Opinion - Editorials   

Maternal mortality challenges

Data on maternal mortality in India show that tens of thousands of malnourished, health-poor and resource-poor women without access to hospitals continue to die during pregnancy, while giving birth or immediately afterwards. Maternal Mortality Ratio (MMR) is an important indicator of the reach of clinical health services to the poor, and a composite measure of the overall quality of life. The MMR has no doubt dropped significantly in recent decades. It fell to 301 (per 100 ,000 live births) in 2001-2003, from 398 in 1997-98. The figure was as high as 750 in the 1960s. While this is quite an achievement for India, which used to rank high globally in maternal mortality, the pace of decline is not enough. About 78,000 women continue to die here each year. This is a significant proportion of a total of five lakh pregnancy-related deaths globally. The U.N. Millennium Development Goal is to bring the MMR down to 200 by 2007, and to 109 by 2015.

The crisis is rooted in poverty and social inequity. India continues to spend a lower percentage of GDP — 2.4 per cent — on public health compared virtually to every other country. The scale of the tragedy can be reduced by stepping up interventional strategies and facilitating institutional delivery. In 2003, only about 28 per cent of all births in India took place in institutions. Two-thirds of the deaths occurred in the northern swathe that includes Rajasthan, Uttar Pradesh/Uttaranchal, Madhya Pradesh/Chhattisgarh, Bihar/Jharkhand, and Orissa, as well as Assam. Significantly, only 15.8 per cent of births occurred in institutions in these States, as against the all-India figure of 28.3 per cent. On the other hand, in the four southern States, which account for 18 per cent of the births, 64 per cent were institutional explaining their much better performance in this area. The correlation is hard to miss. A massive and time-bound programme to increase institutional delivery in the low performing States can make a real difference. The government should devise a composite package to improve institutional infrastructure in the area of maternal health, and provide quick and easy access to round-the-clock emergency obstetric care everywhere. A broader blood safety agenda needs to be pursued, aimed at providing universal access to safe blood transfusions. For, excessive blood loss accounts for a quarter of all deaths related to childbirth. At a fundamental level, the nutritional and health status of women needs to be improved, especially in the rural areas. It is time the special health care needs of motherhood were given urgent attention.

Printer friendly page  
Send this article to Friends by E-Mail

Stories in this Section

Champion of champions
Maternal mortality challenges
The responsibility to protect — and prosecute?
Choosing a President: what the Mahatma said
Weekend of death and destruction in Iraq
Whither British political literature?
Get competitive!
Corrections and clarifications
Shattered myth
Dangerous portent
On CET

Copyright © 2007, The Hindu. Republication or redissemination of the contents of this screen are expressly prohibited without the written consent of The Hindu