Saturday, December 30, 2006

As we continue, needs of women and children remain unfulfilled

Published in Central Chronicle, Bhopal

Adhir Kumar Saxena

Bhopal, Dec 30 : In the year gone by discussions on women and children of the state were dominated with the issues of maternal & infant mortality and malnutrition which was very right too. Madhya Pradesh has highest rates of malnutrition among children and infant mortality in India. Media, media advocacy groups, social activists and civil society networks did aggressively advocate on these issues in the state this year, probably which was right and had brought a positive turn within the civil society networks in the state. Well, as we end the year the latest National Family Health Survey III data reveals that 60 % of children in the state are malnourished. There has been an increase in the malnourishment rates in the state. Last survey held in the year 1998 - 99 pointed out that state had about 54 % children who were malnourished. There has been an increase of six percent in the years rather than a decrease. Just few days back Joint Commission of Enquiry set up by Supreme court commissioners pointed out one of the districts in Madhya Pradesh namely Sheopur as World's hotspot of malnutrition, which means that situation demand immediate action.

State did announce many new schemes and policies but somehow still has not made any mark on the situation. State still reports hunger deaths. Not only Sheopur but recently Badwani district reported hunger deaths too. Children die every day in the state. Women are dying - earlier it was at homes unnoticed now in hospitals and outside the hospital. Recent examples are Shivpuri, Gwalior, Bhind, Bhopal and at many other places.

Many districts of the state have low sex ratio. Bhind and Morena are the worst performing in this regard in the state. This year more than 60,000 thousands people got affected with Chikunguniya in the state while state shelved it as a fashion statement and ignored the pain people went through. Similarly were cases of dengue which came up and many deaths were reported due to dengue. State had floods this year, many died due to floods and others suffered after floods due to the infections, which came after.

State reported cases of polio after being polio free for some time now state reported three case of polio, an example of our low level of immunisation and how we are missing children not only during polio rounds but even during regular vaccination rounds. When we refer to health one cannot forget about the use of veterinary medicine on the humans being right in the hospital in the State capital!

Also to mention about state's website of health department which was underreporting the data on maternal and infant death? Though state has announced setting up of medical and Health University in the state, hope this happens... may help to serve as lifeline to people of the state in the coming year.

* 60% of children under three are malnourished.
* 27 women die every day due to complication within pregnancy or 42 days after pregnancy.
* 79 children die out of 1000 born before their first birthday.
* 60 % of children are not fully immunised.
* 40 % women are malnourished.

Tuesday, December 26, 2006

Discourage child marriage: Strict implementation of law must

Editorial, Central Chronicle, December 27, 2006

Madhya Pradesh stands at number two spot as far as marriage of minor girls are concerned whereas Rajasthan ranks first. Looking from global perspective, average age of marriage of an Indian girl is 20 years. However, in the rural areas, 55 per cent girls are married off when they are quite young. In Rajasthan the minimum age in which the girl is married off is 16 years; it is 17 in Madhya Pradesh and in Goa the average age of a girl for marriage is 22 years. In Bihar the average age for girls to be married off is 17.2, in Chhattisgarh 17.6, in New Delhi and Gujarat it is 19.2, haryana 18 years, Punjab 20.5 and Uttar Pradesh 17.5 years. India leads in child marriages as compared to nations including Pakistan and Nigeria (21 years), China, Brazil and Indonesia (23 years) and America (26). The state of the children report of UNICEF for the year 2007 states that the average age for marriage of girls has been increasing during the last 20 years, but 46 percent girls are married off before they attain 18 years of age. This is a cause for concern as the girls have to suffer many ill-effects. The condition of girls in Rajasthan is pitiable and in Madhya Pradesh too the situation is no better. There is clear violation of rule in marrying girls before age for which the girls have to pass from many dangers. The children born from such minor girls also face dangers. The girls are deprive of education too. Mostly the reason for early marriage of girls is financial. People are also of the belief that by getting their daughters married off early, the girls could be saved from sexual harassment and getting pregnant prior to marriage. In MP, efforts are being made to stop child marriage at many levels. Police and the administration are specially involved in this exercise. However, it's a matter for concern that in spite of all out efforts, early marriage of girls is continuing. Hence the need is for strict implementation of the rule against child marriage. People need to be made aware regarding dangers of early marriage as also the role of social, cultural and non-governmental organisations need to be established for this cause.

Comments - As per UNICEF's The State of the World's Children 2007 girls marrying before fifteen years have five times more chances of dying while giving birth to new life. MP and Rajasthan states already has high maternal mortality and both have high incidences of child marriage !. Lot of efforts need to go in changing people's mindsets in combating this..

Monday, December 25, 2006

VIKAS SAMVAD ANNOUNCES FOUR MEDIA FELLOWSHIPS

Vikas Samvad, a media advocacy group in Madhya Pradesh has called for application for third media fellowships for the mainstream hindi journalists from Madhya Pradesh. These fellowships will be provided to those four journalists who are willing to work on any of these following issues on a full time basis for one year in Madhya Pradesh-

1.Women in Panchayati Raj and their political leadership for social change
2.Women and Child rights (with special reference to Health Rights)
3. Social Exclusion and Discrimination
4. Universalisation of Education with quality

These fellows will be selected by an independent jury. This selection committee includes senior and eminent journalists/editors from Madhya Pradesh and social workers. Interested Journalists may obtain application formats from below mentioned address -

Vikas Samvad, E-7/226, First Floor, Opp. Dhanvantri ComplexArera Colony, Shahpura, Bhopal, Madhya PradeshPh-0755-4252789Mob.- 09827361019

Email- vikassamvad@gmail.com

The last date for the submission of application is 10th January 2007. For forms please contact at above mobile and email.

FIGHTING MALNUTRITION : BETTER WORKPLAN NEEDED

Editorial by Central Chronicle on Malnutrition
December 25, 2006 Bhopal

There has been a 6.3pc rise in malnourished children in Madhya Pradesh. The deduction has been arrived from a report of the National Family Health Survey. In comparison to other states, the state of children is MP is a cause for concern. Percentagewise malnutrition has gone up from 54 to 60.3 whereas the State government has been claiming it to be at 49pc. One reason is also said to be improper use of funds allotted for eradicating the illness. Even the Supreme Court had raised questions over the distribution system of nutritious food to children in the State. The MP government has implemented anganwadi scheme for eradicating malnutrition. However, the number of anganwadis are too little compared to the population. The Supreme Court had, on October 7, given directives for opening an anganwadi centre in every locality, wherein children up to six years of age should be given nutritious diet. It also said that the work of distribution of the food items should not be given to contractors but to women's bodies of localities, self-help groups or other groups of the village people. However, this is not so. A healthy child needs 1700 calories whereas a child is given 80 gm `dalia' in Anganwadi which provides only 300 calories. The state government has achieved notable success in implementation of schemes/ projects but its success in supplying nutritious food to children has not met with desired success. Lack of budget is said to be one of the reasons; other is improper distribution. It is also important to pay attention towards the quality of food being given to the children. The need is for framing a large work plan so that not even one child becomes victim of malnutrition.

Maternal Mortality: Civil Societies Call for Action

by Anil Gulati
Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.........

For full article please click the link on the title....

Saturday, December 23, 2006

Starvation on rise in MP

82 percent state children are anaemic : Survey

Published in The Pioneer, Bhopal Edition December 24, 2006

Girish Sharma Bhopal

82 per cent State children are anaemic: SurveyAbout 82.6 per cent children in age group of 6 to 35 months are anaemic and 60 per cent children under three years of age are malnourished in Madhya Pradesh. This is the finding of latest 2005-2006 National Family Health Survey (NFHS-III) released recently by the Union Government.

This is the third in the NFHS series of surveys and provides information on population, health and nutrition in India and each of the State. This survey is based on a sample of households, which is representative at the national and State levels. In the same category, 75.2 per cent anaemic children are in urban areas while 84.9 per cent in rural areas. As compared to earlier figures, there has been a dramatic increase in anaemia in children in the State. As per NFHS II, only 71.3 per cent children were anaemic while data was not obtained in the NFHS I. In spite of various schemes being undertaken by the State, condition of children is going from bad to worse.

Similarly, in case of married women between 15 to 49 years, 57.6 per cent are anaemic, out of which 48.3 per cent are in urban and 61 per cent in rural areas. The State already has very high maternal mortality rate and anaemia is one of the major contributors to the same. This will have serious implications as far as the condition of women health is concerned. Anaemia is comparatively less in men. As per the data, only 24.4 per cent married men between the age group of 15-49 are anaemic.

The figures state that malnourishment among children has increased in Madhya Pradesh. As per the NFHS data, 60 per cent children under three years of age are malnourished in the State. They are underweight and too thin for their age.
Women and Child Development department has been claiming that it had brought down the malnourishment. But it has actually increased from 54 to 60 per cent when compared with NFHS II data. Madhya Pradesh is among the States with highest number of malnourished children.

The fact sheets provided by NFHS on key indicators and trends were based on the fieldwork conducted by 18 research organisations between December 2005 and August 2006.

