Investments In Emergency Medical Services, Maternal Healthcare Have Offset COVID Disruptions In Tamil Nadu: IIT Madras Study
The study analysed real-world ambulance registry data from 2017 to 2024 on Tamil Nadu’s 108 emergency response system.
Published : May 21, 2026 at 7:13 PM IST
Chennai: A study by the IIT Madras has revealed that sustained investments in emergency medical services (EMS) and maternal healthcare have offset severe disruptions caused by the COVID-19 pandemic and also led to significantly improved maternal and newborn health outcomes in Tamil Nadu in the post-pandemic period.
The study analysed real-world ambulance registry data from 2017 to 2024 on Tamil Nadu’s 108 emergency response system. It examined how the state’s healthcare system performed across multiple pandemic phases and into the resilient recovery period of 2023–2024.
With data from 42 districts having a population of over 84 lakh, the study provides an unprecedented scale of analysis compared to earlier research that has largely been limited to individual hospitals or smaller regions.
The implications extend far beyond Tamil Nadu as the findings reinforce that strategic public investment including expansion of ambulance fleets, strengthening of referral systems and targeted maternal health schemes can significantly improve health outcomes even during large-scale crises.
The research was led by a retired Indian Police Service (IPS) officer P Kandaswamy, who is currently a Professor of Practice in Departments of Management Studies, Data Science and Artificial Intelligence (AI) along with . Ashwin Prakash of Moody’s Analytics Private Limited in Bengaluru.
The findings were published in a reputed peer-reviewed, open-access journal BMC Pregnancy and Childbirth that publishes research on maternal health, pregnancy, childbirth and neonatal care. The initiative was supported by data access from EMS and National Health Mission under the Department of Health and Family Welfare of Tamil Nadu government.
Talking about the exercise, Kandaswamy said, “During the pandemic, particularly in the second wave, Tamil Nadu witnessed severe disruptions in maternal healthcare access. Pregnant women faced challenges in reaching hospitals, home deliveries surged and maternal mortality rose sharply by 98.5% compared to pre-pandemic levels. Against this backdrop, the research sought to understand whether these disruptions had long-term adverse effects or if the system recovered. The findings present a strong and encouraging counter-narrative.”
Despite a sharp rise in pregnancy related emergency calls during the pandemic, the key EMS performance indicators including response time, patient transfer time and hospital handoff time improved significantly after the first wave and continued to remain efficient through 2023–2024.
Elaborating on the findings, Prakash pointed out,“More importantly, maternal and newborn health indicators showed substantial improvement in the post-pandemic resilient phase compared to pre-pandemic baselines. Maternal mortality declined by 19% to 37 deaths per 100,000 live births which is far below India’s national average. Home deliveries reduced by over 36%, miscarriages dropped by 28% and complicated vaginal births declined by over 19%. Neonatal and infant mortality also saw reductions of 17% and 19% respectively.”
The researchers concluded that sustained government investments in EMS infrastructure, healthcare workforce expansion and maternal health programmes not only neutralised the pandemic’s adverse effects but resulted in outcomes that surpassed pre-pandemic levels.
This study stands out globally for offering an evidence based counterpoint to widely reported healthcare system failures during COVID-19. Instead of treating the pandemic as a single event, the research breaks it into eight distinct phases enabling a granular analysis of how healthcare delivery evolved over time.
Another unique aspect is its dual track approach of simultaneously evaluating EMS operational efficiency and population level maternal and neonatal outcomes. The study also employed robust statistical techniques suited to real-world, non-ideal datasets ensuring reliability despite the absence of controlled experimental conditions.
For India, the Tamil Nadu model offers a blueprint for states with higher maternal mortality and weaker emergency systems. Programmes such as risk stratified antenatal care and the 108 ambulance network demonstrate how integrated, tiered healthcare delivery can enhance resilience.
The researchers have however cautioned that the study establishes strong associations but not direct causation between EMS improvements and health outcomes. They also noted limitations such as reliance on aggregate data and the need for longer term analysis.
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