The state of Karnataka has taken decisive action following a concerning rise in stillbirths, unveiling a new surveillance and response mechanism aimed at diagnosing causes, improving care, and preventing future losses. The decision underscores growing alarm among health officials over maternal and perinatal health.
What’s the Situation?
Stillbirth rates in the state have recently edged above national averages. Latest data shows about eight stillbirths per 1,000 births statewide—higher than the broader national figure of approximately seven per 1,000. This marks a worrisome trend.
Some districts are seeing disproportionately high rates. Urban areas, in particular, are showing elevated numbers, with districts like Haveri, Dharwad and others reporting significantly more stillbirths relative to previous years.
What Has the Government Decided?
To tackle this, the Karnataka Department of Health and Family Welfare has constituted a new Stillbirth Surveillance and Response (SBSR) committee.
Key features of this initiative:
Strict reporting timelines: Each hospital is required to report stillbirths to district and state health officials within 24 hours.
Audit mechanism: A stillbirth audit committee will evaluate cases—both to determine causes and identify gaps in condition, treatment or systemic failures.
Classification standards: The surveillance will use internationally recognized classifications, especially the ICD-PM (International Classification of Diseases for Perinatal Mortality), to classify cause, timing (antepartum vs intrapartum), and associated maternal conditions.
Oversight at multiple levels: Hospital nodal officers will collect and send reports; review and follow-up will happen at district and state levels. The new state-level audit panel (including experts from public and private sectors) will especially focus on districts where stillbirth rates are highest.
Why Is This So Important?
Stillbirth is not just a statistic—it’s an indicator of gaps in health systems, maternal care, prenatal diagnostics, and sometimes socio-economic challenges. Increased stillbirths suggest that somewhere along the chain—from prenatal care to hospital delivery—there are failures.
Urban districts are particularly worrying: despite better access to facilities, higher stress, lifestyle factors, late detection of complications, or uneven infrastructure can worsen outcomes.
Notably, delays or lack of antenatal check-ups, untreated maternal conditions (like hypertension, diabetes), infection, and poor monitoring during labour are often cited as contributing factors in such situations.
What Challenges Lie Ahead?
Implementing such a surveillance and response system is not easy. Some anticipated challenges include:
Data accuracy & completeness: Ensuring hospitals—especially in rural or resource-poor districts—report all stillbirths, classify them properly, and do so in time. Missed or late reporting could undercut the effort.
Capacity & training: Hospital staff, midwives, communitiy health workers need training in record-keeping, diagnosing maternal risk factors, and following the ICD-PM classification.
Infrastructure and logistics: Some districts may lack diagnostic tools, prompt care, or the means to address complications when detected. Transportation to facilities, quality of referrals, etc., matter.
Public awareness: Pregnant women and their families need to know the importance of antenatal check-ups, warning signs during pregnancy, timely hospital visits. Lack of awareness can delay care.
Accountability: Ensuring that officials at hospital, district, and state levels act on audit reports; follow recommendations; provide feedback loops; and that systems for internal review are effective.
What the New System Could Enable
If implemented well, the new system could bring:
Earlier detection of risk: Identifying high-risk pregnancies earlier (e.g., gestational diabetes, hypertension, infections) so interventions can begin in time.
Targeted district-level action: Since the audit will highlight which districts are worst affected, resources can be allocated where they are needed most, instead of uniformly.
Policy refinement: Quarterly or periodic reports will allow policymakers to adjust protocols, refine maternal health programmes, strengthen care guidelines.
Reduction in preventable stillbirths: Strengthening antenatal care, labour monitoring, facility readiness should help reduce many cases that stem from care delays or lack of detection.
Improved data & research: Over time, a rigorous surveillance system feeds into better research, improved health metrics, and clearer public health planning.
Looking Ahead
This moment is a potential turning point for Karnataka’s maternal and perinatal health landscape. The surveillance panel and auditing framework put onus on authorities to close gaps—not just gather numbers.
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