SHILLONG, Dec 23: In a move to tackle the high infant and maternal mortality rates, the Meghalaya government has approved a policy to address shortage of medical specialists in the state, which will be implemented through the ‘Adoption of Alternate models for Responding to Shortage of medical specialists (ADARSH) project.
Meghalaya saw a rise in the infant mortality rate (IMR) from 29.9 during the last National Family Health Survey survey to 32.3, as per the latest survey.
Commissioner and Secretary of Health and Family Welfare department, P Sampath Kumar said that the project is an attempt to scale up alternate models for responding to the critical shortage of medical specialists in the state by training doctors in the public sector.
He also informed that the state government has partnered with Public Health Foundation of India (PHFI) and Indian Institute of Public Health (IIPH).
“Under this initiative, the district hospitals will witness strengthening of their capital infrastructure as well as the staffing of specialists. It is anticipated that the presence of postgraduate trainees in the hospital around the year will lead to better services and higher utilisation,” Kumar said.
The state government has also adopted a College of Physicians and Surgeons (CPS) model which allows the government to reserve all seats for candidates who are domiciles of the state and preference is given to in-service doctors, he added. CPS is one of the oldest postgraduate medical education institutes in India.
“The government has recognised that medical specialists are scarce in Meghalaya and availability of specialists like gynaecologists, paediatricians, anaesthesiologists and radiologists is crucial to provide care to high-risk pregnant mothers and low-birth weight children as well as to conduct CS operations,” he said, adding that it has been identified that critical and specialist health workforce is important to achieve health and wider development objectives over the next few decades.
Speaking on the policy, Kumar said, “Around 7,000 villages are remotely located and therefore, there are glaring geographical challenges in reaching out to people in far flung areas”.
“It becomes even more challenging for the pregnant women to reach the nearest PHCs/CHCs. Further, whenever a woman whose pregnancy has been identified as a high risk and a complicated one approaches the nearest health centre, presence of specialists like gynaecologists, paediatricians, anaesthesiologists and radiologists are fundamental for saving mothers and children in the State,” he said. “This policy is aimed at addressing this gap and building the health system in the long run. Currently, there are 141 vacancies in the state, but no medical specialists to fill up the posts. Of course, getting admission for post graduation specialisation is not an easy task but it is time to nip this problem in the bud. If this is left to be continued like this, it will be extremely difficult to reduce the state’s MMR and IMR in the absence of specialists. The vision is that in the next 5-10 years, we should be able to train our own in-service doctors, who can be positioned even at the remote CHC level,” he said.
It may be mentioned that since May 2020, the state government has upped its ante against high MMR and IMR by conducting regular weekly meetings with all districts to put in effect a granular monitoring system of Reproductive, Maternal, Neonatal, Child, Adolescent Health (RMNCH).
The close monitoring has led to an increase in data reporting thereby initiating discussions and sensitising the masses about the seriousness of the situation. The maternal mortality status of Meghalaya is 182 per live one lakh deliveries, which is higher than the national average of 122 per one lakh deliveries.
The weekly review meetings has led to the identification of three important dimensions that needs to be considered pertaining to the prevalence of high rate of MMR and IMR – Clinical dimension; Public Health dimension including extensive training of doctors and grassroots healthcare providers; and Social and gender dimension.
Meanwhile, steps are already being taken to address the other two dimensions including the public health as well as social and gender dimension.
In August this year, Meghalaya passed an enabling policy for women’s empowerment by effecting 50 per cent reservation for women in village employment councils, a first of its kind in India, to enable increased women participation in development activities.
Further, the MOTHER app, launched in August 2019, is already in place to track and monitor all pregnant women in the state.