Govt claim on institutional delivery at stake

Published in Central Chronicle
By Our Staff Reporter
Bhopal, Dec 23: Shivpuri district has been noticing a different trend these days, which has put all the great proclamations' of the state for promoting institutional delivery at stake. Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.
In the same league on December 13, last a Harijan, Sanida Bai along with her husband Kailash Jatav from village Badagaon came to the Shivpuri district hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside the hospital.

http://www.centralchronicle.com/20061224/2412025.htm

‘Institutional delivery’ means ‘delivery outside the hospital’ in Shivpuri

Shivpuri district has been noticing a trend these days which has put all the great proclamations’ of the state for promoting institutional delivery at stake.

Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.

In the same league on December 13 2006 a harijan namely Sanida Bai along with her husband of Kailash Jatav from village Badagaon came to hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside hospital – probably this is institutional delivery in Shivpuri !!

This is not first, one can see many of similar cases in last few months cases but probably they are getting more visibility now………by media.

Adapated from Dainik Bhaskar, Shivpuri edition, December 14, 2006 and other press cuttings

Struggling for her daughters treatment for last 21 day in state capital

Dina Pragyapaiti is from Chhattarpur district and he has come to state capital with lots of hopes for treatment of his girl child aged 12 years. She is suffering from vascular disease and suffers from acute pain in her fingers. A per media report doctors at the hospital say that his treatment will cost Rupees one lakh only as he does not have any money they have not only refused the treatment but even the admission in the hospital. When contacted by the media the Dr M P Chincholkar said that we cannot treat her and many diseases are such which do not have any treatment so why admit?

Published in Dainik Bhaskar Bhopal edition Decemeber 23, 2006

Comments - If this is the reply – It’s inhuman…We urge all media professionals to please raise this issue in way they can.

Thursday, December 21, 2006

Mother’s concern raised by women in Panna

Madam ANM hardly comes to our village! Where should we go for vaccination? Why do pregnant women need the third check up? These are examples of some of the questions raised by women to the Chief Medical and health officer of the district at Women Samellan held on December 7, 2006 at District Panna of the State of Madhya Pradesh. Panna District not only has high rates of maternal deaths but also has very low level of institutional delivery, only 7 % deliveries happen in the institutions. The women convention was organised by Jan Adhikar Manch, a network of civil society organisations in the state.

Dr Sinha, Chief Medical Health Officer and Laximanarayan Diwedi from Panchyati Raj and Social Welfare Department were present to listen to woes of women who participated in the samellan. Sandesh Bansal of State coordinator of Jan Adhikar Manch women have need to be come forward for their rights or else maternal deaths will continue to happen. Every five minutes a women dies in the country due to complication in pregnancy.

Adapted from press reports in Dainik Bhaskar, Dainak Braham, and Nav Swadesh of Panna dated December 8, 2006

Wednesday, December 20, 2006

High Maternal Mortality in the Heart of India

By Anil Gulati
21 December,2006Countercurrents.org

Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.

But unfortunately the kushwai health centre, where they had come with lot of hopes, did not had a medical doctor for last one and half years. One male health worker mans the centre. Though, he puts in his best but that may not be enough for women like Munna and others who need medical support.
Inspite of reaching the primary health centre, she did not get any help. She has to travel another eight kilometers to Burhar, the place where there is a community health centre. The centre is fortunately newly built and has facilities for delivery. Munna did develop some complications during the delivery but fortunately survived to see her new born.

She was lucky but thousands of women which die in the state are not. App 10,000 women die every year in Madhya Pradesh during pregnancy or within 42 days after pregnancy. Majority of these could be prevented. Medically these deaths may be due to hemorrhage, infection, eclampsia or unsafe abortion or any of three delays. But fact is there exists a yawning gap in our health system which stands in between life and death of women in the state. This gap has linkage to availability and access to health services, infrastructure, awareness among communities of not only the services but even recognizing danger signs, issue of how where they can access the services etc. Studies also tells us that for every maternal death in India, 20 more women suffer from the impaired health.

But if the situation at ground is like this, and has been there. What is the state’s response to an issue like this? Does it impact the political leaders, their discourse? Does issue of women dying in the state is debated in discussions where funds are allocated or decisions are made? Does state’s machinery care for it? Does civil society raise its concern?

The year 2004

To answer some of these questions a dip stick assessment was done in year 2004 at various levels within civil society, debates in the state assembly, media analysis. Outcomes were revealing. First of all the issue concerned only few in health department. There were only handful of civil society partners, and their major role was to support service delivery system. As such there was no push or urgency to bring change. Interestingly, the issue had never being debated on the floor of the state assembly, a place where elected representatives ‘of the people, for the people and by the people’ decide. It did not impact them, many of them were not even aware of the fact that state has this high number of maternal deaths? An issue like this was never raised by the political leaders in the debates which happen there – an issue of total neglect at the highest political body. Media covered ‘event news’ around the safe motherhood day, probably they never got the right information too.

Present

That was a starting point, but nevertheless situation has changed today. Today state recognizes it as a major issue when it comes to women and children. State calls for an action. It is on high priority list of the political head of the state, state party is being questioned on the number of deaths, gaps on the infrastructure and many related points. Today more than 150 civil society organizations are raising concern on the issue and demanding urgency and urgency of action in the state.
How it happened and what does it impact and what strengths does it generate? Movements don't just happen; the energy that underlies them must be marshaled, channeled, and focused. The principal means by which this is achieved in our society, and within our political tradition, is through advocacy networks and coalitions.

Networks like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Jan Adhikar Manch and Collective for advocacy, resource and training, Madhya Pradesh Samaj Sewa Sanstha, Mahila Chetna Manch, and many others have not only contributed to help bring the issue at an individual level but as a part of informal collation added to that force which helped bringing the agenda on political normative framework. Some of the strengths which this informal network helped bring were the numbers of civil society partners raising concern on the issue spread across different regions of the state. From a handful few now it is more than 150 civil society partners in the state working in all divisions to bring the issue to forefront. The turn around is also in their way of working from being a service delivery partners or a social mobilization partners in supportive and submissive role in a new avatar of advocacy partner. In this new role civil society speaks on the issue of right to health, its violation, demands state’s accountability to provide for safemotherhood. In this new business influencing people who make decisions which impact human lives is the key.

The primary target of the civil society was to bring the issues which impact lives of women at the villages, blocks and districts to the agenda of the people who make or influence decisions, i.e. state assembly debates, political leaders, members of legislative assembly, ministers, media, rights commission etc. They had been to some part successful. ex-pression of this concern was undertaken by directly meeting and sensitizing political leaders. The evidences highlighting gap were shared with political leaders, urging them to rise above politics and give a strong call for action. These non governmental organizations wrote memorandums, shared information and collected evidences for the same purpose. Media engagement also supported by providing an enabling environment for change. Strong evidences i.e. case of maternal deaths which can be presented, health system gaps were highlighted which added pressure on the state and the leaders to react. Resultant of this solid gains achieved. Today questions on maternal mortality are being raised in the state assembly, the highest policy making body of the state. It is not just few many voices are being publicly heard on the issue. There is a increased concern within media.

From nowhere it came to a point where state publicly acknowledge the problem, and its commitment to act. Many new polices and schemes have been announced and that too in the rapid succession. This amount of concern and even expressed publicly by leaders had never been seen earlier in the state on the issue of maternal mortality. But that is not enough today empowered civil society and media is always looking with eagle’s eye on the new measures of the state and vocally points out the gaps This is a positive sign, where people are voicing their opinion. But it is not easy as said. Political leaders have started picking up real cases of deaths, gaps in infrastructure in the state, violation of rights, gaps in policies and seeking answers to what is being done by the state to response to the situation.

Advocacy experts tell us that ‘people centered advocacy’ is the best, i.e. position when people who suffer can speak for themselves. A step has been taken in the same direction by the engaged networks. Madhya Pradesh Jan Adhikar Manch in their work with communities helped to bring the issue to debate in various gram sabhas which were held by panchayats in Gwalior – Chambal division. Similarly women who had participated in various women conventions hosted by Madhya Pradesh Samaj Sewa Sanstha came forward and wrote about the problems women face in rural areas when it comes to issue of safemotherhood and why do women die in their villages while giving birth. As per sources of Madhya Pradesh Samaj Sewa Sanstha more than 200 women have written to the Chief Minister. On a simple fifty paise post card, they wrote by theselves and it was send to the Chief Minister. It looks simple but powerful, if it gets to his eyes. Recently a large number of women from villages across Madhya Pradesh have joined a signature (or thumb-impression) campaign to press for their right to health and to call upon the Government to ensure that the dream of safe motherhood becomes a reality. As a part of a special drive to raise concern on this crucial issue, more than 20,000 women from different villages of the State are now in the process of signing (or placing their thumb impression) on a various banners demanding the right to health and calling upon the State to ensure that the dream of safe motherhood becomes a reality. Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha are the civil society partners who are collecting these signatures/thumb impressions of women. They say that they do so after they are adequately sensitizing them on the issue of maternal mortality. Then if they feel that some concrete action is needed to improve the situation, they come and sign. Plan is to present the banners with their signatures to policy makers.
One might say that this is good effort, which indeed it is to bring the agenda of maternal mortality on to the political and action framework but it is still a long way to go. This is true. But if one looks back one and half years where there was hardly any concern, hardly anyone called for action, except few that too ‘within the box’. The focus was limited. From nowhere it has come somewhere, which is an important achievement by any means. Need of the day is to provide possible answers to the state, which is willing to listen. Answers which can help deliver results, within the context of the field realties and socio – cultural aspects – a new call to many !

