Maternity and New-Born Health Schemes in India
According to the report Trends in Maternal Mortality: 1990 to 2015, the global maternal mortality rate (MMR) fell by nearly 44% over the past 25 years, to an estimated 216 maternal deaths per 100,000 live births in 2015, from an MMR of 385 in 1990. The approximate global lifetime risk of dying during maternity dropped considerably from 1 in 73 to 1 in 180. Developing regions are where 99% of the global maternal deaths occurred in 2015. India, along with Nigeria, accounted for approximately one-third of all maternal deaths across the world in 2015. Approximately 45,000 maternal deaths occurred in India in 2015, while Nigeria saw 58,000 maternal deaths during the same period. India’s MMR was 174 in 2015, still far from the Millennial Development Goal of 70 maternal deaths per 100,000. Progress has remained slow due to the ineffective implementation of the various schemes that the Indian government has launched, to safeguard the health of mothers and their new-born children. Leave alone a painless delivery, thousands of women in India still don’t have access to proper medical attention during their pregnancy and delivery.
Schemes in India for Pregnant Women and New-born Children
There are various schemes under the National Health Mission run by the Ministry of Health and Family Welfare of the government of India. Some of these schemes are as follows.
a) Janani Shishu Suraksha Karyakram (JSSK): This scheme was launched on 1st June, 2011, and provides free treatment, along with free drugs and other consumables, free diagnostics and diet advice, free provision of blood, free transport from home to health institutions and back, and free transport between facilities in case of referral, for pregnant women and ill new-born children for up to 30 days after birth.
b) Facility Based New-Born and Child Care: Neonatal morbidity in India contributes to two-third of infant mortality. Thus, states have been asked to set up at least one Special New-Born Care Unit in each district. New-Born Stabilization Units are to be set up in community health centers, while New-Born Care Corners should be present at every facility where deliveries take place.
c) Home-Based New-Born Care: This is a scheme that incentivizes ASHAs (Accredited Social Health Activists) to visit new-born children and their mothers for up to 42 days after delivery. The ASHA worker would have to record the weight of the baby, ensure initial vaccinations such as the first dose of the oral polio vaccine, the DPT vaccine and the BCG vaccine, and make sure that the new-born and the mother are safe and healthy.
d) Janani Suraksha Yojana (JSY): According to pacsindia.org, the aim of JSY is to get poor pregnant women to give birth in registered health institutions with proper medical staff. The scheme was launched in April 2005 across all the states of India, with a special emphasis on low-performing states, where less than 25% of women give birth in a health institution. The ASHAs have a role here, to identify the pregnant women in their area who can benefit from the scheme, educate these women as to the benefits of institutional delivery, help these pregnant women get at least three ante-natal checkups, including tetanus injections and iron folic acid tablets, prepare birth plans and escort these women to the health center for delivery, arrange immunization for the new-born child, and provide breast-feeding and other support to the new mother. The mothers receive monetary compensation for registering at the health institution, as does the ASHA worker.
Lack of Adequate Spending on Healthcare in India
Despite all these schemes being available, the MMR in India remains far from the Millennium Development Goal. According to an article on financialwxpress.com, healthcare spending in India was just 1.3% of GDP in the past two years, putting India in 143rd place among the 190 countries ranked by the World Health Organization’s Universal Heath Coverage Index. As an article on rainbowhospitals.in suggests, proper care for the mother, including options such as painless delivery, can be very helpful to the mother during the strenuous time of delivery of her child.