On Mother's Day, Let's Ask for Better Maternal Healthcare in India


Like Women's Day, Mother's Day is ripe with cliches about what moms 'really want'.

We love pampering our mothers with flowers, cards and breakfasts in bed - but how about using this dedicated day to go beyond the superficial and work towards creating effective, life-saving changes for all mothers to show them we really care.

So, this Mother's Day lets take maternal healthcare and well-being more seriously.

Where Do We Stand on Maternal Care?

According to damning data by UNICEF , globally, we lose around 800 women daily due to preventable issues during childbirth.

Out of these, 20 percent are from India.

That means, annually, estimates suggest that "44,000 women die due to preventable pregnancy-related causes in India."
A 2018 Health Index by NITI Aayog and the Ministry of Health and Family Welfare reveals that despite the economic strides made in India, overall healthcare has not progressed as much. This is especially stark when compared to similar developing countries with "comparable levels of spending on health."

The report suggests that while maternal mortality has reduced between 1991 and 2015 by more than 60 percent, the rate of improvement has been "inadequate as a nation"
However, there are large variations between states and union territories.

Where Does the Indian Government Stand on Maternal Healthcare?

Government schemes like Janani Shishu Suraksha Karyakaram (JSSK) and Janani Suraksha Yojana (JSY) to address the health status of women before, during and after childbirth.
JSSK was launched by the Government of India in 2011 to increase access for maternity services, including free delivery for pregnant mothers and healthcare for sick infants.

UNICEF data says that India's maternal mortality rate fell from 212 deaths per 100,000 live births in 2007 to 167 deaths in 2013, owing largely in part to JSSK.
Although the fall in mortality is commendable, the question remains to be seen is if India is really on track to meet the UN's Sustainable Development Goal of "reducing neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births," by 2030.

For now, the only states to have reached this target are Kerala, Maharashtra and Tamil Nadu, as per this report in Observer Research Foundation.

Government Scheme JSY for Rural Mothers
Women living in rural areas, especially in the depths of India, are still hard-pressed to find safe and reliable healthcare providers, and thus face a much higher risk of dying during childbirth.

UNICEF data says that women in India's lowest economic bracket have around a "two and a half times higher mortality rate."
Adolescent girls who become pregnant are also at an increased risk.

Launched in 2005, JSY is a safe motherhood intervention under the National Rural Health Mission (NHM) that focusses on "promoting institutional deliveries among the poor pregnant women".

Under JSY comes the government's Janani Shishu Suraksha Karyakaram, introduced in 2011 that is targeted at women who deliver at home to opt for government health facilities and institutional deliveries which are provided free. This is done to provide a safer environment for birthing.

A Harvard University report has mapped, among other health indicators, the outcomes of the JSY scheme per state. The image below shows how each state fared on the percentage of mothers who have received financial assistance under the scheme.

The map shows a some-what mixed result, but large states like Maharashtra, Gujarat, Telengana and the union territory Goa have a dismal proportion of mothers being helped by JSY, at under 13.5%percent.
Studies have said that JSY has increased access but needs better implementation and but the data by Harvard, broken up by constituencies, provides detailed figures of the ground reality.

Interestingly, data shows that despite low assistance by JSY to mothers in Gujarat, the state run scheme Chiranjeevi Yojana that provided financial assistance to rural mothers was instrumental in increasing the percentage of institutional deliveries there.

Dissecting each scheme by states and even constituencies, is when the Indian government's priority to maternal healthcare for every Indian woman becomes clear.

And while there have been improvements and dedicated schemes, it's time women's health and maternal care came to the forefront.

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