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Maternal Mortality

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    According to the data received by the Registrar General of India, in 2007 to 2009 the maternal mortality rate in India is 212 per 100,000 live births. The country needs to reduce the maternal mortality rate to less than109 deaths by 2015 to achieve the United Nations-mandated Millennium Development Goals (MDG). Every ten minutes there is one maternal death in India as reported by the United Nations and at this rate India is unlikely to achieve the Millennium Development Goals. What is Maternal Death?

    According to the World Health Organization “maternal death is defined as the death of a woman while pregnant or within 42 days of the termination of the pregnancy, irrespective of the duration and the site of pregnancy, and from any cause relayed to or aggravated by the pregnancy or its management but not from accidental or incidental causes. ” (http://www. who. int/healthinfo) PROBLEM DESCRIPTION On an average the Indian economy has displayed a growth rate of more than 7% since 1997 decreasing poverty by ten percentage points.

    India is considered as one of the fastest growing economies in the world with an astounding growth rate of 8. 5% in the year 2010. But for many Indians this growth has made no difference at all and failed to translate into any real gains. In 2005, an estimated 536,000 maternal deaths occurred worldwide out of which 117,000 maternal deaths occurred in India which added up to a quarter of the maternal deaths worldwide. More women die from largely preventable pregnancy related causes in India than anywhere else in the world. The constant occurrence of maternal mortality in India exposes the government’s failure to preserve women’s reproductive rights and is a violation to a woman’s right to life. Every woman is entitled to this basic human right of surviving pregnancy and childbirth. ” (www. reproductiverights. org 2008) Most common causes for maternal mortality are anemia, severe bleeding after childbirth, infections, high blood pressure and malnutrition, illiteracy, poverty stricken, insufficient access to methods of family planning and information, unavailability of care, poor quality care.

    RIGHTS and POLICIES: Reproductive rights “ rest on the recognition of the basic rights of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have information and means to do so and the right to attain the highest standard of sexual and reproductive health” – International Conference on Population and Development Program of Action. According to the National Rural Health Mission (NRHM) and Janini Suraksha Yojana in 2005 the Central Government established a scheme that vowed to reduce maternal mortality rate to 100 per 100,000 live births by 2012.

    NHRM promised to concentrate on women and children belonging to the rural area. Janini Suraksha Yojana scheme offered financial help to women below poverty line. NRHM pledged to provide the following services: 1) Registration of all pregnancies 2) Routine check ups with services included. A minimum of four prenatal checkups for pregnant women. 3) Recognition and management of highly complicated pregnancies. 4) Women should be provided with iron and folic acid supplements and free counseling on health and nutrition. ) Tests conducted to check hemoglobin levels, sugar, urine albumin and syphilis. Failure in Implementation of NHRM and Janini Suraksha Yojana: Unfortunately the government has miserably failed in decreasing the maternal and perinatal mortality rates. Many providers do not take any responsibility and turn the family away and these families lack awareness of maternal health and obstetric care. They have no means for transportation and have no money left and this results in life threating delay. Many of them give birth at home without any skilled assistance.

    Only 5% of women receive their financial entitlements under the Janini Suraksha Yojana. Children are left motherless and families are broken. Not only are the children denied the right to care from their mother but also many times siblings lose their rights to live together. RECOMMENDATION: Several failed attempts to implement a successful program by the government or nonprofit organizations have been disappointing. I recommend Home Based Life Saving Skills (HBLSS) which is based on a modified “pathway to survival. This is a strategy that would educate pregnant women and their primary family caregivers and home birth attendants on critical knowledge and skills to keep a pregnant woman healthy. F

    urther this strategy would help caregivers to recognize life threatening maternal and newborn complications and promote the adoption of healthcare and health seeking behaviors at the individual and community levels. A field test trial conducted in southern rural Ethiopia assessed the performance of HBLSS training guides, the trial showed strong retention, higher satisfaction, stronger organization and dedication among the community members. Importance of skilled delivery and facility based services cannot be denied for maternal and new born care, but there is sufficient evidence to scale up community based care through packages which can be delivered by a range of community based workers.

    References

    Dhar, A. (2012, July 02). U. N. : India likely to miss MDG on maternal health. The Hindu. Retrieved October 05, 2012, from http://www. thehindu. com/health/policy-and-issues/article3595095. ece Maternal Mortality In India. (2008). Retrieved October 05, 2012, from http://reproductiverights. rg/sites/crr. civicactions. net/files/documents/MM_report_FINAL. pdf Maternal mortality ratio (per 100 000 live births). (2004). WHO. Retrieved October 07, 2012, from http://www. who. int/healthinfo/statistics/indmaternalmortality/en/index. html S. L. , & B. S. (2004). A Review of the Ethopia Feild Test. Journal of Midwifery Womens Health. Journal of Midwifery Womens Health, 4-49. Trends in Maternal Mortality. (2008). Retrieved October 06, 2012, from http://whqlibdoc. who. int/publications/2010/9789241500265_eng. pdf

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