May 14 which is marked for the celebration of Mother's day reveals a sad picture on the status of motherhood in India. According to the statistics released by UNICEF in India every five minutes a woman during childbirth. When compared to the world scenario this accounts to more than 20% of the maternal deaths. In India for every 100 000 live births there are about 540 maternal deaths.
There is an increase in the number of maternal deaths than those seen a centaury ago despite the evolution in science and technology and innovation of the latest gajets in the medical field. In rural India, the figure is even higher at 619, according to facts and figures brought out by the United Nations Children's Fund (UNICEF).Maternal mortality is generally defined as the death of a woman during pregnancy or delivery, or within 42 days of the end of pregnancy from a pregnancy-related cause.
Approximately 30 million women in the country experience pregnancy annually, and 27 million have live births. Nearly 136,000 maternal deaths occur annually, most of which can be prevented, says the UNICEF study. States with high maternal mortality rate (MMR) include Rajasthan, Madhya Pradesh, Orissa, Jharkhand, Uttar Pradesh and Bihar. "Approaches leading to reduction in maternal deaths and safe motherhood need to address a diverse range of issues, from awareness campaigns using community-level mobilisers and animators, improving infrastructure and providing reliable emergency obstetrics care," said a health ministry official.
The major causes of maternal death are excessive bleeding during childbirth (common in home deliveries), obstructed and prolonged labor, infection, unsafe abortion, disorders related to high blood pressure and anemia. Forty-seven percent of maternal deaths in rural India are attributed to excessive bleeding and anemia resulting from poor nutritional practices. Further contributing to MMR, only 15 percent of mothers receive complete antenatal care, and only 58 percent receive any iron/folate tablets or syrup. In rural areas, 75 percent of births still take place at home, mostly without any skilled help to ensure a safe delivery.
For each one of these deaths, between 30 and 100 more women suffer from acute maternal morbidities that are painful, debilitating and often permanently disabling. Moreover, babies of deceased mothers are three to 10 times more likely to die within their first two years than children growing up with both parents. To bring the MMR under control, UNICEF is unveiling a new tool, Maternal and Perinatal Death Inquiries (MAPEDI) method, to help save mothers' lives MAPEDI, developed and implemented with Johns Hopkins University in the US, uses the "verbal autopsy method" to gain insight from people in communities that have the firsthand experience with the tragedy of maternal mortality.
Equipped with a detailed MAPEDI questionnaire, UNICEF India volunteers have begun conducting one-on-one interviews with family members and healthcare workers in five high-risk states. The data collected at these interviews will be analysed and presented to local governments as part of the National Reproductive and Child Health Programme, which is supported by the World Bank and seeks to significantly reduce the MMR.
Evidence from India shows that to reduce maternal deaths the country's health infrastructure needs focused antenatal care, birth preparedness, skilled attendance at birth, post-partum and neonatal essential care within the first 24 hours and the first seven days and access to emergency obstetric care.
Earlier this year, Prime Minister Mammohan Singh observed that MMR in India was higher than in Bangladesh. The National Rural Health Mission, the government's ambitious social service programme launched in April 2005 along with the Reproductive and Child Health programme, is now expected to help India achieve a lower maternal mortality in the next seven years to less than a fifth of current rate of maternal deaths.
Source: Indo-Asian News Service