Need to develop effective surveillance system
A recent report of the British medical journal, lancet, on maternal mortality deaths, is worrying. It says that India accounts for one-third of the total maternal deaths in the world. Around 45,000 mothers dying either during pregnancy or in child-birth indicates a lack of adequate maternal healthcare here. The falling standards of basic healthcare in the vast public health system must be addressed. The under-five mortality rate (U5MR) in India is higher than in the advanced countries, so this brings into focus the post-natal healthcare facilities in the country. Another report published by the same journal in 2015 records that one in five under-five deaths took place in India.
This was 20 per cent of the total global deaths. The point hammered home by these reports is clear: There must be a thorough review of the existing medical facilities, particularly at the grassroots level. The most vulnerable sections of society are those that cannot afford quality healthcare. To achieve the underlying objectives of the UN Sustainable Development Goals, the focus should be to make basic health facilities available to all. The reduction of maternal mortality has been a part of the UN Millennium Development Goals and a key concern of the Global Strategy for Women's and Children's Health initiated by the UN Secretary General in 2010. To achieve this, further understanding is to be developed on the main causes of deaths, and the decisions on health programmes taken by countries like India, where such deaths have been an issue. Details of maternal deaths due to direct or indirect causes should be collected with extreme care. Unfortunately, a poor registration system and the absence of data, among other things, have caused problems in the identification of the causes of maternal deaths in developing countries like India.
Besides, the lack of access to quality healthcare and the non-availability of essential medicines at affordable price could be one of the root causes of maternal deaths in rural areas. Another disheartening trend is the lack of skilled birth attendants in poor countries, which leads to complications during child-birth. The global trends released by the lancet report underline that absence of basic resources like water, electricity, power and sanitation, largely affects the maternal health system. This reflects how we need to stress on aligning our developmental goals with an improvement in basic healthcare systems. The maternal mortality rate is decreasing in advanced countries, but there is a huge variation between national and international levels. An improved surveillance system needs to be developed and put into action for registering the causes of maternal deaths. India will soon achieve one of the MDG goals, as its under-five mortality has recorded a four-point decline — from 49 deaths per 100 deaths in 2013 to 45 in 2014. As India’s MDG target is 42, the country is on its way to achieving the target despite odds.