The Consortium for Affordable Medical Technologies (CAMTech) India and the Public Health Foundation of India (PHFI) attribute the rising maternal and child fatalities to the poor postpartum care which need to be adequate to save from infection.
Postnatal care is a critical component of maternal and new-born health. Immediately after birth, bleeding and infection pose grave risk to the mother’s life, while preterm birth, asphyxia and severe infections threaten the life of a new-born contributing to two-thirds of the neonatal deaths, observed CAMTech and PHFI.
Despite the launch of National Rural Health Mission, Janani Suraksha Yojana and many other schemes targeting maternal, new born and child heath, India still continues to struggle with the global burden of infant, child and maternal deaths which reflect the poor status of some of the basic reproductive maternal, newborn and child health (RMNCH) services in India, noted Dr Priya Balasubramaniam Kakkar, senior public health specialist and director, Universal Health Coverage for India Initiative, PHFI.
Annually over 5,00,000 women succumb to causes related to pregnancy and childbirth, and almost 4 million newborns die within 28 days of birth. There are millions more who suffer from disease, infection, injury and disability, she added.
Appropriate postnatal care, critical to reduce maternal and neonatal problems, is unfortunately one of the most neglected components of maternal care in India, said Dr. Kakkar, who is in Bengaluru for the recent CAMTech India event addressing quality of care and accountability in reproductive maternal, newborn and child health.
Emphasis of the Janini Suraksha Yojana on institutional deliveries driven by compensation package for the delivering woman and ASHA worker has led to sidelining of other important aspects like immediate postpartum contraception that ensure good maternal health. Moreover most women who deliver in public health facilities are discharged within 4-6 hours of delivery due to high workload or lack of space, she noted.
Data from National Family Health Survey-3 indicates that only 42 per cent of women surveyed received postnatal care after their most recent delivery. Urban areas too face health care issues due to lack of knowledge and awareness about health facilities among the urban poor, weak linkages between service providers and communities, and the limited role of communities negotiating capacities.
“Only responsible health system that facilitates and supports safe maternal health, motherhood and childbirth is equally dependent on the care and attention delivered by families and communities. There is also need to ensure expertise of skilled health workers, availability of adequate hospitals, equipment, medicines and emergency care when required. It is time that India’s health policies and programmes that help implement a host of targeted interventions are based on accountable decision making, good evidence and supported by consistent monitoring and evaluation,” Dr Kakkar said.