Contact
Anil Gulati E mail – anilgulati5@gmail.com

Tuesday, December 19, 2006

Call for 'Right to Safe Motherhood'

UNI release at www.netindia123.com Bhopal, December 18, 2006 9:40:27 PM IST

Women participants from various districts of Madhya Pradesh today called for a 'Right to Safe Motherhood' during a convention being organised here by the Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality.

More than 150 women from Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalpur, Dhar, Bhopal, Mandsaur, Jhabua and other districts are taking part, a release said. ''Mobilised communities can make the system work and it is time we come together and channelise our energy for decreasing maternal death,'' said MPVHA Executive Director Mukesh Sinha.

Speaking as a guest, UNICEF State Representative Hamid El Bashir said that it is imperative for Madhya Pradesh to move resolutely from the realm of words to the realm of concrete action, which could help bring about a positive change in the lives of women at village level.

''Safe motherhood is a human rights issue. Though this state's Maternal Mortality Ratio has declined it is still very high and Madhya Pradesh figures among six states that have the maximum number of maternal deaths in the country,'' he added.

Mr Bashir felt that the state needed to invest in infrastructure, upgrade health centres, increase the number of blood banks and help build capacity of human resource. UNICEF's Project Officer (Health) Ramani Atkuri spoke on the technical aspects of maternal mortality and interacted with the women on the problems they faced at the village level. UNICEF Communication Officer Anil Gulati, Dr Ajay Khare of the People's Health Movement and MPVHA President B K Nilosey also spoke.

The women posed several questions such as unavailability of health services, lack of awareness about schemes, lack of proper information on problems, untrained midwives, poor roads, anaemia, malaria etc, the release added.

http://www.netindia123.com/showdetails.asp?id=541353&cat=India&head=Call+for+'Right+to+Safe+Motherhood'

Missing girls in Madhya Pradesh

Letter to the Hoot: Recent articles in the media have tried to give visibility to an issue which is prevalent yet neglected.

Female foeticide and infanticide is not a new phenomenon, but debate on it is growing. Stories from Punjab, Haryana, Delhi, Gujarat get space in media, which is genuine as they have the lowest child sex ratio in the country. A few months back the news channel Sahara Samay had undertaken some sting operation on nursing homes in states including Madhya Pradesh which were illegally undertaking use of pre natal diagnostic technique for purpose of sex determination of the foetus, banned as per PC & PNDT Act. Some NGOs had filed the first public interest litigation in the state on the issue, which was covered by newspapers like Hindustan Times, The Hindu, Pioneer and Rajya Ki Nai Dunia.

This children’s day there was a first lead story in Dainik Bhaskar from Morena, a district in the state of Madhya Pradesh which has the lowest sex ratio in the state i.e. 837 girls per 1000 boys. The story helped to raise concern on the declining sex ratio in the state, which remains unnoticed by many decisionmakers and media. The story did bring out the focus on the issue of female infanticide prevalent in our society. It pegged the child sex ratio in some parts of the district as 400 girls per 1000 boys. Though statisticians may debate this, but fact of the matter is that girls are being knowingly killed , which still remains unnoticed by many. That story which was call to action and prompted many others to follow. Dainik Jagran another leading daily in the state wrote an editorial on the issue, which was much needed. Following this there was a recent article in the Hindi magazine Maya by Dr Manohar Agnani. He has being a front runner in raising concern on the issue of female foeticide and in his article points out that it is not only Morena but is prevalent in other districts of the state too. He talks of a village in the district Shivpuri which may have sex ratio as low as 600/ 1000. He adds that time has come that we start talk about the solutions. It may be pertinent to mention about Dr Manohar Agnani’s recent book on female foeticide. It has been titled as Missing Girls and was published by ‘Books for Change’.

Recent articles in media in the state have tried to give visibility to an issue which is prevalent yet wilfully neglected by us. These stories should be a call to people within media, civil society and all of us who feel pained to convert this into a sustained and regular concern feeding media with needed evidence and stories which are newsy and backed by substance to make sure that not only people who make policies but society as a whole rises to put a stop to this killing of girls. This may be just one way to raise concern by engaging media though the solution still lies within all of us.

Anil Gulati, Bhopal.
November 25, 2006

http://www.thehoot.org/story.asp?storyid=Web5917615202Hoot23724%20PM2414&pn=1

Women ask right to safemotherhood

Published at www.mpnewsonline.com

Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality in Bhopal have called for 'right to safe motherhood'. More than 150 women from districts like Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same. Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities could make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.

Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action, which can help bring positive change in the lives of women at village level. Talking about safe motherhood, he said that it was a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states, which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. Dr Ramani Atkuri, UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.

Earlier, during opening session Anil Gulati, UNICEF’s Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country. During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.

Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.

http://www.mpnewsonline.com/index%20181206.htm#Women_ask_right_to_safe_motherhood_

Women express concern over MMR in MP

By Our Staff Reporter

Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association on the theme of maternal mortality in Bhopal have called for 'right to safemotherhood'.

More than 150 women from districts like Chhattarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same.
Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities can make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.

Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action which can help bring positive change in the lives of women at village level. He in his address to women called safemotherhood as a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. State needs to take steps to assure safemotherhood, which is mandated by CEDAW and Constitution of India. He also distributed prizes to the winners of the various quizzes held at the convention. Dr Ramani Atkuri. UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.

Earlier during opening session Anil Gulati UNICEF Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country.
During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.
Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.

Monday, December 18, 2006

8 hunger deaths in Badwani

HT Correspondent
Bhopal, December 17,2006

AT LEAST eight malnutrition deaths have been reported in six villages of Sendhwa development block of Badwani district between August and December this year, according to the Right to Food Campaign (RFC) support group.

Addressing a press conference here on Sunday, the RFC support group said the ground reality was very different from that projected by the State Government.

The group members said they would soon file litigation with the National Human Rights Commission (NHRC) regarding malnutrition in Madhya Pradesh.

The group has demanded a white paper on malnutrition status of children of Saharia and Barela tribes, Rs 800 crore budget for supplementary nutritious food, arrangements for intense monitoring of malnutrition, particularly in endemic tribal pockets and fixing responsibility on senior officials in areas where malnutrition deaths have been reported.

The press conference was organised ahead of the `Bal Adhikar Samvad’ to be held in New Delhi on December 19 where a report titled `Focus on children under six’ will be released by eminent economist Amartya Sen and other dignitaries.

Representatives of the RFC support group members (representatives of various voluntary organisations) supported the recently released data of the National Family Health Survey III (NFHS-III) that shows the malnutrition per cent in the State has gone up to 60 per cent. They presented some data from Badwani district in support of their claim.

Dr Ghanshyamdas Verma of Adharshila Learning Centre, Sakad Sendhwa Badwani and Mukesh Dudwe of Adivasi Mukti Sangathan working with Barela tribal in Badwani district claimed that out of the 147 children in the six villages of Chatli, Kunjri, Bhurapani, Pipaldhar, Merkhedi and Sakad in Sendhwa block, eight had died during last five months, owing to malnutrition.

Of these five deaths allegedly occurred in Sakad village. Of the 147 children 46 children are in grade III and 17 children in grade IV of malnutrition (the severest situation) while 16 and 46 respectively are in grade I and II.

Workers alleged malnutrition grading by the State Women and Child Department was doubtful as most of the ground level workers of the department (mainly anganwadi workers) were not trained for the purpose and weighing machines did not function properly at many places. They also alleged that in many cases the block level officers sent across bogus data to district officials and these data form the basis of Government figures.

Representatives said apart from moving the NHRC in the matter, they will be conducting in-depth studies in tribal areas to bring forth the actual situation, will be compiling a report on the implementation of Sup-reme Court orders and will id-entify malnutrition endemic areas in the State and demand intervention. Umesh Vashisht, Uma, Prashant and Sachin Ja-in of the support group were present at the press conference.

As published in Hindustan Times Bhopal December 18, 2006

Sunday, December 17, 2006

Hospital staff demands money for delivery

(Please note - State proclaims to have many schemes which provide for financial support to promote institutional delivery)

‘Sir staff demands money for delivery’ was the reply from when a state government team comprising of the Zonal director and CMHO visited the hospital at Laxmi Ganj.

The rate card which one patients has to shelve - Rupees nine hundred for boy and five hundred for girl – the money goes to the staff posted there. Though the team promised action and took the statements. When the medicine store was checked it was found that it had medicines but same were being prescribed and the patients had to buy it from outside. Labour ward was shabby, oxygen cylinders did not have any oxygen even the oxygen tube was not in order. Though many patients admitted in the wards were from BPL families but hardly any of the got any benefit rather than had to pay for the delivery at this hospital.

