Doctors, Medical staff in Labour room to be financially rewarded by govt

New Delhi: Doctors and medical staff involved in the child delivery process will now be financially rewarded for following strict benchmarks in providing quality care to both mother and newborn, according to a new initiative by the Union Health Ministry.

The initiative -- Lakshya -- will be launched soon across the country to ensure proper implementation of the existing labor room protocols in order to reduce maternal and newborn mortality, a senior health ministry official said.

Steps to be taken to improve environment of natural delivery process include avoiding unnecessary induction, providing privacy to the mother during the intrapartum period, by way of separate labor room, or at least a private cubicle, use of labor beds instead of tables and a no-tolerance policy for any verbal or physical abuse of the woman.

Also, it should be ensured that the mother and the child bond immediately after birth, stressing a comfortable position during delivery rather than insisting on a universal "lying down" position.

Abolishing 'out of pocket expenditures (OOPE)' including demand by facility staff, for gratuitous payment by families for celebration of the baby's birth.

"All these are required to avoid undue stress in mothers," the official said stressing on the need to reorganise the labor room care processes to facilitate natural delivery process and to enable not only adherence to quality standards and clinical protocols, but also address issues such as respectful maternity care.

"Under the 'Lakshya', labor room teams will be financially rewarded if they meet the strict benchmarks and achieve targets in a time-bound manner as defined in the labor room guidelines," the official said.

The targets described include reduction of preventable maternal and newborn mortality, stillbirth rates, reductions in related morbidities such as obstetric fistula, puerperal sepsis, birth asphyxia and newborn sepsis, he said.

According to a Lancet study published in 2014, birth is the time of greatest risk of death and disability. The study highlighted that 40 percent of stillbirths, 25 percent of under 5 mortality and 46 percent of maternal deaths occur at the time of birth.

According to another health ministry official, there has been a substantial increase in the number of the institutional deliveries in the last decade of implementation of the National Health Mission (NHM).

"However, this increase in the numbers has not translated into commensurate improvements in the key maternal and newborn indicators such as maternal mortality and morbidity, stillbirth rates and early initiation of breastfeeding," the official said.

He said the available evidence shows that the first day of birth is the day of greatest risk for mothers and newborns.

Proper implementation of the guidelines and standards will ensure quality care of the mother and the newborns by improving infrastructure with the availability of functional equipment, robust supply system and competent human resource supported by adherence to clinical protocols and behavioral change towards ensuring delivery of respectful care.

There are 20,000 delivery points in the country and 2.64 crore deliveries happen (including the private sector) in India annually and 44,000 maternal deaths.

According to the Sample Registration System (SRS), Maternal Mortality Ratio (MMR) for the period 2011-13 was recorded at 167 per 100000 live births.

This translates into an estimated 44,000 maternal deaths in the country, every year. The infant mortality rate, as per the SRS 2016 stands at 34 per 1,000 live births in 2016.