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The Maternal
Health situation in India
Each year in India, roughly 30 million women
experience pregnancy and 26 million have a live birth (MOHFW, 2006). With an
estimated 77,000 deaths per annum, India contributes to a majority
of maternal mortality burden in the region.
Maternal mortality ratio, an important indicator of
maternal health in India
is estimated to be 301/100,000
live births. Major causes of maternal mortality in India remain haemorrhage
(38%), sepsis (11%), Abortions (8%), hypertensive disorders (5%), obstructed labour (5%) and other conditions including anaemia, medical disorders during pregnancy contributing
to 34% of all maternal deaths (RGI-SRS 2006)..
Regional disparities in maternal and neonatal
mortality are wide with states like Kerala having
an MMR of 110/100,000 live births and others like Uttar Pradesh with
517/100,000. It is also recognised that delays in
accessing specialised maternal care happen at all
levels leading to maternal mortality and severe morbidity.
The healthcare indicator used to monitor the process
of reducing maternal mortality is the proportion of deliveries attended by a
skilled birth attendant.
WHO defines a skilled birth attendants as “an accredited health professional-such as a midwife,
doctor or nurse-who has been educated and trained to proficiency in the skills
needed to manage normal(uncomplicated) pregnancies, childbirth and the
immediate postnatal period and in the identification, management and referral
of complications in women and newborns”. At present, only 48% of all
births are attended by skilled health professionals with only 41%
institutional deliveries (NFHS 3).
It is recognised that in order to
further improve maternal and newborn health by reducing mortality and
morbidity related to pregnancy and child birth, it is essential to build continuum of care that increases
access to and use of skilled care during pregnancy, birth and the post partum
period. The continuum of care need to
extend from care in the household to the care provided by a skilled health
professional at the primary care level, to that provided at the referral
facility for those women and newborns with complications. Having a pool of
skilled manpower for provision for this continuum of care is a major
challenge for India
towards improving its maternal health situation.
Specific Areas
of Technical Assistance provided by WHO:
· Advocacy and Policy Development
· Development of technical and operational guidelines
· Technical contributions
towards development of training and reading material for ANMs/LHVs,
Staff Nurses, Medical Officers, ASHA
· Dissemination of guidelines
and facilitating planning at state level
Partners:
Government:
 Maternal
Health Division, Ministry of Health and Family Welfare, GOI
National
Institute of health and Family Welfare, New
Delhi
Medical
Colleges
UN
Agencies:
United Nations Fund for Population Activities
(UNFPA)
United Nations Children’s Fund (UNICEF)
WHO
Collaborating Centre and Centres for Excellence
National Institute
of Research in Reproductive Health,
Mumbai Department of Obstetrics and Gynaecology,
AIIMS, New Delhi
Department of Obstetrics and Gynaecology, PGIMER, Chandigarh
Department of Community Medicine, MGIMS, Sewagram
Safdarjung
Hospital, New Delhi
Professional Associations:
Federation of Obstetric and
Gynecological Societies of India (FOGSI)
Indian Medical Association (IMA)
Indian Association of Preventive
and Social Medicine (IAPSM)
Indian Public Health Association
(IPHA)
NGOs:
White
Ribbon Alliance India (WRAI)
Centre for Development and Population
Activities (CEDPA)
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