Ramachandran R* and Rajendran S
Background: In developing countries, specifically in India, millions of women and newborns die or experience serious health problems related to pregnancy and childbirth each year and many women do not have the good fortune to be attended by skilled personnel during childbirth. This lack of skilled attendance could be considered as one of the major factors in maternal and infantile mortality. Each year 3.3 million babies or may be even more are stillborn, more than 4 million die within 28 days of coming into the world, and a further 6.6 million young children die before their 5th birthday. From 2006 to 2012 the average complicated neonatal admissions with low birth weight children’s in virudhunagar district were 200. Also the researcher would like to found that how the Comprehensive Emergency Obstetric and New Born Care Centre (CEmONC) service gives opportunity to celebrate their 5th birthday for low birth children born in 2007 and to assess the factors determining the place of delivery and is Health system giving life year gain to Children?
Methodology: The present study was undertaken in Virudhunagar District of South Tamil Nadu with primary and secondary data. The Secondary data were collected from all CEmONC Centres under Tamil Nadu Health System Project (TNHSP) and beneficiaries under Muthulakshmi Reddy Maternity Benefit Scheme (MRMBS) in 2007. Due to gives life year gain up to 5 years to children through these schemes. The primary data were collected from 200 who delivered their children with low Birth Weight (LBW) (<2.500 kg) in 2007. There are nine Public Hospitals in Virudhunagar district, namely Virudhunagar, Aruppukottai, Tiruchuli, Kariapatti, Rajapalayam, Watrap, Srivilliputtur, Sattur and Sivakasi and for the present study, Virudhunagar, Aruppukottai, Rajapalayam, Srivilliputtur, Sattur and Sivakasi government hospitals were selected as only these hospital have CEmONC services.
Results: A sample of 40 (20%) attended Antenatal care (ANC) for previous pregnancy, 120 (60%) had their last delivery in private hospitals, while 80 (40%) had their last delivery at Government Hospital. Determinants of choice of delivery place include free cost of treatment (100%), friendly attitude of community health workers (75%), and good care of doctors, nurses and village health nurses (90%), distance to health care centers (80%), and cash incentive (100%). There is significant differences between age (P<0.001), caste (P<0.001), education (P<0.001), annual income (P<0.001) and place of deliveries in Government Hospital and not significant with type of family (P>0.001). There is a significant difference between consumption of Iron and Folic Acid (IFA) tablets and Low Birth Weight (LBW) in the study areas (P<0.001). There is a significant difference between mother age at birth and LBW (P<0.001). There is a significant difference between birth interval and LBW (P<0.001). There is a significant difference between income of the respondents and postnatal care (P<0.001). There were 196 children got life year gain above five year through the TNHSP and MRMBS. Lack of care and money is one of the reasons for less than five deaths in the study areas.
Conclusion: Female education, female empowerment, attitude of health care workers and distance of health facilities to the people in most communities are factors to be addressed in reducing child morbidity and mortality rates and improving maternal health, thus achieving the Millennium Development Goals (MDGs) 4 and 5. To get this done, policy makers, health personal and community at large should join hands.