Progress and Stagnation
Recent studies, including one in The Lancet Obstetrics, Gynaecology & Women’s Health, highlight significant achievements in India's maternal health initiatives,
demonstrating a nearly 80% reduction in maternal mortality since 1990. This remarkable decline is largely attributed to enhanced government programs, an increase in facility-based births, and a greater public understanding of maternal health. However, the momentum has waned since 2015, and India continues to bear a disproportionate burden, accounting for one in ten global maternal deaths. Persistent systemic issues prevent the nation from reaching the Sustainable Development Goal of 70 maternal deaths per lakh births by 2030. Women are still succumbing to preventable causes such as severe bleeding, infections, and hypertensive disorders during pregnancy, underscoring that while access has improved, the quality of care remains a critical bottleneck.
COVID-19's Impact
The COVID-19 pandemic laid bare the vulnerabilities within India's maternal healthcare infrastructure. During the crisis, vital frontline health workers were redeployed to manage the pandemic, leading to disruptions in routine maternal care. This resulted in delayed institutional deliveries and a significant drop in crucial antenatal check-ups. While the government has acknowledged these challenges and initiated programs like LaQshya to improve labor room care and Pradhan Mantri Surakshit Matritva Abhiyan to enhance tracking through anganwadi workers and digital platforms, their effectiveness is hampered by uneven implementation. The decentralized nature of health services, where states hold primary responsibility, means that the success of national programs hinges on local administrative capabilities and political commitment. Reports and the Lancet study indicate that while states like Gujarat, Maharashtra, and those in the South are on track, significant gaps persist in Uttar Pradesh, Madhya Pradesh, Bihar, Rajasthan, Chhattisgarh, Odisha, Jharkhand, and Assam.
Strategic Overhaul Needed
To truly address the persistent maternal mortality rates and meet global targets, a fundamental shift in strategy is imperative. Strengthening primary and secondary healthcare facilities is paramount to ensure early detection and prompt management of potential complications. This requires ensuring functional emergency transport systems are readily available, labor rooms are adequately equipped, specialists are accessible, and blood banks are reliably stocked, as these elements can be life-saving. However, infrastructure development alone will not suffice. Policies must also rigorously consider the social determinants of health. It is a well-established fact that many women, particularly in certain socio-economic groups, consume meals last, leading to nutritional deficiencies like anemia, which negatively impact health outcomes. The Lancet report's crucial message advocating for a holistic approach that intertwines improved healthcare services with empowering women and enhancing their social agency should be a guiding principle for policymakers.