Adapted from Dainik Bhaskar Gwalior news on December 2, 2006

Saturday, December 16, 2006

Right to safemotherhood - an elusive dream

Gwalior , December 12, 2006

Village Sarari Khurd, Sheopur - has a primary health centre but no doctor. Since when it does not have doctor, even villagers can’t remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipments and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometers of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there, are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily).

District has population of app. 6 lakhs residing in 533 villages. It has one district hospital with a capacity of 175 beds. In the 175 bedded hospital, 150 beds have never being changed since last 15 years. Though state is pushing institutional delivery but districts like Sheopur hardly have any infrastructure to match the same push. Number of beds in labour ward remain same, neither the position of gynecologist, lying vacant has been recruited, medicines are always in shortage. In situation like this big question is that how can mothers get right to safe motherhood – a right which needs to be demanded in the state of Madhya Pradesh.

Adapted from op-ed published in Acharan, Gwalior December 12, 2006

Women don’t get benefits of various schemes

Concern over high IMR/ MMR

Tikamgarh December 8, 206

As part of save our mothers campaign, Jan Adhikar Manch held a women samellan at Topkhana ground, Tikamgrah. Large number of women from rural areas had participated in the same. The issue of schemes not reaching the poor and many women dying enroute to the hospital even before reaching the hospital was raised by Saroj Rajput member state women commission. She said that need today is generate awareness and motivate women to go for an institutional delivery. Similarly Madhu Khare participating in the meeting said that there is a strong need to help improve facilities available at the health centre.

As published in the Dainik Bhaskar

Sunday, December 03, 2006

Aren't these hunger deaths ?

Rolly, Sheopur, Madhya Pradesh

Published at www.mynews.in

You may give a piece of bread to a hungry person, and when the cravings of hunger return someone else must administer to his wants again; to put that person in a position to earn his own subsistence is true charity. In this way you direct his feet on the path of true independence. He is then only dependent on his own exertions and on the blessings of his God. -Daniel H. Wells. In May 2006 Dilli Dakha lost their first child when she was one and a half years old, after this, they had a child, Sugreev who is two years old now. The couple then lost their twin daughters Ganga and Jamuna and according to the mother Dakha she was not able to feed them, as there was no milk. She says that she is only able to eat one Roti with onion once a day. Her family’s diet does not include any pulses or vegetables because they cannot afford it. Her husband earns around Rs.20 per day on the days he goes out to work, which is very less. After her third delivery she has started loosing her eyesight, which is largely due to the deficiency of vitamin A. Dilli Dakha and her husband belong to Sahariya tribe. Sahariyas or the tribals who call themselves “Sehera or Sair” claim to be the first of the tribes of the country. They were dependent on forest for survival for generations and lived a subsistence life with limited needs. Their traditional means of earning a livelihood was one of agriculture, gathering forest products and hunting. Ignored by the society, inhuman behaviour of system and deprived of their basic needs they are a community that has been subject to a lot of social, economic and political discrimination.

Life has not been easy for the Sahariyas after their eviction from the forests. Unable to bear the political, social and economic exploitation and discrimination meted out by the people who live in villages these tribals moved over to live in Saharanas (Sahariya Hamlets) away from the villages. For past couple of years Sahariya in Madhya Pradesh have been in the news. The reasons are many like drought, vulnerability, exploitation and irresponsibility of the state etc, which is constantly making them victims of death. But even then one does not find any change in the pathetic conditions that exist in the area. Sahariya children are the worst affected due to poverty, lack of livelihood resources and Govt. policies. Data from Government of MP's Bal Sanjeevani Abhiyan (8th Report) indicate that 58% of the children in the age group 0-6 in the district suffer from malnutrition. These indicators show that Sahariya’s are one of the poorest and most deprived communities in the entire country. It is representative of the hilly and forested, SC-ST dry lands of India, where poverty and malnutrition are concentrated. Within this overall picture, the appalling levels of deprivation of the tribal population of the Sheopur district, the Sahariyas, adds another dimension to the whole problem.

According to the information by the Regional medical research centre for tribals, Jabalpur that the Infant Mortality rate (per 1000 lives births) of Sahariya is 88 and 93.5% of Sahariya children are victims of severe malnourishment and 15% are almost on the verge of death, due to malnourishment. The average life span of a Sahariya is 45 years, which is 25% less than that of an average mans life span.74.3% children’s were underweight and 75.4% are stunted. It is difficult to trace even a single child, youth or a family that is not a victim of severe malnourishment and anemia. However the health and nutritional status of these children is the last priority on the list of the government. The figures for the Sahariyas place them amongst the worst in the world Sometimes, some schemes were enacted to provide temporary relief and then when the condition became stable, the administration adopted it’s as usual step motherly treatment to the community A village, Patalgarh has been in the news in February 2005, for the most distressing reasons- death of 13 innocent children .

The village, which is part of the Karahal Block, is situated at a distance of 70 kms from the district headquarters and 65 kms from the block headquarters. It can be reached by taking the Goras road from Karahal and one has to travel through the thick forest and bumpy, muddy roads. The village situated in the interior does not have even the basic infrastructural facility. In order to reach the village one has to travel almost 70 kms by road, crossing forest area. The nearest hospital is situated at a distance of 35 kms. This can be clearly understood if we look into the functioning of the Anganwadi centers and the Mid Day Meals scheme in the state, especially in Sheopur, a Sahariya dominated district in Madhya Pradesh. Previously there was no anganwadi in Patalgarh village and the nearest anganwadi is situated in Hirapur village, 17 kms away. A worker, Mithilesh who was holding a temporary post, looks after the temporary Anganwadi in Patalgarh village. According to the villagers there are 70 children in the village who have been enrolled in the Anganwadi. The enrolled children have been given Supplementary Nutritious Food only till January 2006. There is a Multipurpose Heath Worker for the village who manages to make a round once in a month.

However one cannot blame him for this because he has to look after 3 panchayats. He has also been entrusted the duty of registration of births and deaths and in the given circumstances he leaves out many children. This is the main reason why the government has been denying the deaths. Most of the new born die within one month and neither their birth nor their death gets registered. It was found that not only children in Patalgarh are dying but huge number of Maternal Deaths has also become a part of the daily life here. Now Right to Food alliance demanded a joint commission of enquiry from the Commissioners for fixing the accountability and to identify the policy level gaps. At this moment Joint Commission of Enquiry is in the process to finalize its report on the matter of malnutrition deaths. After these incidents Madhya Pradesh RtFC filed and interim application in the Civil Writ Petition 196/2001 to make state more accountable towards the issue But presently after the intervention of Supreme Court the story of Patalgarh was totally different, the village has the functioning Anganwadi, the ANM has also been appointed; there was no PDS access in January. But now, a "PDS tractor" brings grain to the village from the nearby Hirapur village (15 km away) once in a month. During the previous Supreme Court intervention, temporary cards were distributed in the village to enable PDS access to people. The cards were still in circulation, in spite of the assurance by the district administration that issue of fresh cards will be completed by August 2006. Under NREGA a road construction work was going ahead. The people of patalgarh are also getting minimum wages (Rs. 60 per day) and have to excavate 100 cubic feet per day.

Patalgarh is on priority of the government but the question is that there are many villages like Patalgarh which don’t get the attention of the administration and result of this negligence causes the death of innocent children. In spite of the death of Ganga and Jamuna and the death of 6 children and two mothers this year, life in Patalgarh village in Karahal Block of Sheopur District of Madhya Pradesh, seems to be pulling along as usual. The villagers as usual go about their work; the children in the village are running around oblivious of the grave situation that is building in the village. Death of the children like Ganga and Jamuna are nothing new to the district. Every summer many Sahariya Children like Ganga and Jamuna die and every death doesn’t make to the headlines of newspapers who are bothered more about the illness of Mahajans – pun intended – and Bachhans.

Link to the story : http://mynews.in/newsdetail.aspx?news_id=187

Saturday, December 02, 2006

lack of blood bank kills two in Bhind

Published in Pioneer, December 2, 2006
Staff Reporter Bhopal

Rekha Bhadoriya, Kiran Jatav die for want of blood, proper careTwo pregnant women, Rekha Bhadoriya and Kiran Jatav Sarkar, lost their lives within an hour at the district hospital of Bhind on Thursday, due to the alleged gross negligence of the hospital authority.

Rekha Bahdoriya, in the seventh month of pregnancy, was admitted to the hospital after she suffered from bleeding. The hospital, however, did not have a functional blood bank facility and she lost her life due to lack of blood.

Similarly, Kiran, wife of Mukesh Jatav of Bhind, was also pregnant and complained of pain on November 10. Her family brought her to the hospital and doctors advised some routine tests (haemoglobin and blood group) to be done. She was prescribed a medicine for stomach ache and was sent back.

Kiran gave birth to a baby at home on November 16. But after she showed signs of delivery complications, her family rushed her to the hospital. The doctors in the hospital reviewed her condition after an hour where allegedly she was not given any treatment. Her family waited with hope that doctors would take care of her for another two hours but by the time the doctors could make up their minds to treat her, she was no more.

