are available and are unutilized.( in 2014 only 48% of NHM funds were utilized)
* Appoint adequate office staff
* Administrator with hospital administrator degree to help medical superintendent
* Improving cesarean facilities:
* To provide adequate dedicated nurses and OT technicians
* Clerical staff for documentation and administrative work
* Define and procure high quality materials used in the OT
* Ensure availability of blood in all hospitals conducting cesarean
l Ensure availability of blood:
l Increase financial assistance to blood banks in the district hospitals to provide free blood to all patients.
l Equip all blood banks with required equipments and personnel
l Establish & functionalize ( already existing non functional) blood storage units
l Improve transport of mothers:
l Provide life into Janani Surkasha Vahini a year old project.
l Convert Nagu- Magu ambulances to “neonatal transport” ambulances
l Adequate staffing of the ambulances.
l Establishing help desk/ administrative team at district/ taluka level to achieve convergence at district/ taluka levels which coordinates between all concerned departments, community and local political system, this would enhance fund utilization at all levels. When the demand comes from people the system should work well.
l Convergence of all concerned in the MCH care:
l Department of health and family welfare, department of Women and child development, department of health and education, drug control department should converge and interconnect at all levels to evolve “mother and neonate centric approach” and KSCPCR can monitor. Most important is finance department which calls the final shots.
In utmost interest of child rights; the Karnataka State Commission for Protection of Child Rights has requested the Health Minister to implement the short term measures at the earliest to stop the devastating incidents of Stillbirths.

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