Rehan A. Khan, Managing Director, MSD India talks about the need for quality maternal healthcare in India
Maternal mortality is a litmus test for the efficacy and strength of the healthcare system, as well as the extent of women’s empowerment and socio-economic development in the country. Most maternal deaths are preventable and are often caused by a structurally weak healthcare. There is no excuse for countries not to focus on stepping up maternal care because it is the right of women, and there is no excuse for oversight.
The importance of a strong maternal healthcare system is underlined by the fact that a nation’s long-term socio-economic progress relies on healthy mothers and healthy babies. The quid pro quo aside, every nation has the responsibility to ensure that women have an enabling environment where they can give birth and celebrate the arrival of a new life.
The COVID-19 pandemic has, no doubt, impacted healthcare delivery systems. But its impact on maternal health delivery is even more profound as the focus has shifted from critical care priorities such as maternal and neonatal care.
While the loss of a mother’s life is an individual tragedy, it has deep, longitudinal impacts on her children, family, and community at large – particularly in underserved and low-income communities. There is evidence on the intergenerational ripple effects of maternal deaths on education, employment, financial stability, and other socio-economic indicators.
Maternal deaths are often linked to high infant mortality-babies who lose their mothers during childbirth are far more likely to die before they turn one, and ten times more likely to die before age two. For older surviving children, several detrimental impacts come to play such as the loss of education, malnutrition, child labor, ill-health, and unemployment in the long run. Young girls are disproportionately impacted and are often embroiled in household responsibilities, early marriage, and early pregnancy, once again unable to break the intergenerational cycle.
The good news is that India has been able to make great strides in reducing maternal mortality. The government’s concerted efforts in incentivizing institutional births and improving access to quality care have led to a massive decrease in the Maternal Mortality Ratio (MMR), from 254 per 100,000 live births to 113 in just a decade.
However, India still loses 32,000 mothers every year to pregnancy and childbirth-related complications. This stems from fragmented access to quality healthcare, which is divided along socio-economic lines and deepening health inequities. The average percentage of women in India who don’t receive any antenatal care (ANC) is 16.4% (National Family Health Survey-4).
In Kerala, which outperforms most states in India on development indicators, this number is just 0.6%, while in Bihar, it is a whopping 43.9%. Similarly, the percentage of women in Kerala receiving ANC from a skilled provider is 99.2% vis-à-vis Bihar at 49%. These regional disparities – not only between states but within states when one examines the urban-rural divide – point to socio-economically engineered inequities in healthcare access and delivery. This must change and women are demanding it.
To meet the SDG 3.1 target of reducing MMR to 70 per 100,000 live births by 2030, these gaps must be bridged. We must focus on integrating health equity with a special focus on maternal health. We must standardize quality health care services across maternity facilities so that every woman has access to evidence-based standards of quality and life-saving care, no matter where she is.
Manyata, a quality improvement and certification initiative for private-sector facilities, aims to precisely do that – particularly for low-income mothers in underserved communities. By training healthcare staff in rural and semi-urban areas on 16 clinical standards, aligned with national and WHO guidelines, Manyata is equipping providers with the tools to provide high-quality, life-saving care to mothers and newborns in hard-to-reach areas. The initiative is active in 14 states across the country, and serves 27 aspirational districts where quality care access, delivery, and standardisation are needed most crucially to save mothers’ lives.
With initiatives such as these, which can be scaled across the country and integrated into the government’s efforts, maternal deaths can be prevented. And ensuring the wellbeing of mothers is our real investment in the future of our nation. It is the MomEffect.
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