National Safe Motherhood Day is observed on 11 April every year. The focus this year is on respectful maternity care (RMC). RMC is a universal human right that is due to every childbearing woman in every health system around the world.
Women’s experiences with maternity caregivers can empower and comfort them, or inflict lasting damage and emotional trauma. While many interventions aim to improve access to skilled birth care, the quality of relationships with caregivers during maternity care has received less attention
Safe Motherhood Day aims at enforcing the strong voice that all women should have access to care and no maternal death is acceptable. Maternal death has a devastating impact not only on the family and communities, but is especially so for the surviving children. A newborn baby is more likely to die within its first two years without its mother.
Situation in India and Jharkhand
About 8.3 lakh women give birth every year In Jharkhand, of them 1726 women die during delivery (SRS 2013). The Maternal Mortality Ratio (MMR) estimates have dropped from 371 maternal deaths per 100,000 live births during 2001-03 to 208 maternal deaths per 100,000 live birth (SRS 13). In Jharkhand, highest number of deaths occur in Palamu region (302/100,000 live births) as compared to other regions of Jharkhand (AHS 2012-13).
The Government of India is committed to the Sustainable Development Goals (SDGs) which aim to bring down the maternal mortality ratio in India to 70 from the current level of 167 by 2030. It seeks to “accelerate the decline of maternal mortality” by ensuring that “all women have access to high-quality delivery care: a skilled attendant at delivery, access to emergency obstetric care in case of a complication and a referral system to ensure that those women who experience complications can reach life-saving emergency obstetric care in time”.
How can death of mothers be prevented
Ensure delivery in hospitals/institutions or by skilled birth attendant –
Ensuring institutional deliveries and proper care around birth for mother and baby can avert maternal and neonatal deaths by 40%. At present only 56% deliveries are conducted in institutions (Ministry of Women & Child Development’s Rapid Survey on Child – RSOC 2013) which means 3, 70,000 mothers are still delivering at home. Making these deliveries safe by promoting institutional deliveries is most important intervention to prevent these deaths.
Reduce maternal anaemia and improve ante-natal care (ANC) –
In Jharkhand, the prevalence of anaemia among women (18-59 years) is highest amongst all states at 84.5% (Clinical, Anthropometric and Biochemical survey – CAB 2014). Two-thirds of adolescent girls (15-19 years) are anaemic. Maternal anaemia is a major cause for death of mothers during delivery due to haemorrhage which in turn is most common cause of maternal deaths. It is important to ensure all pregnant women get IFA tablets and at least three ANC services during Village Health and Nutrition Days.
Postnatal care for mothers and newborns –
Postnatal care (within 24-48 hours of delivery) is the most critical period as most deaths occur within this time frame. Therefore all mothers should be monitored regularly for excessive bleeding, pain and infection during this period.
Stop child marriages –
Child marriage is a major indirect cause for maternal mortality because of early conception and early delivery. Girls who become pregnant as adolescents have an increased risk of death. Their babies are also at risk of infection, malnutrition and death.
Invest in girl’s education –
Education is the best guarantee for preventing child marriage, empowering adolescent girls and ensuring better health.
UNICEF in Action
UNICEF has partnered with the Government of Jharkhand (GoJ) to promote simple interventions which can significantly improve maternal survival. UNICEF is committed to reduce maternal deaths in the state and has partnered with the GOJ to support training of skilled birth attendants; Village Health and Nutrition Days (VHNDs) to reach out to pregnant women in underserved areas & hard-to-reach area and community; facility based review of maternal deaths; and supplementation of iron in all age groups, especially adolescents and pregnant women.
Community participation to avert such deaths by promoting care around birth is very much essential. Newly elected PRI member can play vital role in strengthening maternal care and awareness creation for safe deliveries. All PRI members are requested to take cognizance of the maternal deaths in their panchayat and prepare a plan to reduce it.
Special gram sabhas are planned from 14 April 2016 across the state to make PRIs and communities aware of the availability of Mamta Vahans in their panchayat to transport pregnant women to delivery points on time; ensure 100% registration of pregnant women in villages where institutional delivery is low and most of the deliveries occur at home; increasing awareness about the nearest delivery point where all services are given free of cost to pregnant women and infants (children below the age of 1 year).