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Make maternal morbidity a priority: health experts

Apr 04, 2013

Maternal morbidity is far more difficult to handle than maternal mortality and it is high time that the Indian government addresses health concerns related to it, said speakers at a consultation on maternal health in New Delhi.

The consultation held by the Population Foundation for India (PFI) in collaboration with the Woodrow Wilson International Center for Scholars, the Maternal Health Taskforce of the Harvard School of Public Health, and the United Nations Population Fund, critiqued the government for not having a proper mechanism to assess the impact of interventions for improving maternal healthcare in the country.

Poonam Muttreja, Executive Director, Population Foundation of India (PFI), lamented that the Millennium Development Goal 5 (MDG 5) which focuses on improving maternal health has failed to address the health issues of the poorest of the poor including the Dalits and tribals. “In spite of increased skilled attendance at the time of birth and access to institutional deliveries, pregnancy continues to be a major health risk for women in many parts of the country. Only half of all women in India receive three or more antenatal checkups. The situation is much worse when we look at data for scheduled caste, scheduled tribes and minorities,” she said.

Muttreja said that MDG 5 has only benefitted women from the relatively well-off families in the rural parts of India. She also stressed that the post-MDG agenda for maternal health should be country specific for better delivery. “The likelihood of having received antenatal care from a doctor is lowest for scheduled tribe mothers and highest for mothers who do not belong to a schedule caste, scheduled tribe or backward class,” she said.

Talking about the role of consultation in influencing policy makers, Muttreja said, “Medical practitioners and researchers from India and around the globe will deliberate on what needs to be done, and frame a road map, including a list of key policy priorities and recommendations which will help the government in reframing policies, which have neglected maternal morbidity so far,” she said.

Dr Srinath Reddy, President, Public Health Foundation of India (PHFI), highlighted the role of gender preference in perpetuating violence against women and said it was unfortunate that the MDGs have talked about mortality but not morbidity. He said 42 per cent of pregnant women worldwide suffer from anemia while around 15 per cent live with gestational diabetes.

Reddy pointed out that that not less than 53 per cent of pregnant women face maternal morbidity in rural India.

Dr AK Shiva Kumar, Advisor, UNICEF and Member of the National Advisory Council of India, said that six deficits - knowledge deficit, proper evaluation system, competency, trust deficit, financial deficit and the ownership issue - need immediate attention for improving maternal health in India.

Defending the Government, Dr SK Sikdar, Deputy Commissioner of Family Planning Division, India’s Ministry of Health and Family Welfare (MoHFW), said that the health ministry is asking for monthly reports from the states about maternal health care.

Sikdar highlighted how community health workers can be roped in for furthering the cause of improving maternal health care. “In family planning, the distribution of contraceptives is being efficiently carried by the ASHA health workers,” he noted.

Dr Gita Sen, professor of Public Policy at the Indian Institute of Management Bangalore (IIM-B), and adjunct professor of Global Health and Population, Harvard School of Public Health, said that morbidity is far more difficult to handle than mortality and hence it needs the same kind of attention which is given to maternal mortality.

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