India lags far behind in protecting mothers

Azera Rahman (IANS)Gwalior (Madhya Pradesh), February 13, 2007

There has been no appreciable decline in the number of women dying at childbirth in India since 1990, quite unlike other nations like Bangladesh, Gautemala and Morocco that have managed to arrest this trend. India's Maternal Mortality Ratio (MMR), the number of maternal deaths per 100,000 live births, was 301 in 2002 and 2003. According to the Sample Registration Survey (SRS), 70,000 women die every year in India but UNICEF says the number crosses 100,000.
"The real concern for the high MMR in India is not lack of resources but failure in the system," said Aparajita Gogoi, national coordinator of the White Ribbon Alliance (WRA) that works on issues concerning safe motherhood.

Gogoi was speaking at a workshop on maternal mortality organised by UNICEF in Gwalior last week. Talking about the successes in reducing MMR in other countries, Gogoi said there are various facets that have been worked upon in those countries, which if looked into here would bring down the number of maternal deaths to a great extent.

Increasing availability of emergency obstetric care (EmOC) facilities, skilled birth attendants, maternity waiting homes and financial accessibility, which have been adopted in countries like Zimbabwe, Indonesia, Bolivia and Honduras have greatly helped. These nations have been able to reduce their MMR by 52 per cent.

In India, only 40 per cent women have access to skilled birth attendance. And according to the National Family Health Survey (NFHS), only one in six women receive post-natal care when 60 per cent of the maternal deaths occur after the delivery of the child. Promoting accountability is another factor that, when looked into seriously, brought down the number of maternal deaths in China from 1,500 per 100,000 live births to less than 200 in the year 2000. "Accountability is very important. No one is held responsible when a mother dies ... most of the times it's not even registered. It's very important to keep a tab of the health of a pregnant woman". "Only then can the matter be looked into if any complication arises and a similar situation can be prevented in the future," Gogoi said.

Bangladesh has brought down its MMR by 22 per cent, Egypt by 52 per cent, Honduras by 41 per cent, Morocco by eight per cent and Guatemala by 30 per cent. One of the reasons for the high MMR in India country is the ratio of the population to the number of skilled medical staff available. Although 70 per cent of the population resides in rural areas, only 20-30 per cent medical aid is available to them while the ratio is the opposite in urban areas.

Non-functional health centres, scarcity of blood banks, inadequate number of specialists like gynaecologists and anaesthetists in rural areas and the poor condition of the transport system are some of the bottlenecks of the problem. "Seventy per cent of the national budget allocated for health support goes back unutilised. The system is not delivering end results and that's where the problem lies," stated Hamid El-Bashir, Madhya Pradesh state representative of UNICEF. "These deaths are completely preventable and that is the greatest tragedy. It is a silent tsunami," remarked Gogoi.