Monday September 24, 2018

Dreary state of Maternal Health Care in Jharkhand

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By Prachi Salve

New Delhi: This week, as Prime Minister Narendra Modi announced – quoting the World Health Organisation (WHO) – that India was free of maternal and neo-natal tetanus, the state of maternal health in the eastern state of Jharkhand indicates the long road still ahead in the country’s dark spots.

Women_at_farmers_rally,_Bhopal,_India,_Nov_2005
Modi was speaking at the just-concluded 24-nation Call to Action Summit, which discussed how to end preventable maternal and infant deaths, particularly in high-risk areas globally, including Jharkhand.

Since its birth in March 2000, Jharkhand has seen its maternal mortality ratio (MMR), or maternal deaths per 100,000 live births, improve from 261 in 2007-09 to 219 in 2011-12 due to improved access to healthcare.

But this is 41 points higher than the national MMR average of 178 in 2011-12, worse than Myanmar and Nepal and about the same as Laos and Papua and New Guinea, according to WHO data.

Jharkhand is a part of a group of eight poor states, called the empowered action group (EAG), which includes Bihar, Chhattisgarh, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh. The EAG was formed by the central government following the 2001 Census to contain the population explosion in these states.

The real maternal and infant-health problems in Jharkhand are revealed when we compare the state’s health indicators with other EAG states, such as Chhattisgarh and Bihar.

Jharkhand does not fare well on any of the nine key indicators including government schemes, such as the Janani Suraksha Yojana (Mothers’ Protection Programme).

The JSY is fully sponsored by the central government and provides cash incentives, including out-of-pocket expenditure incurred by pregnant women: Rs 1,400 for rural women and Rs 1,000 for urban women.

Jharkhand has the lowest ante-natal care coverage with only 60 percentof women receiving such facilities. Compare that to Bihar with 85.4 percent and Chhattisgarh with 91.8 percent.

Mothers who opted for institutional deliveries in Jharkhand were also low at 23.6 percent, compared to 39.5 percent and 29.2 percent in Bihar and Chhattisgarh, respectively. The women who do use state-run health institutions receive poor quality care.

Seen from the view of those who provide healthcare, they work at substandard facilities and there are too few of them.

The gulf between targets and reality in India’s dark areas

At the Call To Action Summit, Prime Minister Modi talked about how India had achieved 75 percent institutional deliveries nationwide, a significant factor in improving maternal and infant healthcare.

But as Video Volunteers’ ground reports reveal, absolute numbers are not enough: The quality of healthcare is an important draw for women in remote, rural areas. If infrastructure is crumbling, centres lack medical staff and patients must pay out of their pockets-apart from being treated badly-they are unlikely to use institutions.

The idea behind the JSY is to encourage women to deliver babies at health facilities by making these services free and available, especially in rural areas.

Of Jharkhand’s 24 districts, there is a significant urban bias among the bottom five districts, based on maternal-health indicators.

In general, mothers in urban areas received better maternal care in Jharkhand, including facilities under JSY, emphasising the point that poor facilities attract fewer women.

(IANS/IndiaSpend)

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Ebola-Stricken Congo Suffers From A Rebel Attack

The latest Ebola outbreak, which causes hemorrhagic fever, vomiting and diarrhea, is believed to have killed 99 people since July and infected another 48.

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Ebola, congo
The violence "will have a considerable impact on the whole response to Ebola," a local public health official told Reuters on condition of anonymity. VOA

At least 14 civilians were killed on Saturday in a six-hour attack by rebels on the town of Beni in eastern Democratic Republic of Congo, local officials told Reuters, warning the unrest may hamper efforts to quash an Ebola epidemic in the area.

The latest outbreak of the deadly disease has been focused in North Kivu and Ituri provinces, which have been a tinder box of armed rebellion and ethnic killing since two civil wars in the late 1990s.

Militants believed to belong to the Allied Democratic Forces, a Ugandan Islamist group active in eastern Congo, clashed with Congolese troops in Beni, a town of several hundred thousand people, local civil society leader Kizito Bin Hangi said by telephone.

“Beni is ungovernable this morning. Several protests have been declared in the town where the people express their anger with consternation,” he said.

Ebola, UNICEF. congo
A boy runs past a dispenser containing water mixed with disinfectant, east of Mbandaka, DRC. VOA

In addition to the known fatalities, dozens of civilians were wounded as they fled the violence, which broke out in the early hours of Saturday evening and lasted until midnight, Bin Hangi added.

A spokesman for the army declined immediate comment.

The attack underscores the challenges the government and health organizations face in tackling Ebola in an area where years of instability has undermined locals’ confidence in the authorities.

The violence “will have a considerable impact on the whole response to Ebola,” a local public health official told Reuters on condition of anonymity.

“The general hospital which houses one of the Ebola treatment centers was the focus of angry protests this morning.

Ebola, Congo
Little 11-year-old German Umba, whose father died in May of Ebola and who is being monitored by the U.N. for potential signs of infection along with her 6-year-old brother, hides her face in her shirt, sobbing, outside her classroom in Mbandaka, Congo. VOA

This is a normal reaction for a community that is bereaved for the umpteenth time,” the official said.

Also Read: Ebola Increases The Number of Orphans in DRC: UNICEF

The latest Ebola outbreak, which causes hemorrhagic fever, vomiting and diarrhea, is believed to have killed 99 people since July and infected another 48. (VOA)