India’s apathy to its maternal mortality

India continues to lag on this metric

The UN and WHO jointly released their report on maternal mortality, and it certainly does not bode well for India. The introduction to the report goes as follows-

In 2000, the UN member states pledged to work towards a series of Millennium Development Goals (MDGs), including the target of a 75% reduction in the 1990 maternal mortality ratio (MMR; maternal deaths per 100 000 live births), to be achieved by 2015. This target (MDG 5A) and that of achieving universal access to reproductive health (MDG 5B) together formed the two targets for MDG 5: Improve maternal health.

In the 2010–15 timeframe, several initiatives were established to galvanize efforts towards reducing maternal mortality. These included the UN Secretary-General’s Global Strategy for Women’s and Children’s Health, which mobilized efforts towards achieving MDG 4 (Improve child health) as well as MDG 5, and the high-level Commission on Information and Accountability (COIA), which promoted “global reporting, oversight, and accountability on women’s and children’s health”. Now, building on the momentum generated by MDG 5, the Sustainable Development Goals (SDGs) establish a transformative new agenda for maternal health towards ending preventable maternal mortality; target 3.1 of SDG 3 is to reduce the global MMR to less than 70 per 100 000 live births by 2030.

Granted, MMR did fall from 385 to 216 (all numbers are maternal deaths per 100,000 live births) in the period 1990 to 2015. In absolute terms, globally there were still 303,000 maternal deaths in 2015, out of which 302,000 deaths were from the developing World, and more specifically, 66,000 from South Asia. India alone accounted for 45,000 maternal deaths in 2015, an equivalent of 5 mothers dying every hour somewhere in India. This is simply not acceptable.

Having said that, the outlook is not as grim as statistics show. The India MMR has dropped from 370 in 2010, to 145 in 2017, in terms of deaths per 100,000 live births. The glass is not half empty, but half full. It is time that each of us takes time to introspect the changes that are contributing to lowering the MMR in India — social changes, government initiatives, education, institutional deliveries and accountability.

Institutional deliveries — Institutional deliveries in public facilities has tripled from 18% in 2005 to 52% in 2016. It is common knowledge that a woman has a high risk of fatality should complications arise and she i

Government initiatives — The National Health Mission; the government has also announced a new scheme SUMAN under which free healthcare benefits would be provided to pregnant women, and mothers for up to six months after delivery. Almost 75% of India’s health infrastructure is concentrated in urban areas. Once this gap is bridged, maternal mortality will become a thing of the past.

Certain states like Telangana have leapfrogged in their maternal health initiatives. Riding on the Central government schemes, Telangana offers pregnant women birth kits, a dedicated toll-free number to call for free pick-up and drop for prenatal checks, cash incentive of Rs 13,000 for the birth of a girl, and standardisation of labour rooms. The state is also leading in institutional deliveries.

Reporting: The Government of India has rolled out a program to dole out Rs 1000 to anyone reporting a maternal or newborn death through a toll-free number, and subject to verifications. This may help the Government get a grasp of actual figures.

To ensure accountability, India has developed guidelines for maternal death audits, and near-miss analyses. India also has strengthened the MDSR (maternal death surveillance and response). While all this is good, what is missing is the efforts to educate every woman of her rights, her maternal health and her childrens welfare.

Government programs and subsidies help, no doubt. I will argue that they are required, especially in third world countries, to push the mothers to grab the dole outs the state offers. The ultimate goal would be to empower women to take control of their own bodies, and their health.

I aimed for a portal that empowers women to take control of their maternal health. I realised early on, that until you get the last mile connectivity with the poorest of the poor and the socially backward, no real progress can be made. So our focus has been to reach out to everybody using simple, animated and easy to comprehend videos in a language of their choice. That was the genesis of MedhealthTV.

In just over three years, MedhealthTV’s reach has confounded my expectations. Our YouTube channels alone have views upwards of 60 million. We get thousands of queries daily from women from the remotest parts of South Asia, who are keen to know more, and who care for themselves and their babies.

Ultimately, this has to be a private-public cooperation, because our goals are common. Whether it is by empowering women, or reaching out to reduce maternal mortality, if together we succeed in saving lives of our mothers and their babies, this is truly fulfilling.