MATERNAL AND NEWBORN DEATHS IN INDIA

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Context: The United Nations (UN) has recently released a report that reveals the alarming state of maternal and newborn health and survival around the world.

Details

• The United Nations (UN) has recently released a report, titled Improving Maternal and newborn health and Survival and reducing stillbirth, shows that despite over 4.5 million women and babies dying every year during pregnancy, childbirth or the first weeks after birth, global progress on mitigating this has halted since 2015.

Highlights of the Report

• The report highlights the major causes and risk factors of these deaths, which are mostly preventable or treatable with proper care.
• It tracks the provision of critical health services, such as antenatal care, skilled birth attendance, emergency obstetric care, newborn care units, and family planning.
• It finds that many countries need to provide these essential services to all women and babies who need them, especially in conflict zones and humanitarian crises.
• According to the report, over 5 million women and babies die every year during pregnancy, childbirth or the first weeks after birth. This is equivalent to one death happening every seven seconds.

Regions and Countries

• The report also shows the uneven distribution of these deaths across regions and countries.
• Sub-Saharan Africa and Central and Southern Asia are the regions with the highest burden of maternal and newborn deaths, accounting for 80% of all such deaths globally.
• India alone accounts for 17% of global maternal deaths, stillbirths, and newborn deaths, followed by Nigeria (10%), and Pakistan (7%).

Calls for urgent action

• The report calls for urgent action to reverse this trend and accelerate progress towards achieving the Sustainable Development Goals (SDGs) related to maternal and newborn health.
• It urges governments, donors, civil society, and other stakeholders to invest more and smarter in primary healthcare systems that can deliver quality care to every woman and baby, regardless of where they live or their socioeconomic status.
• The report urges countries to prioritize maternal and newborn health in their COVID-19 recovery plans. It warns that without immediate action, millions more women and babies will die unnecessarily in the coming years.

Address the gaps and challenges

• The report calls for urgent action to address the gaps and challenges in maternal and newborn healthcare delivery.
• It recommends;
  • Increasing political commitment and financing for primary health care.
  • Strengthening health systems to provide quality care for all women and babies.
  • Improving data collection and use for decision-making.
  • Fostering innovation and research.
  • Enhancing multisectoral collaboration and accountability.
• It advocates for strengthening data collection and monitoring systems to track progress and identify gaps and challenges.

Challenges

• The report highlights that the COVID-19 pandemic, rising poverty, and worsening humanitarian crises have intensified pressures on stretched health systems.
• One in 10 countries (of more than 100 surveyed) reports having sufficient funds to implement their current plans.
• Around 25 per cent of countries still report ongoing disruptions to vital pregnancy and postnatal care and services for sick children.

Maternal and Newborn Deaths in India

About

• India is a country with a huge population and a high rate of childbirth. However, it also faces the serious challenge of reducing maternal and newborn deaths, which are among the highest in the world.
• According to a recent report by the United Nations, India is among 10 countries that account for 60% of global maternal deaths, stillbirths and newborn deaths.
• Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management.
  • Stillbirth is defined as a baby born with no signs of life at or after 28 weeks of gestation.
  • Newborn death is defined as the death of a live-born baby within the first 28 days of life.

Common causes of maternal and newborn deaths

• Haemorrhage: Excessive bleeding during or after childbirth, which can lead to shock and death.
• Infection: Bacterial or viral infections that affect the mother or the baby, such as sepsis, tetanus, pneumonia, meningitis, etc.
• Pre-eclampsia and eclampsia: A condition characterized by high blood pressure and protein in the urine during pregnancy, which can cause seizures and stroke in severe cases.
• Obstructed labour: A condition where the baby cannot pass through the birth canal due to its size, position, or shape, or due to a problem with the mother’s pelvis or uterus.
• Complications of unsafe abortion: Injuries or infections caused by unsafe methods or untrained providers of induced abortion.
• Birth asphyxia: A condition where the baby does not breathe adequately at birth, leading to brain damage or death.
• Prematurity: A condition where the baby is born before 37 weeks of gestation, which increases the risk of infections, breathing problems, bleeding in the brain, etc.
• Congenital anomalies: Birth defects that affect the structure or function of the baby’s organs or body parts.