The hospital administration complained about the lack of adequate financial resources. "We do not have sufficient number of beds in the maternity ward and that's why Kiran could not be admitted," said the hospital superintendent, on the condition that her name was not to be published.
The superintendent also said that owing to fact that the hospital blood bank does not function, the blood loss suffered by Rekha could not be compensated.

http://www.dailypioneer.com/indexn12.asp?main_variable=BHOPAL&file_name=bhopal12%2Etxt&counter_img=12

Friday, December 01, 2006

The health centre which does not have facility

Sheopur, Madhya Pradesh

Primary Health Centre at Village Dodar in Sheopur does not even have basic facilities which it should be having. Though people have been demanding the same for quite some time but this dream still eludes them.

The health centre which has to caters to many villages like Khojipura, Hasilpur, Badiya, Balwani, Khikhari, Manpur, Dhiroli, Makdhod and many others in its near vicinity. It neither has adequate infrastructure nor the adequate medical support which can help people of the block. It neither has X ray machine, nor the pathological laboratory. Even the behaviour of the staff is such that people feel that staff if and when it treats is like doing a favour to them. A lady recently lost her life during delivery in the hospital. There is no drinking water in the health centre? People are urging State and district administration to immediately look into the matter.

Published in Dainik Bhaskar, Sheopur Edition November 30, 2006

Tuesday, November 28, 2006

Civil hospital faces shortage of gynecologist

Sewada Tehsil, Madhya Pradesh

The civil hospital here has seven sanctioned posts of the medical doctors but only two are posted. Not to talk of doctors even equipments and X ray machines are not working and they are like a showpiece in the hospital.

This is the situation at the main hospital at the tehsil. This looks quite good from outside but internally it faces heavy crunch in terms of the staff. For last five years this hospital is working on the strength of two doctors though the sanctioned posts are seven. Many pregnant women do not get delivery here as lady doctor is not there. Only one fourth of deliveries do happen here which are referred from PHC Indergarh. Even the two posted doctors most of the time are engaged in the various campaigns or meetings while patients suffer !

A published in Dainik Bhaskar November 20, 2006

(Blog’s comments : State’s Health & Family Welfare Minister Ajay Bishnoi had accepted in response to the question in the floor of the house that there is shortage of gynecologists in the state - out of the total 138 posts in the district 40 are vacant. Though state is aware of the fact but there is not definite plan in recruiting them !)

Monday, November 27, 2006

AIDWA’s troupe gives call to women on their right to health in Sheopur

All India Democratic Women Association as way to commemorate its 25th anniversary is taking out special troupe in Sheopur on November 11, 2006 .Troupe is conducting it street plays and sabhas to create awareness on the issue of women’s health and motivate them to ask for their rights.

As published in Swadesh, Sheopur edition, November 7, 2006

Sunday, November 26, 2006

HUNGER DEATHS HAUNT STATE

As published in The Hindustan Times, Bhopal, November 25, 2006

by Sravani Sarkar

A JOINT Commission of Enquiry (JCE), instituted by the Commissioner, Supreme Court, has substantiated reports of malnutrition deaths in Sheopur and termed the predominantly Saharia tribe district as ‘one of the malnutrition hot spots in the world’.

In its report the five-member JCE forewarned the district administration of severe drought in the coming summer owing to monsoon failure this year.“Unless the steps outlined by the commission are taken urgently and in earnest, we could see a huge human tragedy unfolding next year,’’ the report has warned.

The JCE was instituted by commissioner Dr N C Saxena and special commissioner Harsh Mander at the intervention of advisor to the commissioner Dr Mihir Shah following reports of malnutrition deaths in the district during the last two years. It had received complaints of child deaths from villages – 11 of them from one village Ranipura.

The commission visited the affected parts of Sheopur on October 5 and 6 and submitted its report to Dr Saxena on Friday. The JCE comprised PS Vijay Shankar as the representative of Dr Mihir Shah, two civil society representatives Dr S K Singh and Dr Vijay Gupta, joint director of Women and Child Development R N Raghuvanshi and divisional joint commissioner of health, Gwalior, Dr Mohan Singh. A copy of the report has also been sent to the district collector with the directive to submit an action-taken report (ATR) to Dr Mihir Shah latest by December 31.

Decrying the row between social activists and the administration in trying to “prove” or “disprove” the deaths due to starvation, JCE says “the undeniable fact is that Sheopur is one of the malnutrition hot spots of the world”. The report has held the pathetic health facilities and poor implementation of various government programmes mainly responsible for the situation.

The report further deplores the fact that even after the JCE visit malnutrition deaths did not stop in the district. “Most alarmingly, we have received unconfirmed reports after the visit of the JCE that all the four children included in the list of severely malnourished by the local administration (Bansi, Sonu, Sukhlal and Kiran) have died. This points to the dangerous level to which the current situation can escalate,’’ the report observes.
Sravani Sarkar, Bhopal November 25, 2006

“All this points to a complete failure of governance, of the failure of the state to provide the very basic entitlements to its citizens, in this case the nation’s future— its children,’’ it adds. The JCE has come out with 42 recommendations for immediate action. They include immediate attention to the severely malnourished and chronically ill children, setting up of fully staffed 13 new primary health centres (PHCs) and 38 new sub-health centres, proper implementation of health schemes, urgent steps to meet the target of 850 anganwadi centres in the district in six months as per the Supreme Court directive, proper implementation of midday meal scheme and the National Rural Employment Guarantee Scheme, increasing public distribution system (PDS) outlets in the tribal areas, enforcing of SC orders on purchase of grain and ensuring that all members of primitive tribe families get Antyoday Anna Yojana cards.

http://www.hindustantimes.com/news/5922_1853055,0015002100000000.htm

Saturday, November 25, 2006

Blood shortage in Shivpuri's blood bank

District Shivpuri has only one blood bank which always faces the shortage of blood

Ten years back Shobha blood bank was established in the district. It has facility of to store blood and blood exchange but there may be few which had availed of this facility.

One can see many visiting the blood bank for want of the blood for their near and dear admitted in hospital or elsewhere, which they never receive. Either one fulfills the need by getting blood from outside the district or from a blood donor. Even people who have been registered as blood donors are not ready always to donate blood.

On the call of the Dr Manohar Agnani District Collector of Shivpuri, non governmental organisations did started monthly blood donation camps in the district, there were few takers. Blood bank has facility to store 250 bottles of blood for 35 days but still when people need there is a standard reply which one gets ‘blood of this group is not available at the moment’.

As per Dr O P Sharma statement in the news - blood bank face variation but blood of group O+ and B group faces shortage. He acknowledged that since the time NGOs have started the monthly blood donation camps there has been change in the situation.

Published in Dainik Bhaskar – November 17, 2006 Shivpuri edition

(Blog’s commentsAs per official records State has 107 blood banks for 60.38 million people. If situation of the limited available blood banks is same as in Shivpuri and Bhind (story and impact of non functional blood bank is published below) how can one save lives of people including women and children in the state. Availability of the Blood is a major issue, which needs urgent ACTION- A wake up call for state's helath department)

Within two hours, two pregnant women lose their lives at the Bhind district hospital

Will we be able to reduce MMR ?

by Aarti Pandey, November 23, 2006.

In last few days in the Bhind district two pregnant women lost their lives within one hour in the district hospital. As per the article penned by Aarti Pandey published in the hindi daily of Madhya Pradesh ‘Deshbandhu’ two pregnant women namely Rekha Bhadoriya and Kiran Jatav Sarkar lost their precious lives due to negligence at the district hospital.

Article analyses that optimum adequate facilities at the hospitals are just missing and the most needed blood bank facility is not functioning, and as a result of which these two women lost their precious lives.

Rekha Bahdoriya was admitted to the hospital as she reported of bleeding in her seventh month of pregnancy, but unfortunately hospital did not had have any functional blood bank facility and hence due to lack of blood she lost her life. (blog’s additional comments - Though as per the state’s health department website district has a functional blood bank in the state).

Similarly Kiran wife of Mukesh Jatav of Bhind was pregnant and complained of pain on November 10, 2006, when her family brought her to the hospital wherein doctors advised her for some routine tests i.e. hemoglobin and blood group. She was prescribed medicine for stomach ache and was sent back. She delivered baby on November 16, 2006 at her home and had some complications when her family rushed her to hospital. At the hospital doctor saw her after one hour but she not given any treatment. Her family waited with hope that doctors would take care of her for another two hours but the time they could decide to treat her she was no more.

The article questions sensitivities of the staff at the hospital and facilities available at the at the district headquarters. On the issue of Kiran hospital administration say that they did not have the proper beds so she could not be admitted while in case of Rekha blood bank was not functional. Article also ponders over available human resources at the hospital and the way these hospitals are working ?.

Article was published in ‘Deshbandhu’, Bhopal on November 24, 2006

Saturday, November 11, 2006

Dainik Bhaskar calls for strategic action plan to combat IMR/MMR in the state of MP

Edit by Dainik Bhaskar reflecting on the need of a strategic combat plan to helps reduce IMR and MMR in the state at much faster pace with focus on rural madhya pradesh..

