The Union Ministry of Health and Family Welfare has embarked on a major initiative to train doctors at the sub district level on emergency obstetric care. The training programme is being implemented in the backdrop of the increasing number of maternal deaths due to pregnancy and childbirth in the country.

The initiative would attempt to address the shortfall in the availability of anesthetics at the first referral units (FRU). To start with, the programme is being launched for doctors in Chhatisgarh. Once it succeeds, the model could be replicated in other parts of the country.

The government feels that the training programme would be a major step towards decentralising infrastructural support systems in medical delivery systems. It expects to generate adequate human resources through the programme.

Under the programme, training would be conducted for 18 weeks. Out of this duration, the last 4 weeks would be at State Medical College. The size of the trainees would be between 8 to 10 MBBS doctors. The selected participants should have put in at least 5 years' service. The selection of participants should follow the selection of FRUs where they would be posted after the training is completed.

It has been found that most of the maternal deaths in India have been due to haemorrhage, unsafe abortions, eclempsia, sepsis and obstructed labour. It is expected that the training programme would provide good quality ante-natal care, post natal care, safe institutional delivery services and timely referral and emergency obstetric care.

The Tenth Plan Working Group on Health of Women and Children has observed that Shortage of anaesthetists is perhaps the single most important cause of inadequacy of emergency Obstetric Care in Government Hospitals particularly in rural areas.

The government has stressed the importance of corrective measures that need to be taken to bring down maternal mortality rate significantly and improve maternal health in general. It feels that the provision of timely and adequate emergency obstetric care would not only improve the out reach of the RCH programme but also facilitate the improvement of obstetric care services at first referral units.

The programme will try to solve the problem arising out of the lack of specialist manpower, namely, gynecologists and Anesthetics in rural areas. Though the centre had introduced a scheme for hiring of anaesthetists at FRU/CHC level at a payment of Rs. 1000/- per emergency operation has been in operation for the last 4 years, it was not workable due to acute lack of anaesthetists particularly in sub-district areas. The new initiative is expected to go a long way in filling the critical gap of the absence of specialists in dealing with emergency services at referral services.