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.