Maternal, newborn, child and adolescent health

Safer pregnancy in Tamil Nadu

From vision to reality

World Health Organization (SEARO)

Publication details

Number of pages: 100
Publication date: 2009
Languages: English
ISBN: 978-92-9022-356-6



India has the highest numbers of maternal and newborn deaths in the world. However there are major differences in what individual states within the country have achieved. The southern Indian state of Tamil Nadu is a good example of how over a relatively short period of time, an optimal combination of high level commitment, good technical leadership and strengthening of the health system have together have contributed to significant reductions in maternal and newborn mortality and improvements in the quality of life.

The state adopted a three-pronged approach to make pregnancy safer through: provision of services for the prevention and termination of unwanted pregnancies; provision of accessible, high-quality antenatal care, essential care for childbirth and basic emergency obstetric care at primary level; and provision of accessible, high-quality emergency obstetric care at the first referral level.

Between 1980 and 2006, maternal mortality ratio in Tamil Nadu fell from 450 to 90 per 100 000 live births. Neonatal mortality rate fell from 53 in 1971 to 26 per 1000 live births in 1990.

This monograph documents how these improvements in maternal and newborn health and shows that it is possible to improve maternal and newborn health through a health systems approach in resource poor settings.