In India 55000 pregnant women die every year due to preventable causes such as lack of access to health care services, corruption and caste prejudices. In most cases infections and disease are compounded by chronic hunger and malnutrition and a lack of access to affordable pre-birth health care services because of corruption or caste bias. The maternal mortality rate (MMR) deaths per 100,000 live births fell from 212 in 2007 to 167 in 2013 but many deaths are still occurring. The maternal death rates remain the highest in the populous states of Assam, Bihar, MP, Odisha, Rajasthan and Uttar Pradesh the total number of women dying is also high.
To tackle this Government of India launched the Pradhan Mantri Surakshit Matritva Abhiyan to provide free antenatal care to pregnant women on the 9th of every month at government health centers and hospitals across India’s 687 districts. Building on the National Health Mission’s flagship Janani Suraksha Yojana all pregnant women must be given a physical and abdominal examination, a tetanus shot and 100 iron folic acid tablets. They must also be tested for anemia, high blood pressure, high blood sugar and other problems linked with pregnancy to lower India’s MMR and infant mortality rate (deaths of children under five years of age per 1000 live births).
Women in the lowest socio-economic sections in India are two and a half times more likely to die of childbirth largely because they don’t get the medical support they need to deliver a healthy baby. A maternal death also adversely affects the health of new born and surviving children who get trapped in a vicious cycle of malnutrition, stunting and wasting. Incomplete antenatal care also lowers the chances of the mother and child’s survival. Malnutrition begins after six months when the baby needs additional nutrition that the mother is not able to provide. That’s when weight drops and wasting sets in making the baby susceptible to infections such as pneumonia and diarrhea.
Frequent infections aggravate chronic hunger with most severe acute malnutrition deaths taking place between nine months and five years. Apart from saving mothers, antenatal care and institutional deliveries boost chances of newborn survival. Under the JSY, all services for the mother and her new born are free and incentives are given to families to opt for institutional deliveries yet corruption and apathy in the public health system make the poor hesitant in accepting services.
Hospital staff sometimes demands a bribe up to Rs 500 for a delivery because they know mothers get Rs 1400 for an institutional delivery. But since the money is transferred directly to the parent’s bank account villagers have no money to give hospital and clinic so they opt for home deliveries.