This initiative aims to identify and treat any potential health issues, safeguarding the well-being of both the mother and the unborn child.
A TIFFA scan is a key scan that is used to assess the health of the baby and identify any concerns. (Wikimedia Commons)
After its unique “Family Doctor Programme” — which includes free antenatal services — the Andhra Pradesh government has gone a step ahead and announced one TIFFA (Targeted Imaging for Fetal Anomalies) and three ultrasound scans that pregnant women can avail for free at all Dr YSR Aarogyasri-empanelled hospitals.
With the primary objectives of reducing the maternal mortality rate (MMR) and alleviating the financial burden on expectant mothers, the state government has taken a significant stride towards ensuring safe and healthy pregnancies.
Speaking to reporters on Friday, 9 June, after the launch of the initiative, Minister for Health, Medical and Family Welfare, Vidadala Rajini said, “From today onwards, pregnant women across the state can freely avail ultrasound and TIFFA scanning services at Aarogyasri network hospitals.”
The TIFFA scan is a specialised scan performed generally by a radiologist on pregnant women between the gestational age of 18 to 22 weeks of pregnancy. This evaluates the baby’s growth and detects potential abnormalities.
TIFFA scan is performed between 18 to 22 weeks of pregnancy. (Wikimedia Commons)
The scan examines organs like the heart, brain, and lungs to ensure proper formation and functioning. It detects conditions such as congenital heart defects, spinal cord and brain issues, hernia, and gastroschisis. It also assesses external organs to evaluate their development, including eyelids, lips, fingers, toes, and ears.
Meanwhile, the scan also assesses the position of the placenta, especially useful in identifying conditions like placenta previa where the placenta obstructs the birth canal. Early detection helps plan a smooth and lower-risk delivery.
A press release from the Andhra Pradesh Health Department stated that the scan also measures the amniotic fluid, length of the birth canal, umbilical cord position, and blood flow to the womb. It detects chromosomal abnormalities and determines the baby’s size and overall growth.
Through this, both the maternal mortality rate and the infant mortality rate can be brought down, it said.
To address various health concerns, pregnant women are now offered free diagnostic services, including tests for anemia, blood pressure, HIV, HBsAg, and syphilis. This initiative aims to identify and treat any potential health issues promptly, safeguarding the well-being of both the mother and the unborn child.
Transportation is often a significant challenge for pregnant women, especially those residing in remote areas. To mitigate this issue, the government has implemented a scheme providing free transport for expectant mothers from their houses to hospitals for delivery.
Andhra Pradesh government launching free TIFFA scan for pregnant women. (Supplied)
Additionally, medical officers offer transportation services to high-risk pregnant women, ensuring that they have access to timely medical care.
Furthermore, the government has introduced drop-back services through the Talli-Bidda Express, providing transportation for women who have delivered in public hospitals, allowing them a safe return home.
This initiative not only supports postnatal care but also ensures the well-being of both mother and child after delivery. In an effort to alleviate the financial burden on pregnant women, the government provides monetary assistance through the Janani Suraksha Yojana (JSY) and Pradhan Mantri Matru Vandana Yojana.
These schemes offer financial support to pregnant women who deliver in public institutions, ensuring that they receive appropriate care and support throughout their pregnancy journey.
Speaking to South First, obstetrician and gynaecologist Dr Seethalakshmi Chunduri said, “Offering TIFFA scan at no cost will allow expectant mothers to have access to vital information about their baby’s health, thus enabling them to make informed decisions and seek appropriate medical care, if necessary.”
WHO states that maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy. According to the MMR in India data — released by the Sample Registration System (SRS) office in its 2018-20 bulletin — Andhra Pradesh has significantly and constantly reduced the MMR from 74 per every 1 lakh live births in 2014-17.
In 2016-18, the MMR was at 65, in 2017-19, it was 58, and in 2018-20, it was 45 per every 1 lakh live births. The maternal mortality ratio is derived as the proportion of maternal deaths per 1 lakh live births.
Under the Arogyasri scheme, a pregnant woman can get three ultrasound scans (one in each trimester) in any government or empanelled hospital. Also, high-risk pregnant women can get a TIFFA scan under the scheme in any empanelled private facility with a TIFFA scan facility.
Under this initiative, pregnant women can undergo their scans at any empanelled hospital, irrespective of their choice for delivery. This flexibility ensures that all pregnant women, regardless of their geographical location, can avail these essential services even in private hospitals empanelled under the scheme, the press release added.
It is available for high-risk pregnant women with any history of genetic disease in the family, previous child/children with congenital/mental/chromosomal/metabolic disorders, previous children with sex linked/single gene disorders or haemoglobinopathies, pregnant women who are in consanguineous marriage, age of pregnant women is more than 35 years, women with poor obstetric history or any other condition indicated by the serving government doctor.
The Andhra Pradesh government estimates that approximately 64,624 pregnant women will benefit from the TIFFA scan each year, with an expenditure of ₹7.10 crore. Additionally, 9,23,200 beneficiaries will receive three free ultrasound scans, resulting in a total expenditure of ₹69.24 crore.
Vidadala Rajini explained that for a TIFFA scan, a woman has to typically pay more than ₹3,000 and approximately 64,000 women are prescribed this scan every year. She said that this scheme will benefit many women.
These measures taken by the Government of Andhra Pradesh to provide free antenatal services, including the provision of a TIFFA scan, are expected to play a significant role in reducing the maternal mortality rate.
While several doctors South First spoke to appreciated the state government’s move, a few of them expressed concern over the availability of radiologists and functioning of the ultrasound machines at government hospitals.
Speaking to South First, Dr Jeshwanth J, President of the AP Junior Doctors Association (APJUDA) said, “Not just in AP, I would say in any state, the functioning of the available machines is important. The government should ensure the working of the machines in all government hospitals.”
On condition of anonymity, a gynaecologist from a private hospital cited the example of Telangana’s recent judgement from the Consumer Redressal Forum (CRF) in January 2023 that directed the National Medical Council to ensure that only radiologists and specialists use TIFFA scan machines.
“In our neighbouring state of Telangana, overworked gynaecologists are forced to operate these machines. It is risky as there are possibilities of incorrect diagnosis, while radiologists are best to operate them,” said the gynaecologist.
She said that the NMC was even asked to formulate stringent guidelines to regulate antenatal USG protocols. This holds good for the Andhra Pradesh government too.
However, Dr Jeshwanth disagreed that there are fewer qualified specialists in Andhra Pradesh and said that the state has enough radiologists and specialists to perform the scans.
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