Tuesday July 16, 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.

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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

Know How Football is Protecting Tribal Girls in Jharkhand from Poverty, Trafficking and Child Marriage

"I was all awkward wearing the sports gear, and afraid of people judging me," she reminisced

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"Football has changed my stand in the society and without it, I would have simply dropped out of school like many other girls in my village," she said. Wikimedia Commons

As an uneducated tribal woman, Tetri Devi, 51, has seen many struggles, but seeing her youngest child, Anshu Kacchap, scale heights in football and visit the UK to play an inter-school football tournament has brought alive dreams, hopes and the zeal to continue her fight against the naysayers. Girls like Anshu are breaking the mould and smashing the glass ceiling with football.

Tetri revealed that when Anshu started playing football, everyone in the community, including her husband, was against the idea. “A girl wearing shorts and spending time playing football was not only looked down upon but was fiercely opposed by many. I remember being stopped by villagers concerned about me allowing the girl to play football and being called out for being a bad mother,” she said, adding that every snide comment she ignored and every advice she didn’t heed was “worth the trouble”.

With her husband unemployed for the larger part of the year, Tetri earns a living for her family of six – among them four daughters, of whom Anshu is the youngest – by selling Hadiya, a locally brewed rice beer in the nearby haats (rural market) in Pahan Toli, a remote village on the outskirts of Ranchi. Football has given her and her daughter a reason to dream again.

Anshu has been associated with OSCAR (Organization for Social Change, Awareness and Responsibility) Foundation’s football training programme, which runs from Chari Huzir on the outskirts of Ranchi, for five years now. She has not only represented Jharkhand in national tournaments but has also been one of the eight girls from Jharkhand who played in a UK Schools Tour, OSCAR ‘Kick Like a Girl’ in October last year.

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Not only has she inspired her elder brother to resume education, but also many other children in her village to become a part of the change that football has initiated in her life. Wikimedia Commons

The transformation through football wasn’t an easy one for the 200-odd girls who have taken to the sport around Irba and Kanke. Social stigma aside, acute poverty and challenges like the lack of even a single square meal, looming threats of early marriage and absence of support from their families have been a problem for these tribal girls, living about 30 kilometres from Ranchi. Through all the struggle, football has been their tool against fear, one kick at a time.

Shital Toppo, a student of commerce at a local college, said she was in disbelief when she found out she would be going to Russia in 2018 to watch a FIFA World Cup match as a part of the Football for Hope Movement, a project of FIFA to promote football as a medium for development and growth. She said the first time she went on the field, she couldn’t even manage to kick the ball for the first week.

“I was all awkward wearing the sports gear, and afraid of people judging me,” she reminisced. But it wasn’t all bad for Toppo, who played a friendly match with other members of the delegation from all over the world. She even befriended a representative from Brazil, Barbara.

“Football has changed my stand in the society and without it, I would have simply dropped out of school like many other girls in my village,” she said. Not only has she inspired her elder brother to resume education, but also many other children in her village to become a part of the change that football has initiated in her life.

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Social stigma aside, acute poverty and challenges like the lack of even a single square meal, looming threats of early marriage and absence of support from their families have been a problem for these tribal girls. Pixabay

For Tinky Kumari, 16, like hundreds of young girls in the area, an early wedding was supposed to celebrate her passing the matriculation examinations. Her elder brother, a school dropout himself, forced her to work as a farm labourer but football became her weapon of protest.

“My brother didn’t hesitate to beat me up just to stop me from playing football,” she recalled. She said her trip to the UK was a turning point as now everyone in her family has finally stopped talking about marrying her off. With her parents’ support, she is now continuing her education.

The narrative of how football empowered these village girls is a story that never fails to inspire. Helena Tete, 53, has been mentoring the girls since the early days of the programme. She has been a witness to the story of these girls and how football has empowered them to become what they are.

She recalled that when the training started in 2013, the girls taking part in the training were scared and hesitant. Their families were reluctant as they didn’t see a future in sports for them, she said. “Today, every time they play a national tournament or win a match, it is such a proud moment for us,” she added.

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The transformation through football wasn’t an easy one for the 200-odd girls who have taken to the sport around Irba and Kanke. Wikimedia Commons

Started in Chari Huzir in Kanke block, the programme by OSCAR foundation now covers eight different tolas (a group of villages). A few players from the training institute have made it to Under-15 and Under-17 teams of Jharkhand.

Though professional football will not be a part of the larger plan for many girls, for now they are rewriting their life through a sport that has helped them realise their worth in the world.

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“I started playing football when I was in class eight and I arrived on the field wearing a traditional skirt,” recalled Anshu. She thought people would make fun of her but instead, she became less conscious over time and mastered the sport.

She noted that the most important factor in her story was her mother’s decision to let her play. “As I teach young girls now, it feels good to be a person who others look up to,” added Anshu, who dreams of taking her football career forward along with higher studies. (IANS)