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  The Institute has produced three policy briefs on Public Health Care System with the support of Unicef, Hyderabad. 

PB01: Primary vs Specialist Medical Care: Which is more Equitable:

Equity in health and equitable access to healthcare has been at the core of health policy in India. Time and again Governments have reiterated their commitment to improve access to medical and health care by the poor and disadvantaged, to medical and health care. Achievement of this objective has been a key policy challenge.  

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PB02: Mere Institutional Delivery is Not Enough: Quality Obstetric care is Important for Further Reductions in Maternal Mortality: 

Strategic focus, by the National Health Mission (NHM), on institutional deliveries has improved coverage substantially. However, the maternal mortality ratio (MMR) in many areas remains high. For example in Telangana & Andhra Pradesh; the maternal mortality ratio (MMR) is still around 100 per 100,000 live births, despite upto 98% deliveries in medical institutions. About 60% of maternal deaths are due to four causes namely; (a) severe bleeding (25%), sepsis or infection (18%), complications of abortion (10%), and hypertensive disorders of pregnancy (7%). Obviously giving birth in a health facility does not necessarily equate with high-quality care or fewer maternal deaths. Neglected midwifery, continuing problems of under staffing, deficient facilities, and poor management are of concern.

In this regard, we have prepared a policy brief on the importance of Quality Obstetric Care for further reductions in Maternal Mortality. The brief suggests; (a) increasing the number and improving competence of midwives; (b) expansion and dynamic revision of skilled birth attendant (SBA) training centres; and (c) collaborative SBA training initiatives. Ensuring that all EmOC centres and linkages are fully functional is also equally important. Reorganization and consolidation of EmOC facilities with appropriate obstetric volume, and geographic spread is likely to help better management and improve access. Independent evaluations are important in addition to departmental monitoring.

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PB03: Rising Cesarean Sections: Causes & Concerns Towards a Public Health Agenda for Quality & Safty of Maternity Services: 

A Cesarean section (C-section/CS) is an operation to deliver a baby through the abdominal route, instead of the natural vaginal route. When medically indicated, CS saves lives and enhances perinatal outcome in high-risk pregnancies. In the absence of medical indications, the operative and consequential risks of C-sections may outweigh benefits. Hence, overuse of C-sec on is cause for concern.

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