April 18, 2005
Dying moms: A Blot on Indian Healthcare
By Arun Veembur
The rise in
maternal mortality rates in India speaks volumes of the
country's poor health and medical facilities.
In every 1,00,000 childbirths in India, four to five hundred mothers die of birth complications. Alarmingly, this number has shown no signs of decrease over the decades.
In fact, two studies by the National Family Health Survey showed a slight increase in the figure from the beginning of the 90s. This, when the UNDP Millennium Development Goals say that maternal mortality rates should be reduced by three quarters from 1990 to 2015.
Even countries like Sri Lanka and Malaysia haven't seen such rates since the 1950s. Barely 20 - 30 mothers in Malaysia die in childbirth; slightly higher in Sri Lanka.
Dr Hari Singh, the director of the Institute of Health Management Research (a public health research organization that collaborates with The John Hopkins University and the WHO) says there are three delays that matter.
The first is in the house, where the family, and even the Traditional Birth Attendants (TBAs) are unable to identify signs of complications -- the woman no longer crying out, or starting to bleed profusely.
Moreover, getting her to the nearest treatment facility proves to be difficult with a bullock cart on a mud road. Most of the deaths, says Dr Singh, happen on the way. At the health center itself, the doctor might not be available, and even if he is, the facilities for, say, a caesarean, might be lacking.
Available funds are spread too thinly, and there is too much of a mismatch for them to do good in any place.
Spread awareness
Even spreading awareness about the issue is badly handled. A film star or two talking about the matter would do a lot better than several thousands of badly-printed pamphlets.
Doctors today are unable to look at public health in entirety. Besides, young doctors, fresh out of medical schools, get frustrated with the realities of rural health.
The seniors who reach positions of decision-making are on the verge of retiring and are not too enthusiastic about change.
One good sign, says Dr Singh, is NGOs that have started managing Primary Health Centers (PHCs). The Karuna Trust has adopted 14. In fact, they handle deliveries at their centers, which never used to be done. Besides, one trained nurse goes to every house where a baby is being born.
From the Deccan Herald, April 2005