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High Maternal Mortality Rates in India

23/11/09November 23, 2009

536,000 women die every year due to complications related to childbirth, according to the latest UN report on the subject. While many regions have experienced a major reduction, Sub-Saharan Africa and South Asia are far from reaching the millennium goals on reducing maternal mortality.

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Women, particularly in rural India, have poor health facilities
Women, particularly in rural India, have poor health facilitiesImage: AP

With 117,000 maternity deaths per year, India accounts for a quarter of worldwide deaths. Medically, many of these deaths are preventable. It is only due to a lack of access to health care that many pregnancy complications prove fatal.

“There are socio-economic factors that play a very important role in maternity deaths,” says Melissa Upreti, the Regional Manager for Asia at the US-based Centre for Reproductive Rights. “It’s mostly poor women who die or suffer complications during pregnancy.”

Fight against tradition

There is a rural bias, too. Villagers have to cross distances of an average of 40 kms to reach the next district hospital, often to find that doctors are not even present.

70% of the population live in Rural areas, but receive only a quarter of the health expenditure. As a result, half of the births take place without trained personnel.

“There are many policies that the government has introduced, but implementation has been very weak and monitoring is also very weak as a result of which its own policy is being flouted and violated all the time,” says Upreti.

Dr. V.K. Singh, Director of the Institute of Health Management Research in New Delhi agrees, but adds that it is difficult to fight against tradition. Families have been doing home deliveries for generations. To change this habit means not only investment, but also awareness. Singh points out that there is failure on the government’s side, but insists that the issue is more complicated. “The state or the government wants to do many things, but people are not participating so much in those programmes, and there is probably neglect from the public side also.”

Patriarchy, the root cause

Melissa Upreti sees the disregard for women in a patriarchal society as the root cause of all these shortcomings.

“There is still a very conservative, deeply entrenched gender discrimination,” says Upreti. “The notion that women are dispensable is also an underlying cause of the government's failure and also society’s failure as well to reduce maternal mortality.”

Furthermore, she points out that in India, traditional caste discrimination and the more modern HIV stigma are additional obstacles for the poor which prevent them from receiving immediate health care.

To combat this misery the government has launched a National Rural Health Mission for the next five years. According to Dr. Singh, three billion US dollars will be pumped into the rural health service.

“So that would definitely bring some changes. But you understand that the people can’t be trained overnight.”

A few months ago a majority of the countries signed a resolution, adopted by the Human Rights Council, recognising maternal mortality as a human rights issue. India was not one of the party.

Author: Verena Degens
Editor: Grahame Lucas