Bhubaneswar: Odisha on Thursday rolled out a dedicated clinical protocol for the management of pregnant women with sickle cell disease (SCD), becoming the first state in the country to do so, officials said. The move aims to reduce maternal and foetal complications by standardising care pathways and clarifying responsibilities across the health system.
Policy launch and partners
The document, titled Protocol for Management of Pregnancy with Sickle Cell Disease, was unveiled during a state-level workshop on "Sickle Cell Disease during Pregnancy" held in Bhubaneswar. The event was organised jointly by the National Health Mission (NHM), the Directorate of Blood Safety and UNICEF Odisha, with participation from state medical colleges and NHM programme divisions, according to an official statement.
The protocol is the outcome of a collaborative process involving obstetricians, haematologists and public health officials, the statement said. It provides clinical guidance for antenatal, peripartum and postnatal care of women with SCD and defines the roles and responsibilities of healthcare providers at different levels of the state health system.
Why the protocol matters
Pregnancies complicated by sickle cell disease carry a substantially higher risk of maternal morbidity and adverse neonatal outcomes compared with unaffected pregnancies. Timely, systematic interventions — including enhanced screening, targeted counselling, specialised antenatal monitoring and planned referrals — are essential to reduce these risks.
Odisha has been at the forefront of screening and detection for SCD in India. The new protocol is intended to translate detection into improved outcomes by laying out clear clinical pathways and an implementation plan tailored to district health systems.
Workshop focus and district readiness
The one-day workshop reviewed the progress of the state's Sickle Cell Anaemia Elimination Programme and oriented senior health officials from 21 high-burden districts on the new guidance. Sessions addressed the current status of screening and treatment services, mechanisms for follow-up, and non-clinical supports such as transportation for pregnant women requiring referral.
Officials and technical consultants from NHM, together with development partners including representatives from the William J Clinton Foundation, participated in technical deliberations. The workshop concluded with the development of a joint action plan for rolling out the protocol across the districts represented.
Operational priorities outlined
While the protocol document sets clinical standards, the dissemination workshop emphasised practical steps for districts to operationalise the guidance. Key areas highlighted for immediate action include:
- Strengthening screening at community and facility levels to ensure early identification of pregnant women with SCD;
- Clear referral pathways linking primary health centres, community health centres and tertiary care for high-risk pregnancies;
- Capacity building of providers in district hospitals and medical colleges on SCD-specific antenatal and intrapartum management;
- Transport and logistics arrangements to enable timely transfers for women needing specialised care;
- Follow-up mechanisms to monitor mother and neonate after discharge.
| Item | Workshop focus |
|---|---|
| District coverage | 21 high-burden districts oriented |
| Stakeholders | NHM, Directorate of Blood Safety, state medical colleges, UNICEF, development partners |
| Programme reviewed | Sickle Cell Anaemia Elimination Programme |
Implications for pregnant women and families
The protocol is expected to improve clinical decision-making around pregnancies affected by SCD, reducing preventable complications such as severe anaemia, vaso-occlusive crises during labour and preterm birth. For families, better coordination of care and clearer referral options should reduce delays in receiving specialised treatment.
Health officials said the protocol also aims to integrate non-clinical supports — including arranged transport and follow-up visits — into routine maternal health services so that high-risk women do not default on care.
Next steps and implementation
Following the dissemination workshop, district health teams are to incorporate the protocol into local maternal health plans and commence training of frontline staff. A joint action plan prepared at the workshop will guide monitoring and phased implementation across the represented districts, officials stated.
Given Odisha's leadership in SCD screening, the new protocol may serve as a model for other states seeking to standardise care for pregnant women with haemoglobinopathies. Successful implementation will depend on sustained training, resource allocation and close linkage between community-level screening and facility-based specialised care.
Pregnant women and families in affected districts are advised to seek early antenatal registration, inform their attending provider if they have a known SCD diagnosis, and follow referral advice promptly when directed to higher-level facilities.
