~Archa A J
Introduction
Women’s health throughout pregnancy, delivery, and after delivery forms maternal health (WHO). Improved maternal healthcare translates into improved newborn health and economic development. Evidence (2000-2017) for South Asia indicates inefficient use of resources and inefficient quality of care services as key determinants of high maternal mortality rates. Inefficient budgeting, inefficient healthcare facilities, and cultural beliefs hinder access. Population growth also puts pressure on maternal healthcare services.
India is prone to maternal healthcare inequality due to economic recessions, government inefficiency, social norms, and living standards. Conditions of delivery, antenatal care coverage, and postnatal care are the strongest determinants. Caste differentials exist, and SC/ST groups have poorer outcomes. Interstate variability and household assets also influence accessibility.
Consequences of Maternal Death
A study from Sub-Saharan Africa discovered that maternal mortality negatively correlates with per capita GDP. Better maternal health enhances workforce participation, productivity, and intergenerational gains. Better conditions in terms of child health result from decreased maternal mortality.
.Comparative Analysis: Uttar Pradesh and Kerala
- The Fifth Annual Health Index (2020-21) places Kerala at rank one and Uttar Pradesh at rank 20 out of 20 large states in the healthcare level. The two states are very different regarding children’s health indicators, beliefs, and economic conditions.
- Antenatal Care (ANC): 47.8% of UP pregnant women got ANC from a doctor, while 97.9% did in Kerala. Nutrition counseling among mothers included 75.6% of UP fathers and 93.5% of Kerala fathers. Facility birth in India is 86%, in Kerala 100%, and in UP 84%.
- Adolescent Pregnancy: UP’s 15-19 years age-specific fertility rate is 22 and in Kerala, it is 18. It indicates that UP needs more campaigns.
A Positive Correlation between Birth Interval and Education (General Trend)
- Studies reveal that more excellent education among women increases child health and improves birth spacing. Short birth intervals of fewer than 24 months are related to risks of stunting (28%) and underweight (26%). Nutritional education of mothers lowers the prevalence of stunting.
- More educated women will postpone childbearing and have improved maternal and child health. Improved health awareness means more family planning and more medical care. Mother education in nutrition was seen to avert instances of children being stunted.
An Inverse Relationship Between Schooling and Intervals Between Births in Kerala and Uttar Pradesh
- The median years of schooling in UP are 4.3, while in Kerala are 9. Kerala does not follow the overall pattern of years of schooling and birth spacing.
- Birth Interval Data: In UP, 9.3% of the women with <5 years of education had an interval of 7-17 months. In Kerala, even after 8-9 years of education, 11.2% of them had the same interval.
Here, the unhealthy and short birth interval of 7-17 months is considered. According to NFHS-5 data, women in Kerala experience a shorter interval than in Uttar Pradesh. This does not imply that children in Kerala have more instances of stunting. This association is not significant in the case of Uttar Pradesh and Kerala because Uttar Pradesh has more instances of stunting than Kerala. Stunting among children aged 0-59 months is 23% in Kerala and 40% in Uttar Pradesh (NFHS-5). The research not only rejected the fact that more excellent education leads to an increased birth gap but also rejected the fact that a shorter birth gap results in more stunting because Kerala, with a higher percentage of women having a 7-17 month gap compared to Uttar Pradesh, has much lower rates of stunting as shown in the graph below. Hence, in the case of Kerala and Uttar Pradesh, the greater the mother’s education, the lower the instances of stunting among children, even when the birth interval before the birth is high.
Policy Interventions
There are several schemes introduced by the government of India to provide quality maternal health care to mothers. Schemes like Janani Suraksha Yojana( JSY), Janani Shishu Suraksha Karyakram (JSSK), and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) are examples of the schemes. The study and discussions enable an understanding of the schemes’ scope and reach. Schemes like JSY focus on bridging the gap in accessing institutional and safe delivery. At the same time, the PMSMA focuses on enabling quality antenatal care to mothers around the nation. This scheme plays a crucial role in reducing the maternal mortality rate in India and also helps control the neonatal mortality rate. Integrating digital platforms like the RCH portal helps improve the transparency and accountability of the services.
Concerns: There are challenges in effectively implementing the schemes. The success of JSY depends upon awareness programs and timely registration in the areas. This unevenness across the states also causes gaps in the scheme’s efficiency. The lack of specialists available under the PMSMA scheme causes concerns. While the RCH portal and digital platforms are still evolving, unevenness in digital literacy across the states of India causes hindrances in efficiency.
Conclusion
Maternal morbidity and mortality are unacceptable and need more significant policy intervention. India is lowering the maternal mortality rate but insufficiently. Increased financial investment in education will directly impact maternal health outcomes for Uttar Pradesh and Kerala. Benefits cutting across several states and socio-economic classes are needed. In addition, effective measures toward increased awareness of family planning, strengthening scientific thinking, and changing the mindset of society are also required.
References
Singh, Lucky, et al. “Coverage of Quality Maternal and Newborn Healthcare Services in India: Examining Dropouts, Disparity and Determinants.” Annals of Global Health, vol. 88, no. 1, Jan. 2022, https://doi.org/10.5334/aogh.3586.
Kumar, Abhishek, and Aditya Singh. “Explaining the Gap in the Use of Maternal Healthcare Services Between Social Groups in India.” Journal of Public Health, Dec. 2015, p. fdv142. https://doi.org/10.1093/pubmed/fdv142.
Viswanathan, Kaladharan Perumpaparmpil, and Vineesh K. Appunni. “COMPREHENSIVE ANALYSIS OF MATERNAL MORTALITY IN INDIA: STATISTICAL, ECONOMIC, AND GLOBAL CONTEXTS.” UGC Sr. No. 1208 RESEARCH DIRECTIONS, by Sree Neelakanta Govt. Sanskrit College Pattambi and Govt. College Munnar, vol. 9, no. 6, Dec. 2018, p. 208.
Bhatia, M., et al. “Pro-poor Policies and Improvements in Maternal Health Outcomes in India.” BMC Pregnancy and Childbirth, vol. 21, no. 1, May 2021, https://doi.org/10.1186/s12884-021-03839-w.
Government of India. INDIA REPORT. Mar. 2022, dhsprogram.com/pubs/pdf/FR375/FR375.pdf.
Heckman, James J. and Center for the Economics of Human Development. Key Quotes. 7 Dec. 2012, cehd.uchicago.edu/wp-content/uploads/2016/12/Quotes_2016-08-02_mb.pdf.
Chungkham, Holendro Singh, et al. “Birth Interval and Childhood Undernutrition: Evidence from a Large Scale Survey in India.” Clinical Epidemiology and Global Health, vol. 8, no. 4, Dec. 2020, pp. 1189–94, https://doi.org/10.1016/j.cegh.2020.04.012. Accessed 9 Mar. 2021.
Recent Comments