In 2017, the Telangana government embarked on a revolutionary midwifery initiative, initially launched as a pilot. Since then, this programme has achieved remarkable growth, evolving from its modest beginnings of training 30 midwives to establishing a formidable cadre of 353 midwives currently serving across the State.
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Telangana’s midwifery endeavour has become a beacon of success within the realm of maternal healthcare in India. So significant was its impact that in 2018, the Government of India adopted midwifery as an integral part of public health.
Speaking at the fourteenth Dr. Lourdes C. Fernandez Oration held on Sunday, Vakati Karuna, Secretary of the Department of Education in the Government of Telangana, recounted her journey of initiating the midwifery programme within the State during her tenure as the Commissioner of Health and Family Welfare. The oration took place as part of the ‘Better Birthing Conference,’ a two-day event organised by the Fernandez Foundation and UNFPA.
Fruitful collaboration
Telangana’s midwifery initiative was made possible through a collaboration between the State government, UNICEF and Fernandez Hospital. The programme focused on training nursing students in midwifery, offering an intensive 18-month course aligned with the competencies outlined by the International Confederation of Midwives (ICM).
After the training, the midwives were deployed in various hospitals across the State. “At a remote hospital in Bhadrachalam, a new mother who had just given birth after a 12-hour labour shared, with tears in her eyes, that she did not miss her mother as midwife Vijaya was right there with her encouraging her during the whole labour period,” shared Ms. Karuna.
Post the success of the first batch of midwives, the government expanded its efforts by enrolling an additional 120 trainees in two subsequent batches. Some of these midwives were selected from tribal areas. They were trained and, subsequently, deployed back in their communities, with the aim of enhancing maternal healthcare in these regions.
Reasons for programme
The decision to introduce midwifery in Telangana was driven by three critical issues that the State faced. First was the alarming disparity in Maternal Mortality Rate (MMR), which was often 2-3 times higher in rural areas compared to urban centres. The second challenge was the reluctance of gynaecologists to work in rural areas, despite generous salary offers from the government.
Finally, Telangana was grappling with the highest rate of Caesarean sections in the entire country, standing at a staggering 58% in 2017. While the MMR was declining, it came at the expense of an excessive reliance on C-sections. Telangana’s midwifery programme sought to address these pressing issues, heralding a new era in maternal and newborn care, Ms. Karuna added.
