The resilient strength of people cannot be underestimated. Even during the worst of times we showcase our best sides. Take the case of the COVID-19 pandemic. We could have surrendered to this crisis. But we did not. Healthcare sectors all over the world fought this pandemic with courage and creativity.
The COVID19 pandemic was a terrible crisis, disrupting healthcare services all over the world. During such a crisis, how was maternal and child healthcare managed across the world?
As mentioned, people did rise up to the challenge. Innovative ways to deal with the crisis were thought of. For example, in Malaysia, despite inordinate delays in maternal and child health services, immunisations for babies remained consistent. In Kenya, the digital platform MomCare was used by the people to find care during lockdowns.
So, how did India tackle the situation?
In North India, a 30% decline in institutional births was reported. But government programmes like Janani Suraksha Yojana (JSY) acted as a safety net, and pregnant women utilised alternative ways to deal with stress.
The aim of this study conducted by the authors Prof. Kandaswamy Paramasivan from the Department of Management Studies, Indian Institute of Technology (IIT) Madras, Chennai, India (Prof. Kandaswamy Paramasivan is also affiliated with the Department of Data Science and Artificial Intelligence, IIT Madras; and the Department of Computational Intelligence, SRM Institute of Science and Technology, Kattankulathur, Chennai, India), and Mr. Ashwin Prakash from Moody’s Analytics, Bengaluru, India, was to investigate emergency medical services (EMS) during the resilient phase of COVID19 (2023 to 2024) in Tamil Nadu, in Southern India.
Tamil Nadu witnessed the COVID19 pandemic in three distinct waves from March 2020 to March 2022, followed by the post-pandemic phase from April 2022 to December 2022, and finally the resilient recovery period from January to November 2023.
This study investigated the response time, travel time, hospital handoff time, and the total distance travelled by the ambulance to understand the efficiency of emergency medical services in Tamil Nadu.
The authors wanted to find out whether the pandemic has had a lasting effect on the reproductive health outcomes of mothers and infants in Tamil Nadu.
During COVID19, especially during Wave-2, which was the most disastrous phase of the pandemic, with the highest number of COVID19 cases and fatalities, pregnant women and families stayed indoors as hospitals were overcrowded, and they feared risk of infection. Therefore, home deliveries increased sharply during this time.
In Tamil Nadu, residents can call the number 108 to get emergency medical services. The present research studied data from the State 108 EMS Registry.
The second set of statistics – more essential – has to do with perinatal (refers to the time immediately before and after birth) outcomes. These statistics cover institutional and home births, complicated vaginal births, C-section deliveries, etc. for Tamil Nadu from 2013-2014 to 2023-2024.
The researchers employed a range of methodologies — including statistical methods such as ARIMA, machine learning approaches such as generalised additive models, and advanced deep learning architectures such as transformers — but as the predictive accuracy proved unsatisfactory, they resorted to a statistical comparison of the distributions of the predicted and actual EMS metrics.
The findings revealed that emergency service call volumes rose during the pandemic owing to the emergence of new COVID-19 variants. During the resilience phase, however, call volumes gradually returned to pre-pandemic levels. Notably, despite the overall surge in call volumes across the various phases of the pandemic, key emergency call metrics — including response time and hospital handoff time — improved significantly, particularly for pregnancy-related calls.
Even though the pandemic caused challenges, the resilient phase saw a big improvement in maternal outcomes. The Maternal Mortality Rate (MMR) fell to 37 deaths per 100,000 live births, which is a substantial 19% decrease from the pre-pandemic baseline.
In June 2024, the MMR in Tamil Nadu fell to 24. This is considerably lower than the national average, and that of other emerging countries, for which the rate is typically around 100.
In conclusion, the pandemic seems to have not impacted the reproductive health of women in Tamil Nadu.
Although this investigation cannot be definitive that improved emergency medical service efficiency caused better maternal outcomes, their co-occurrence suggests that systematic adaptations would likely have played an important role in mitigating adverse pandemic effects on the reproductive health of women in Tamil Nadu.
Dr. Balaji Venugopal MBBS, MD, FRCP, FRCP (Edin), Honorary Clinical Associate Professor, University of Glasgow, United Kingdom, greatly appreciated the work done by the authors with the following comments: “It is my pleasure and honour to provide a commentary on the research article titled “From pandemic to progress: maternal health resilience in the post COVID-19 era in Tamil Nadu, India” that has been authored by Prof Kandaswamy Paramasivan and Mr Ashwin Prakash and published in BMC Pregnancy and Childbirth on 30th Jan 2026.
In this study led by Prof Kandaswamy Paramasivan, the impact of the COVID-19 pandemic on maternal and neonatal health outcomes in Tamil Nadu, India during different phases of the pandemic is being examined in a comprehensive manner with specific emphasis on the resilience of the health system after the pandemic. Prof Kandaswamy Paramasivan and Mr Ashwin Prakash have systematically analysed the data on maternal health over an eight-year period from January 2017 to December 2024, including eight pandemic phases in 2020-22 and the resilient period of 2023 and 2024.
The analysis of the data by authors succinctly demonstrates that despite an increase in call volumes to emergency medical services (EMS) during the pandemic there has been a significant improvement in EMS metrics such as response time, transfer time, and hospital handoff time. The authors highlight the investments in healthcare infrastructure by government of Tamil Nadu including improving EMS infrastructure, hiring healthcare professionals, and enhancing maternal health programs, and put forward a credible hypothesis that these government led initiatives could have contributed to the improved outcomes during the resilient phase of the pandemic.
I would like to commend Prof Kandaswamy Paramasivan for leading on this study that showcases the resilience of the Tamil Nadu’s healthcare system during and after the COVID-19 pandemic, and for the thoughtful insight on further areas of research. Data-driven analyses like this research are complex and require a deep understanding of managing large volumes of data. However, they are essential for improving planning and enhancing the delivery of public health services for both healthcare professionals and government officials. I congratulate and laud Prof. Kandaswamy Paramasivan for his outstanding research contribution and his support and commitment to advancing public health research.”
Article by Akshay Anantharaman
Click here for the original link to the paper
