Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.
Foundation for People-Centric Health Systems, New Delhi, India.
Indian J Pediatr. 2023 Dec;90(Suppl 1):63-70. doi: 10.1007/s12098-023-04807-2. Epub 2023 Aug 22.
Stillbirth is a major public health challenge and a multifaceted issue that leads to significant financial, physical, mental, financial, and psychosocial implications. India has made substantial progress in stillbirth reduction. Yet, many challenges continue and the absolute number of stillbirths remain high. This paper presents the national and state level burden of stillbirths and discusses about the magnitude, risk factors, causes and inequities in stillbirths. A few additional approaches for reduction of preventable stillbirths have been suggested. The authors argue that the institutional mechanisms need to be developed to ensure all stillbirths are registered in a timely manner. There is a need for standard definition for classification of stillbirths and document the cause, to roll-out suitable interventions. There is a need for state specific interventions to address different causes, as Indian states have variable stillbirth rates. The stillbirth audits should be institutionalised as a continuous quality improvement exercise to bring local accountability and reduce stillbirth rate. The healthcare system and providers must be trained to offer bereavement support to the affected mothers and families. These approaches should be implemented through primary healthcare system as well.
死产是一个主要的公共卫生挑战，也是一个多方面的问题，会导致重大的经济、身体、心理、财务和社会心理影响。印度在减少死产方面取得了重大进展。然而，许多挑战仍然存在，死产的绝对数量仍然很高。本文介绍了国家和邦级死产负担，并讨论了死产的规模、风险因素、原因和不平等现象。还提出了一些减少可预防死产的额外方法。作者认为，需要制定机构机制，以确保及时登记所有死产。需要为死产分类制定标准定义，并记录死因，以推出合适的干预措施。需要针对不同的原因制定特定于邦的干预措施，因为印度各邦的死产率不同。应将死产审核制度化，作为持续质量改进的一种手段，以实现地方问责制并降低死产率。医疗保健系统和提供者必须接受培训，为受影响的母亲和家庭提供丧亲支持。这些方法也应该通过初级医疗保健系统来实施。
