Delivery of perinatal care in India: priorities and policies

SUMMARY

Delivery of appropriate perinatal care at primary, secondary and tertiary levels is becoming an urgent and important issue in countries of the Third World where maternal, perinatal and neonatal mortality rates remain at an unacceptably high level. A recent WHO report on perinatal morbidity and mortality in the South-east Asian region (Table I) shows the current state of the problem in this region (1). In India, the perinatal mortality rate (PNMR) varies from 12·5 to 147·2/1000 (2), with most centres reporting rates of 70–90/1000 (Table II) (2–5). Ghosh et al. (6) have reported intranatal asphyxia, pulmonary conditions, cerebral birth trauma and neonatal infections as the leading necropsy causes of perinatal death. Several studies have also documented low birth weight as a major contributory factor in perinatal and neonatal mortality.

In India a large proportion of perinatal deaths are preventable. High fetal and childhood mortality adversely affect the acceptance of family planning (7). Therefore, perinatal care is important for India and must form an integral part of national goals of “health for all” by 2000 AD.