In One of MP’s Most Remote Districts, an IAS Officer’s Simple System Helped Cut Maternal Deaths by 50%

For months, health workers in Shahdol could reach only eight of every ten pregnant women on their call lists. 

The other two were the ones most likely to be in danger, women in remote, forested pockets of the Madhya Pradesh district, often skipping their iron and calcium tablets, missing check-ups, and unaware that a headache or swollen feet could be an early warning of pregnancy-induced hypertension.

When IAS officer Shivam Prajapati, CEO of Zila Panchayat, Shahdol, and his team spent nearly two months speaking with villagers in early 2026, they expected to find gaps in medicine supply or staff numbers. Instead, they found something more basic. 

“Our own people were not reaching them on time,” Prajapati says. The schemes existed; the follow-up did not.

The problem was never the medicine

Shahdol, a tribal-majority district known for its dense forests and monsoon-cut roads, has long struggled with anemia and hypertension in pregnancy. Villagers told Prajapati’s team they had never really been counselled about why any of it mattered. 

“If we know, we will take the medicines,” one woman said, echoing what health workers elsewhere have found when they finally sit down with pregnant women in isolated tribal villages and simply listen.

So the district built a doorstep monitoring system instead of a new scheme, calling it ‘Maa Ka Haal – Swasthya Ka Khayal’. 

Launched in January 2026, it began with a village-by-village survey to identify every high-risk pregnant woman in the district. Every 15 days, updated lists went out to Auxiliary Nurse Midwives (ANMs) , a village-level female health worker trained through a two-year diploma course, Community Health Officers and Medical Officers.

Each woman received at least one home visit and two phone calls a month, the kind of steady, silent contact that has long defined the work of ASHA workers walking village lanes at dawn across rural India. 

Women whose haemoglobin fell between 7 and 8.5 g/dL were sent for further blood tests, and monitoring continued for 42 days after delivery, the period when postnatal complications are most likely to go unnoticed.

Meeting mothers where they are

Deliberately, the system stayed low-tech. “We have not used AI because we wanted to keep the system simple. Our lowest-level staff should be able to understand and implement it easily,” Prajapati explained, as reported by Indian Masterminds, even as some Indian states experiment with AI-driven pregnancy tracking tools elsewhere. 

Shahdol’s approach instead mirrors a wider pattern among Indian districts that have found low-cost, high-touch outreach more effective than expensive new infrastructure, not unlike how one Maharashtra district collector cut its own health crisis by sending vehicles to people instead of waiting for them to travel. 

Accountability was built in from the start: officials randomly called beneficiaries to confirm that visits and calls had actually taken place. Some ANMs and ASHA workers initially saw the added workload as a burden, but as outcomes improved, so did participation. Phone monitoring coverage climbed from around 80% of beneficiaries to almost 99%.

The district also began planning for deliveries rather than reacting to emergencies. Officials shared lists of women expected to deliver within the coming week with local administration, ANMs, ASHA workers and sub-divisional magistrates, and arranged ambulances in advance for villages where heavy rains could cut off roads for days.

Numbers that tell the story 

• 5,380 high-risk pregnant women identified (Jan–Jun 2026)

• 100% of these women were monitored through phone follow-ups

• Among them:

  • 4,646 had moderate anaemia

  • 174 had severe anaemia

  • 560 had pregnancy-induced hypertension

• 3,696 high-risk pregnancies were successfully managed through timely intervention

Impact on maternal and child health:

Nutrition Rehabilitation Centres (NRCs):

• Admissions increased from 686 to 1,027 children

• Successful discharge rate improved from 87% to 90%, indicating better recovery outcomes

For Prajapati, the lesson is less about technology than attention. “If the mother remains healthy, the child also remains healthy,” he said, adding that the district now wants this intensity of monitoring to continue year-round rather than as a campaign with a fixed end date. 

In a district where reaching a hospital during the monsoon can take hours, the difference between a missed call and an answered one has turned out to matter more than any new scheme ever could.

Sources

‘How Regular Phone Calls and Home Visits Reduced Maternal Deaths in Shahdol by 50%‘: by Muskan Khandelwal for Indian Masterminds, Published on 1 August 2026

‘The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative study‘: by Tej Ram Jat et al. for BMC Pregnancy and Childbirth, Published on 30 September 2013

‘Anaemia Mukt Bharat‘: Press release by Ministry of Health and Family Welfare for Press Information Bureau, Government of India

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