Factors that contribute to this situation

• Lack of skilled birth attendants and emergency obstetric care
• Lack of antenatal and postnatal care
• Lack of family planning and contraception services
• Lack of awareness and education on maternal and newborn health
• Socio-cultural barriers and gender discrimination
• Poverty and malnutrition

Challenges

• Inequitable access to quality maternal and newborn health services, especially for the poorest and most marginalized populations, such as tribal communities and urban slums.
• Low coverage of essential interventions, such as early and exclusive breastfeeding, skilled birth attendance, emergency obstetric care, and postnatal care.
• High burden of preterm births, birth defects, and infections, which account for most of the newborn deaths in India.
• Socio-cultural barriers and gender discrimination affect care-seeking behaviour and health outcomes for mothers and newborns, especially for girls.

Initiatives taken to improve maternal and newborn health

• Janani Suraksha Yojana provides cash incentives to pregnant women for institutional deliveries.
• Pradhan Mantri Matru Vandana Yojana, to provide maternity benefits to eligible women.
• Pradhan Mantri Surakshit Matritva Abhiyan, to provides free antenatal check-ups for
• LaQshya initiative is to improve the quality of care during delivery and the immediate postpartum period.
• India Newborn Action Plan outlines a roadmap to end preventable newborn deaths and stillbirths by 2030.
• Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) programme, integrates interventions across different stages of life and different levels of care.
• Janani Shishu Suraksha Karyakram (JSSK), provides free transport and care for pregnant women and sick newborns in public health facilities.
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), provides antenatal check-ups by qualified doctors on the 9th of every month for pregnant women.
• The National Health Mission (NHM) supports the implementation of various maternal and newborn health initiatives at the state and district levels.

Steps need to be taken

Increasing access

• Increasing access to quality health care for women and children, especially in rural and remote areas, through strengthening primary health care systems, improving referral networks, expanding the health workforce and ensuring the availability of essential medicines and equipment.

Adequate Financial support

• Enhancing political commitment and financial investment for maternal and newborn health, through mobilizing domestic resources, allocating adequate budget, implementing effective policies and strategies, and engaging with civil society and private sector partners.
• India needs to address the gaps in coverage, quality and equity of health services for mothers and babies. It needs to invest more in human resources, infrastructure, equipment and supplies for maternal and newborn health.

Enhance monitoring

• Improving data collection and monitoring for maternal and newborn health, through strengthening civil registration and vital statistics systems, conducting regular surveys and audits, using digital technologies and platforms, and generating disaggregated data for equity analysis.
• India needs to improve the registration and reporting of births and deaths. It needs to engage with communities and families to raise awareness and demand for maternal and newborn health services.

Awareness

• Promoting community awareness and empowerment for maternal and newborn health, through increasing health literacy, addressing social norms and barriers, involving men and families in decision-making, and supporting women's rights and choices.
• India needs to ensure that every woman has access to skilled birth attendance and emergency obstetric care when needed. It needs to promote early initiation of breastfeeding and exclusive breastfeeding for six months.

Conclusion

• The UN report on maternal and newborn health is a wake-up call for the world to take action now to save the lives of millions of women and babies who are dying unnecessarily every year. It is also a reminder that improving maternal and newborn health is not only a moral obligation but also a smart investment that can yield multiple benefits for individuals, families, communities, and societies.

Must Read Articles:

Maternal Mortality Rate: https://www.iasgyan.in/daily-current-affairs/maternal-mortality-rate-31

Infant Mortality Rate: https://www.iasgyan.in/daily-current-affairs/infant-mortality-rate-imr

Child Mortality Rate: https://www.iasgyan.in/daily-current-affairs/child-mortality-indicators

PRACTICE QUESTION Q. Maternal and newborn health is a crucial issue that affects the lives and well-being of millions of women and children in India. According to a UN report, India had the most maternal deaths, stillbirths and neonatal deaths in 2020, accounting for 17% of such deaths globally. How can India improve its maternal and newborn health indicators by addressing the challenges of access, quality and equity in health service delivery?

https://www.downtoearth.org.in/news/health/un-progress-in-tackling-maternal-as-well-as-newborn-deaths-stagnant-since-2015-89229