Monday April 22, 2019

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)

Next Story

Avoid Smoking During Pregnancy To Prevent Premature Births

The negative health impacts of cigarette smoking during pregnancy, including low birth weight, delayed intrauterine development, pre-term birth, infant mortality, and long-term developmental delays, are well known. 

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The researcher plans to look at quit rates and smoking intensity and their impact on the risk of infant mortality. Pixabay

Expecting mothers, take note. As smoking during pregnancy is linked with negative health outcomes, a team of researchers has found that smoking cessation during pregnancy may reduce the risk of pre-term birth.

The findings, published in the JAMA Network Open journal, showed that the probability of pre-term birth decreased with earlier smoking cessation in pregnancy — up to a 20 per cent relative decrease if cessation occurred at the beginning of pregnancy.

baby
If we determine quitting, and quitting early, reduces the risk of infant mortality, then that may speak to mothers even more saliently about the importance of smoking cessation. Pixabay

“Of concern, though, given the substantial benefits of smoking cessation during pregnancy is that the proportion of pre-pregnancy smokers who quit smoking during pregnancy has remained essentially stagnant since 2011,” said lead author Samir Soneji from The Dartmouth Institute for Health Policy and Clinical Practice in the US.

For the study, the researchers conducted a cross-sectional study of more than 25 million pregnant women who gave birth to live neonates during a six-year period — measuring their smoking frequency three months prior to pregnancy and for each trimester during pregnancy.

The negative health impacts of cigarette smoking during pregnancy, including low birth weight, delayed intrauterine development, pre-term birth, infant mortality, and long-term developmental delays, are well known.

But the good news is that the proportion of women who start their pregnancy as smokers has been declining in recent years, the researchers said.

smoking

The findings, published in the JAMA Network Open journal, showed that the probability of pre-term birth decreased with earlier smoking cessation in pregnancy — up to a 20 per cent relative decrease if cessation occurred at the beginning of pregnancy. Pixabay

However, the study also found that only about 25 per cent of women who smoked prior to pregnancy were able to quit throughout their pregnancy, and approximately 50 per cent of women who smoked during their pregnancy did so with high frequency (more than 10 cigarettes per day).

The researcher plans to look at quit rates and smoking intensity and their impact on the risk of infant mortality.

Also Read: How Netflix Binge-Watching Can Lead You The “Mean World Syndrome”

“Thankfully most premature babies end up doing well,” he said.

“But premature birth is strongly linked to infant mortality. If we determine quitting, and quitting early, reduces the risk of infant mortality, then that may speak to mothers even more saliently about the importance of smoking cessation,” he added. (IANS)