Thursday, November 09, 2006

Issue of MMR in the state assembly of MP

Health Minister Ajay Vishnoi, in a written reply accepted that the maternal mortality rate (MMR) that was 498 in past two years, remained the same in current year. However, he claimed that the infant mortality rate (IMR) has decreased to 79 per 1,000 in comparison to the figure of 82 in past two years. He also informed that there are 138 posts of gynecologists and 134 posts of pediatricians are sanctioned the state, while 40 and 41 posts are lying vacant in these categories respectively.

story on assembly proceedings at

www. mpnewsonline.com

Tuesday, November 07, 2006

Jan Adhikar Manch concerns on MMR

Published at mpnewsonline.com

Bhopal, Nov 07: "Though data available with he government states that maternal mortality rate (MMR) has come down, factually more than 27 women die every day in the Madhya Pradesh. This is more than one death per hour," said Sandesh Bansal, State Coordinator of the Jan Adhikar Manch.

Mr Bansal was speaking at the two-day meeting organised at Bhopal to discuss the status of maternal mortality in the state. He further said that Madhya Pradesh still figures among the six worst states in the country that has high maternal mortality rate. And above all, this data is based on sample survey only.

Jan Adhikar Manch is a network of non-governmental organization within the state of Madhya Pradesh working on issues of women health. The network partners of Manch expressed concern on the issue. The members have called for shifting of mode in state’s response. Time is to shift from awareness mode to action, they added.

Manch members in the meeting felt that the time has now come to strengthen implementation efforts with greater energy at the village level. The partners NGOs from eleven districts of Sidhi, Panna, Tikamgarh Sheopur, Sidhi, Shivpuri, Guna, Rewa, Satna, Bhind, Gwalior, Datia and Ashok Nagar are running a campaign namely ‘Save our Mothers’ in the state. The campaign aims at raising concern on the high maternal mortality in the state and bringing accountability of the maternal deaths in the state.

Manch and its network partners had taken the issue of maternal mortality into the debated of the Gram Sabhas held recently in local panchayats. Approximately 50 such special Gram Sabhas have been organised till now.

http://www.mpnewsonline.com

Tuesday, October 31, 2006

Mother, child mortality rate dips

Published in The Pioneer. Nov. 1, 2006

India's aspiration to be the next super-power is sobered by the fact that every fifth woman in the world is dying of poor medical care during the childbirth resides here.

On Tuesday, however, registrar general of India gave reason to hope that the country is pulling itself out of the bottom-of-the-barrel as a survey of infant mortality and death of mothers during childbirth has shown a sharp decline between 1996 and 2003.
In 1997, as many as 400 women died during the childbirth due to non-availability of proper medical facilities. Awareness on better nutrition for the mother, higher age of marriage of girls and availability of better medical facilities in the past decade or so has seen this number dip to about 300 per lakh live birth, according to the recent report.
The number of children dying before attaining one year has also declined from about 70 per lakh children born in 1997 to 58 per lakh children born in 2004.

The latest survey was conducted among 15 million women in the age group of 15 - 49 years. It found a direct correlation between saving mother's lives and deliveries in clinics or nursing homes. However, over three fourth of pregnant women deliver at home partly out of ignorance and rest out of lack of medical facilities in the rural areas. "The survey clearly brings out that to bring down the maternal mortality there is no substitute to women's education, increasing age of marriage and institutional delivery," health secretary Prasanna Hota said.

Worst performers are the so-called BIMARU States comprising Uttar Pradesh (517), Assam (490), Rajasthan (445), Madhya Pradesh (379), Bihar (371) and Orissa (358). Except Assam, these are also the most populous States and outweigh the better performance achieved by Kerala, Tamil Nadu, Maharashtra, Haryana and Gujarat.

The survey identified hemorrhage as the chief cause of mother's death, followed by septicemia and abortion. Women delivering at very young age and a quick second pregnancy are particularly vulnerable, the survey said.

The National Rural Health Mission (NRHM) and States are offering incentive to health workers and expectant mothers to register and deliver at the nearest Government clinic. Under NRHM, the health worker trained in the community is offered financial incentive to encourage the family of expectant mother to visit health clinic at least thrice during the pregnancy. Money is also given to the health workers to meet incidental expenses like transportation costs in case any complication arises. Progressive States are offering additional incentive to encourage institutional deliveries.

An earlier survey by the Health Ministry, National Family Health Survey, found that Dalits were least likely to opt for institutional deliveries while Christians and Muslims were better-off in giving priority to delivery in nursing homes.

Who cares ? 1739 infants died unnoticed in Katni

This was published in Dainik Jagran in Katni. As a part of our endeavour to make the effort visible we are reproducing it here as it is.

Monday, October 30, 2006

IMR on the rise in Burhanpur

Published in The Pioneer on October 31, 2006

Staff Reporter Bhopal
Burhanpur district in Madhya Pradesh has a maternal mortality ratio of 800 per one-lakh live births and an infant mortality rate (IMR) of 96 per 1,000 births, which is higher than the State's average.

In order to combat this, the district administration has been pushing many schemes to promote institutional delivery, immunisation and other schemes, which the State had launched.

District chief medical & health officer has spent Rs 53 lakh in 2005-2006 and Rs 60 lakh in 2006-2007 (till now) from Information Education and Communication (IEF) funds available under RCH II programme for promoting these schemes, which has had a little impact.

On October 19, district secretary in charge Abha Asthana had been to Doifodia primary healthcentre of the Kharnar block and she had expressed her concern on the situation there. Interestingly, the district does not have any figures of the maternal and infant deaths, which took place in the district so how can success of these schemes be evaluated.
Chief medical and health officer Dr GS Awasia said that the transport scheme had started in 2004 and the department doesn't have IMR and MMR figures of the past two years.

Similarly, the situation is grave in Katni district, where Payri Ma scheme was launched by the State in February 2006 with lot of publicity. The purpose was to promote institutional delivery and help combat maternal mortality. The scheme was launched with aim of getting publicity in the name of social service, without any technical inputs.
Within two months of its launch, glitches started pouring in. In the first month, 224 women were awarded as promised in the scheme, the numbers of awards given (not promised) started dropping after two months. The question was how to fund the same, first it was flexible funds available under different heads. Finally, IEF funds came handy for its survival.

Link to the story
http://www.dailypioneer.com/indexn12.asp?main_variable=BHOPAL&file_name=bhopal20%2Etxt&counter_img=20

Sunday, October 29, 2006

District's beloved mother is on dialysis

Published in Dainik Jagran, Katni as a feature in Hindi. The summary of the same is produced here in English.

Payri Ma is a name of the scheme which was launched by the state in February 2006 with lot of publicity in 6 bocks of Katni district. The purpose was to promote institutional delivery and help combat maternal mortality. Naturally the scheme was launched with aim of getting publicity in the name of social service, without any technical input, into it.

Just within two months if its launch the glitches started coming in. In first month 224 women were given awards as promised in the scheme, the numbers of awards given (not promised) started dropping after two months. Naturally the big question was how to fund the same, first it was flexi funds available under different heads, finally IEC funds came handy for its survival. Though the number of institutional delivery rose in first two months but started giving way, though there is no evaluation why did number increased and how it came down ?

Today scheme is just on dialysis may or may not survive till its first birth day.

Translation by the blog team.

State Schemes for combating MMR face implementation glitches

As published in the Raj Express today October 29, 2006

Schemes initiated by the State of Madhya Pradesh for reducing maternal and infant deaths are not being implemented properly. Maternal and infant deaths continue to happen.

Burhanpur – District Burhanpur in the state of Madhya Pradesh has maternal mortality ratio of 800 per one lakh live births while infant mortality rate of 96 per thousand births, which is quite higher than the state’s average.

In order to combat the district administration by the state’s support has been pushing many schemes to promote institutional delivery, immunization and other schemes which state had launched. Till now district Chief Medical & Health Officer’s office has spend Rs 53 lakh in year 2005 – 2006 and Rs 60 lakhs in te year 2006 – 2007 (till now) from IEC funds available under RCH II programme for promoting these schemes, which has had a little impact.

On October 19 Secretary in charge of the district, namely Abha Asthana had been Doifodia primary health centre of the Kharnar block and she had expressed her concern on the situation there. Interestingly district does not have any figures of the maternal and infant deaths which have happened in the district so how does one evaluate the success of these schemes.
Report in Raj Express has a quote of Dr G S Awasia, Chief Medical and Health officer saying that transport scheme had started in 2004 and we don’t have IMR and MMR figures for last two years.

Comments on the story by the blog

IMR figures and MMR figures no doubt are available at state level, and are not calculate every year. Latest one though old are by sample registration system of GOI which state that IMR Of state is 79 per thousand and MMR is 498 per one lakh live births. It is not easy to calculate figures again and again but nevertheless district should be having the number of maternal and infant deaths in the district, and one can see how the district is progressing, if they do not have the same, then…..

Story translated from Hindi to English

Saturday, October 28, 2006

Government, NGOs stress on safety of mothers

On Mothers Day, the Madhya Pradesh government and NGOs have called on all sections of civil society to ensure safety of mothers and children. Chief Minister Shivraj Singh Chouhan urged women to rise above politics and work towards their welfare by benefiting from government schemes aimed at curbing maternal mortality rate and infant mortality rate in the state. Maternal mortality rate in Madhya Pradesh is as high as 498 whereas the situation in case of infant mortality rate is equally alarming - 83 out of 1,000 children die before their first birthday.

