IIT Madras researchers found that sustained investments in Tamil Nadu’s emergency medical services improved maternal and newborn health outcomes after COVID-19.
Chennai, May 21: Researchers from Indian Institute of Technology Madras have found that sustained investments in emergency medical services and maternal healthcare helped Tamil Nadu recover from the disruptions caused by the COVID-19 pandemic and led to improved maternal and newborn health outcomes in the years following the crisis. The study analysed eight years of ambulance registry data from Tamil Nadu’s 108 emergency response system between 2017 and 2024. According to the researchers, the data covered all 42 districts of the state and a population of more than 84 million, making it one of the largest studies of its kind in India.
The research examined how the healthcare system functioned through different phases of the pandemic and the recovery period during 2023 and 2024. The findings were published in the peer-reviewed journal BMC Pregnancy and Childbirth. The study was led by P Kandaswamy, a retired IPS officer and Professor of Practice in the Departments of Management Studies and Data Science and AI at IIT Madras, along with Ashwin Prakash from Moody's Analytics.
According to the researchers, Tamil Nadu witnessed severe challenges during the second wave of the pandemic, when pregnant women faced difficulties accessing hospitals and emergency care. The study noted that home deliveries increased during this period and maternal mortality rose sharply compared to pre-pandemic levels.
Prof. Kandaswamy said the research aimed to understand whether the healthcare disruptions during COVID-19 had long-term consequences or whether the system was able to recover effectively. He said the findings showed a strong recovery supported by continued investments in emergency response and maternal healthcare services. The study found that despite a surge in pregnancy-related emergency calls during the pandemic, performance indicators of the emergency medical services system improved after the first wave. Response time, patient transfer duration and hospital handoff time remained efficient through the post-pandemic period, the researchers said.
The report also highlighted improvements in maternal and newborn health indicators after the pandemic. Maternal mortality reportedly declined by 19 per cent to 37 deaths per 100,000 live births, remaining significantly below the national average. Researchers said home deliveries reduced by more than 36 per cent, while miscarriages declined by 28 per cent. Complicated vaginal births also fell by over 19 per cent. The study further noted reductions in neonatal and infant mortality rates by 17 per cent and 19 per cent respectively during the resilient recovery phase.
According to the researchers, Tamil Nadu’s investments in ambulance networks, referral systems, healthcare workforce expansion and maternal health programmes played a key role in strengthening healthcare resilience during and after the pandemic. The study also described the Tamil Nadu model as a possible framework for other Indian states with weaker emergency healthcare systems and higher maternal mortality rates. Programmes such as risk-stratified antenatal care and the 108 ambulance network were cited as examples of integrated healthcare delivery.
However, the researchers cautioned that the study established associations rather than direct causation between improvements in emergency medical services and better health outcomes. They also noted limitations including reliance on aggregate data and the need for longer-term analysis.
