BackgroundMethodist Public Health Centre provides healthcare in the rural community of Mursan in the state of Uttar Pradesh, northern India. This paper reviews observations from the daily work at the clinic in January 2007, and an analysis of the birth register.
Method and materialOur main aim was to observe the antenatal care and obstetrical work at the clinic. During four weeks we attended many antenatal check-ups and participated in 15 deliveries. Our descriptions of the routines at the clinic are based upon our own observations and by interviews with the staff. We also attended many of the other activities at the clinic, such as the general practice, HIV-testing camp, baby-show and sterilization camp. These observations are briefly described.
Statistical analyses of the deliveries are based upon the clinic’s birth register. Grouped data from 1992-2006 were obtained from the manager’s electronical register, while individual data from 2002-2006 were obtained partly from a handwritten “delivery book” and partly from the electronic register. Norwegian statistics were mainly obtained from “Medisinsk Fødselsregister”.
ResultsIn the years 1992-2006 4870 babies were born at the clinic. The mean number of deliveries per year was 324,7. There was an evident season variation in the number of deliveries during a year, with a higher incidence in late summer and autumn and with the highest peak in August. 53,6 % of the babies were males, which is a significantly (p<0,01) higher than the male/female ratio in Norway. 3,7 % of the deliveries were breech, which is significantly (p<0,05) lower than in Norway. The perinatal mortality in India is higher than in Norway. At the clinic in Mursan 185 (3,8 %) of the babies were stillborn, while in Norway only 0,4 % babies were stillborn, which is significantly lower (p<0,01).The mean age for multigravida in Mursan was 25 years and for primigravida 21 years. This is much lower than in Norway, where the mean ages are 30,3 and 28,1 years respectively. 32 % of the pregnant women were primigravida. The nature of delivery varies a great deal between the primipari and the multipari. The rate of complicated deliveries is significantly (p<0,01) higher in the primipari than in the multipari. Of all the deliveries, 39 % were considered complicated.The mean birth weight for males were 2828 grams, and for females 2728 grams. The WHO defines low birth weight as birth weight below 2500 grams. Of the babies born in Mursan, 19,2 % had low birth weight. This is significantly higher (p<0,01) than in Norway, where only 3,9 % is born with low birth weight. The mean birth length for males were 50 centimetres and for girls 49,6 centimetres.
ConclusionThe principles of antenatal care and obstetrics are similar in Mursan and Norway. However, the cultural background, competence, economical and technical resources and governmental organization in India are so different from Norway, that the outcome of pregnancy is different. It is thus almost impossible to compare the two populations.