Organisations like Madhya Pradesh Jan Adhikar Manch, Madhya Pradesh Voluntary Health Association, Mahila Chetna Manch and Centre for Advocacy have raised the issue with political leaders and highlighted loopholes in the system.

http://timesfoundation.indiatimes.com/articleshow/1529589.cms

Cultural determinants of maternal and infant mortality in Madhya Pradesh e concern on maternal deaths in MP

Cultural determinants of maternal and infant mortality in Madhya Pradesh (Déterminants culturels de la mortalité maternelle et infantile au Madhya Pradesh)

Author - SAHAY Sarita

Résumé / Abstract- The maternal and infant mortality rate is very high in Madhya Pradesh. Rampant poverty causing severe malnutrition to all and particularly to pregnant women, low age at marriage, early pregnancy, subordinate status of women and certain old age beliefs related to child bearing and rearing practices are some of the major proximate cultural variables, said to be responsible for this situation.

Unwillingness to avail available immunization courses to protect the children against some of the killing diseases, breast feeding without adding supplementary mash food at proper age and practice of sudden weaning further aggravate the situation. This study reveals many interesting perspectives of these happenings that have been analysed in the light of failed observations in the different districts of Madhya Pradesh.

Journal title - Man in India, Ranchi, INDE (1) (Revue)

Link to the story
http://cat.inist.fr/?aModele=afficheN&cpsidt=13498483

Friday, October 27, 2006

Gram sabhas raise issue of maternal mortality

Published in The Pioneer, October 25, 2006, Bhopal Edition

High maternal mortality rate (MMR) in Madhya Pradesh was an issue of debate in the gram sabhas held recently in local panchayats of Gwalior, Chambal, Vindhyachal and Bundelkhand regions of the State. Approximately 50 such special gram sabhas have been organised till now. People who have attended gram sabhas have made out a demand note, which they are sharing with the district administration for implementation.

Jan Adhikar Manch, a network of NGOs working on raising concern over the high maternal mortality in Madhya Pradesh, as a part of their 'save our mothers' campaign in collaboration with local panchayats held various gram sabhas. Sandesh Bansal State coordinator of the Manch told The Pioneer that in these sabhas, the villagers are sensitized about the various schemes available for their benefit being run by the State.Issue of high maternal deaths and lack of adequate facilities in the pancahyat for women health and lack of staff at the primary health centres and anganwadi were the main points. Benefits of the Deen Dayal Antoyadaya Yojana not accruing to all those below the poverty line category, weak village health societies, poor infrastructure and lack of health facilities at the village level were some of the points that came up for discussion.

In Maanpura in Bhind district, more than 200 people had participated wherein issue of the schemes benefit not accruing to all came up in the discussions.During the sabha, people also felt that there was an acute shortage of water in the village and women had to travel long distances to collect water, which impacted on their health especially the pregnant.Bansal also informed, "We have also written to the Chief Minister urging his intervention to help strengthen efforts to combat high maternal deaths.

Link to the story
http://www.dailypioneer.com/indexn12.asp?main_variable=BHOPAL&file_name=bhopal18%2Etxt&counter_img=18

Rural women demand right to health

Published in The Hindu - October 5, 2006

Maternal mortality rates in rural areas are among the highest in the world

Call to ensure that the dream of safe motherhood becomes a reality

BHOPAL: A large number of women from villages across Madhya Pradesh have joined a signature (or thumbimpression) campaign to press for their right to health and to call upon the Government to ensure that the dream of safe motherhood becomes a reality.

Manoj Joshi of Voluntary Health Association, an NGO working for the cause of women's health, told The Hindu on Wednesday that the maternal mortality rates in rural areas across the country are among the highest in the world. It is estimated that pregnancy-related deaths account for one-quarter of all fatalities among women aged between 15 and 29, with over two-thirds of them considered preventable.With maternal mortality ratio of 498 per one lakh live births, Madhya Pradesh ranks third in the country when it comes to maternal mortality, he said, adding that there are 13,000 maternal deaths in the State every year.

For every maternal death in India, an estimated 20 more women suffer from impaired health, Mr. Joshi said raising the issue of safe delivery.He said that as part of a special drive to raise concern on this crucial issue, more than 20,000 women from different villages of the State are now in the process of signing (or placing their thumb impression) on a banner demanding the right to health and calling upon the State to ensure that the dream of safe motherhood becomes a reality. Mr. Joshi informed that a network of 60 NGOs, linked with the Madhya Pradesh Voluntary Health Association and Madhya Pradesh Samaj Sewa Sanstha were involved in the signature campaign.

The NGOs have been given two banners each to collect signatures/thumb impressions of women after they are adequately sensitised on the issue of maternal mortality and feel that some concrete action is needed to improve the situation. The women plan to present the banners with their signatures to the State Chief Minister.

Link to the story
http://www.hindu.com/2006/10/05/stories/2006100512420300.htm

State of Misery

By ANNIE ZAIDI
Published in Frontline (Volume 23 - Issue 21 :: Oct. 21-Nov. 03, 2006)


The Sahariya tribal population in Sheopur district continues to suffer from hunger and malnutrition.LIFE for the Sahariya tribal people in Madhya Pradesh is an unending struggle against hunger, malnutrition, disease and, above all, neglect. In August 2006, Frontline reported hunger-related deaths in Sheopur district, which has a high concentration of Sahariyas. Earlier too, in May 2005, Frontline had reported hunger-related deaths in the district. In another visit in October 2006, Frontline found that not much had changed except in Patalgarh, the village that was in the news so often in the past year, and for all the wrong reasons. In other villages, children continue to slide into the dark folds of hunger, and disappear.

In Ranipura village, about 60 kilometres from the district headquarters, eight children died this year, six of them in August. Right to Food activists had prepared a list of severely malnourished children whose lives were in danger and who needed immediate medical attention. By the time Frontline visited the village in the first week of October, two of the children, both one year old, were dead: Raju, son of Ramdin Sahariya, and Aphim, son of Jasbir Sahariya.Local residents were not sure what went wrong, but they said that the children became weak and looked like they were "drying up from the inside". Imarti, the helper at the anganwadi centre in Ranipura, said: "We did what we could for Raju. I gave him biscuits to eat, but couldn't save his life. What can I do? The jeep [the mobile medical unit] came only twice in the last couple of months. The medicines were not working anyway. If there is no jeep, how am I to take the children to the hospital? Where is the money?"An elderly person of the village, Ramratan Sahariya, put the matter in perspective: "The world dances to the tune of money. That is the trouble." The real trouble is that the Sahariya tribal population in Sheopur district has very little money and therefore limited access to nutrition and health care.

The Sahariyas are one of the three most backward tribes in Madhya Pradesh; they are entitled to BPL (below poverty line) ration cards (which many of them do not have), basic health services and at least 100 days of employment a year. Their children are entitled to mid-day meals in schools. Despite these entitlements, deprivation persists.There is a mobile `medical van' that goes around the district; but it usually visits only 20-25 villages that have been identified as `hotspots' of sickness.Jeevan Devi, who is at least 60 years old, of Gothra village in Karhal block, is suffering from swelling of the stomach, which probably needs surgery. She said she had gone to the district hospital but "the hospital asks for money. They say it will cost at least Rs.4,000-5,000. I do not have that much. Even the nurse asks for money." BPL families are supposed to be given health cards, which entitle them to free treatment up to a certain amount. But residents of this village have never even heard of this.

In Kapura hamlet, at least 13 children have died over the past year. None of their names is to be found in the anganwadi register. The anganwadi worker, Bilasi Devi, cannot write; her husband helps her to maintain the register. She told Frontline: "My superviser came and took down the names of the dead children, but she did not give me a copy." There were other irregularities in the Integrated Child Development Services (ICDS) records. For instance, there were no names of children under one year. In short, there were no records of births or deaths.Recently, a Supreme Court-appointed Joint Commission of Inquiry visited Sheopur district.

The team included activists, doctors and government representatives. P.S. Vijay Shankar, the representative sent by the Supreme Court adviser Dr. Mihir Shah, told Frontline that the commission's report was not yet ready, but that going by first impressions nothing seemed to be working in the district. "Because there was a huge hue and cry, they are doing something for Patalgarh. The Collector often visits the village and activists keep a check too. But elsewhere, curative health in tribal hamlets is almost absent. You cannot even find private hospitals. There are some preventive services, like vaccination. However, in an emergency, the whole structure collapses."The team was witness to some interesting exchanges. In Ranipura, the primary schoolteacher showed up, asking how he was expected to manage alone a school with 108 children. The villagers responded by shouting at him, saying that since he did not "manage" anything at all, he should not talk. The school was open only about once a week, on an average, and that was the only time their children got their mid-day meals.

In another instance, the villagers' job cards were found to be in the custody of the panchayat secretary. After some interrogation by the team, the sarpanch admitted that he and the secretary had split between them the funds meant for wages for work under the National Rural Employment Guarantee Act (NREGA)."Patalgarh was, in fact, the best we could hope to find," Vijay Shankar said. "At least, temporary BPL cards had been issued as an emergency measure after the media reports last year. The villagers were still using them. NREGA schemes were working. Job cards were distributed. A link road is being made. The PDS [public distribution system] supplies are now being sent on a tractor, instead of waiting for the villagers to come to the ration shop." The only problem with this arrangement is that the date of distribution is not a fixed one, and the villagers are never sure when exactly the ration-bearing tractor will show up. If they miss a month's quota of 35 kg of rations, they miss it for good; there is no `carry-over' quota when the rations arrive the following month. Even otherwise, they rarely get more than 30 kg.Vijay Shankar pointed out that in 2004 the apex court ruled that if people could not afford to buy even subsidised grain at one go, they should be able to buy their rations in parts. "This is not happening. If they cannot afford to take it all at once, they can say bye-bye to their rations."An observer present during the court-appointed team's visit said that things have started to change. "There is some social support now, which was missing five years ago.

People are getting work, almost at their doorstep. All of it adds up. That a tractor comes with ration supplies is also a good sign. That way, collecting rations becomes a collective event, and it is harder to turn away people. It is harder to push them around now. Patalgarh is moving in the right direction."Maybe. But Patalgarh is only one of the many tribal villages of Madhya Pradesh that continue to suffer. Jaddapura village, for instance, even more remote than Patalgarh, has recorded at least 10 deaths this year; five of the dead were children. But it gets no attention because, unlike in Patalgarh, no doctor has certified that these deaths were caused by hunger.The administration, of course, denies that there were any starvation deaths in the region. The children who died never got any medical examination, so it is impossible now to prove what killed them. However, Collector M.S. Bhilala admitted that there is widespread malnutrition in the district. "We cannot deny it. It is a perennial problem among the Sahariyas, especially because they are not educated and are very superstitious. But we are also facing a severe shortage of staff. There is approximately a 40 per cent shortage of medical staff, anganwadi workers, teachers and so on. We have written to the State administration and asked for more support. There is one malnutrition rehabilitation centre in Sheopur and we are trying to set up centres in Vijaypur and Karhal."Such centres are needed urgently.

In Sheopur, 57.68 per cent of the children are malnourished, 2.59 per cent of them severely so. Madhya Pradesh has a bad overall record, with 49.2 per cent of the children being malnourished. Compounded by the lack of health services, this translates into a higher death toll. As Vijay Shankar put it - "Hunger is part of the backwardness package, and the Sahariyas are particularly vulnerable. Our aim, during this trip, was not to establish that starvation deaths happen. Those are like the flashpoint at the tip of the volcano. We have to listen to the rumblings beneath the earth.

"link to the article

http://www.hinduonnet.com/fline/stories/20061103000904900.htm

Birthing Nightmare

by Sachin Kumar Jain

A visit to Balwadi health centre in Badwani district of Madhya Pradesh gives the true picture of the little progress the state has made in the area of health care. This health centre caters to around 30 villages which have around 21,000 people (mostly tribals). Since 2002, the health centre has not had any doctor visit the centre. A compounder does the doctor's job. Medicines and equipment are not available for upto nine months in a year.

In 2004, 13 children died due to malnutrition-related problems and 34 women died while giving birth in Balwadi. This scenario is not restricted to Balwadi. Inadequate basic health care has made many women and children vulnerable to disease and death in Madhya Pradesh.

Recently, in Reethi block of Katni district, at least 20 out of 32 infants died in a government hospital which caters to 56 villages. There are no gynecologists in the hospital; no surgery department or provision for emergency services or medicines. Only one disabled woman doctor tries to reach out to maximum patients here.

Around 700 out of 100,000 women in Madhya Pradesh die every year while giving birth. Over 70 per cent births take place outside hospitals and 53 per cent births are managed by untrained persons. However, despite the increasing number of deaths, neither the local administration nor the state government has taken any notice of the trend. The officials appear preoccupied with serving politicians and have little time to respond to the medical crisis. On paper, there are several attractive government health schemes but lakhs continue to die of curable diseases in Madhya Pradesh.

In 2004, the state government initiated the Deendayal Antyodaya Upchar Yojana, aimed at providing at least 220 million people with better health facilities. This scheme has the provision of free health services up to Rs 20,000 per annum for poor families. However, hardly 14,360 poor people have benefited from the scheme. Critics of the scheme say that only people with some political influence can access the scheme. Again, while the state government made a lot of noise about giving women their maternal health rights, it has not done much to implement the scheme for maternity benefits.
The scheme provides for Rs 150-Rs 300 as transport allowance to pregnant women for travelling to the health centre. But a study conducted by the Centre for Advocacy - a resource centre in Bhopal - reveals that 53.7 per cent actual beneficiaries are not aware of any such scheme and among those who know about it, barley 0.8 per cent have benefited so far. In fact, a few years ago, the Supreme Court (while responding to the Right to Food Public Interest Litigation) directed all the state governments/union territories to implement the National Maternity Benefit Scheme (NMBS). It asked the states to pay all pregnant women, who belong to Below the Poverty Line (BPL) families, Rs 500, 8-12 weeks prior to the delivery, for each of the first two births.

The most important feature of this Supreme Court order was to convert the scheme into a universal entitlement for all BPL pregnant women. The court order was an important step towards looking at maternal relief as a source for ensuring food security for women during the critical months. This, for the first time, also ensured maternity relief as a legal entitlement to women in the unorganized sector.

But the Madhya Pradesh government has done little to take the scheme to the needy women. The government has reached out to only 3.7 per cent of the potential BPL beneficiaries.
Even the Madhya Pradesh Family Welfare Programme Evaluation Survey of 2003 claimed that barely 25 per cent of the rural population is covered by the maternity scheme. Research also indicates that in recent years, over 70 per cent women have died due to excessive bleeding, infections, insecurity and high blood pressure during child birth.
According to one research, only 43 per cent women in the state deliver with the help of a trained midwife; around 77 per cent don't have access to any medical facilities and undergo unsafe deliveries.

Birthing, in Madhya Pradesh is indeed a nightmare for women.

February 5, 2006

Link to this story
http://www.boloji.com/wfs5/wfs546.htm

Poor pregnant women expect little in Madhya Pradesh: Report

April 15, 2006 Released by IANS

When India celebrated Safe Motherhood Day on Tuesday, the lacuna in proper care for women during pregnancy and childbirth made it less of a celebration this year in the villages of Madhya Pradesh.Poverty and pregnancy form a lethal cocktail that strikes down rural women in the state, denying them basic and antenatal care, nutrition or medical support.

Prema Bai from Hardhot village, over 70 km from Raisen district headquarter in Madhya Pradesh, is four months into her pregnancy. Wife of a daily wager, she and her husband earn a paltry Rs.40 each daily to feed their five-member family. Medical supplies and prescriptions remain a distant dream as Prema struggles to manage one square meal a day.With every meal at stake, visiting a doctor for an antenatal check up is out of the question. Consequently, she is left with no choice but to trudge in her neighbour's bullock cart to the only government clinic in the village for free medical treatment."For an expectant mother in the remote areas of Madhya Pradesh, it is common to travel in bullock carts or cycles over pot-holed roads to distant rural health centres in the hope of getting proper healthcare," health experts say. However, these centres hardly have any bed to offer to the patients, and painkillers are the only medicines available. Of course, they do offer advice to Prema and other pregnant women to visit a gynaecologist.

But no gynaecologists are available in a village like Hardhot.

"The situation is worse in rural areas," says a new Population Council study.The study adds that less than half of the pregnant women, mostly illiterate and socio-economically disadvantaged, don't even seek any care."The women think that check-ups were not necessary (60 percent) or not customary (four percent)," the report reveals.

Lack of knowledge regarding the importance of antenatal care, the long trek to health centres and a lack of cheap transportation are other bottlenecks that pregnant women face."An inability to meet costs related to visiting a health facility prevents 15 percent of the women from undergoing such check-ups."Still, some of the poor women reach the nearest available medical facilities in the hope of getting better care but are mostly left to fend for themselves.Compelled by myriad disadvantages, the women in rural areas opt for home delivery often in dangerously unhygienic conditions, increasing the chances of fatal complications both for the mother and child.A majority of maternal deaths take place after delivery, most of them within 24 hours after childbirth, for want of postpartum care, which allows health workers to detect and manage problems and to make sure that the mother and child are doing well.The state government had came out with a new Reproductive and Child Health Programme in 1990, but its success can be gauged by Prema's trauma.In a state where women on an average have three children, the maternal mortality ratio is one of the highest in the country, said the study.

Madhya Pradesh Health Minister Ajay Vishnoi, however, seems satisfied with the government schemes promoted by the state under the Rural Health Mission.Though he admitted that fighting traditional gaps would take time, he said: "We will soon be appointing lady officers in rural areas to assist pregnant women and ensure safe delivery with post-pregnancy childcare."

The truth is that despite several improved maternal child health services and postpartum programmes aimed at safe motherhood, the lives of many women in the reproductive age group here are still at risk.

The story is available at

http://www.rxpgnews.com/medicalnews/healthcare/india/madhya-pradesh-healthcare/article_4025.shtml