Do
The Health Infrastructure In
Madhya Pradesh Ensuring
Safe Deliveries?
By Seema Jain
07 January,
2009
Countercurrents.org
Safe Motherhood is the right of all women. But unfortunately safe childbirth is still a hallucination for the rural & tribal folk in Madhya Pradesh. The trends in institutional deliveries age giving a grim picture of safe deliveries in the state. Madhya Pradesh lies in the category of bigger state in the country but the health infrastructure & services proves to be very small to promote safe institutional deliveries to curb high rates of maternal & neonatal mortality in the state. The state has IMR in the country at 72 per thousand live births. Safe Mother & safe child birth emerged as foremost target of RCH-II in Madhya Pradesh but it still lacks prudence in the establishment of health services in the state. This sore truth about safe motherhood has been confirmed by the District Level household Survey (DLHS-III) report for 2007-08 released by the Ministry of Health & Family Welfare, Government of India, revealing the big gap on the front of safe deliveries in the state.
The state government has tried to over glorified data of institutional deliveries but authenticity of data is become questionable while looking DLHS-III data that institutional deliveries had increased at a very slow pace with 18.4% increase from 2002-04 to 2007-08.DLHS-3 survey report with district wise data presents the harsh picture that the average percentage of institutional deliveries in the state is only 47.1% against the state government’s claim of 79% in 2007-08. The situation is most awful in rural areas of the state with only 40.8% institutional deliveries.
Maternal
death is an avoidable tragedy. No mother should die giving life. A
little bit of care can go a long way in preventing this tragedy. However
the analysis of the grass root reality behind low level of institutional
deliveries exposes the failure of the system to establish the health
infrastructure much needed to restrain the maternal & neonatal
mortality & morbidity. Safe motherhood can be ensured by availability
of good quality health services. Safe deliveries demands the deliveries
to conducted in the presence of specialist like Obstetrician/ Gynecologist/Pediatrician.
But in the state the total number of posted Gynecologist in 278 CHCs
is just only 49. It means that only one gynecologist is available
per 5 CHCs. This further means that only One Obstetrician/Gynecologist
was available for 18507 institutional deliveries among the total 906869
institutional deliveries in first eight months of the year 2008-09
(April-Nov, 08).And only 64 lady medical officers (LMO) are placed
so far.
ANC check-ups lead to early detection of complications in pregnancy
& thereby ensuring safe deliveries. However the percentage of
mothers who had at least 3 ante-natal check-up is comparatively very
low in the state. Out of the 48% districts only 8 districts has more
60% women having 3 ANC check-up during their last pregnancy.
Another aspect of safe child births covers the availability of necessary equipments & infrastructure like availability of Normal Delivery Kit, separate Labour Rooms, Operation Theatre with Boyles & Apparatus, Blood Storage Facility, necessary Medicines & Referral Support System including ambulance on 24 hours basis. But the CHCs, PHCs & SHCs in Madhya Pradesh are facing severe shortage of medical equipments & support system resulting in low rate of safe deliveries within the state. Out of 1142 SHCs, only 459 Sub centers having separate labour room, but most of them are not equipped with essential facilities. Tetanus and sepsis are among the leading causes of maternal and neonatal death and illness in India. To prevent that normal Delivery Kit has been provided to every SHCs, PHCs & CHCs. But it is very surprising that only 418 PHCs out of 1142 PHCS in the state are having normal delivery kits up to 2007-08.
The women of most excluded communities like dalits & tribal women in Madhya Pradesh are continue to be in grip of high risks during childbirth due to dual punch from healthcare system with lack of appropriate health system on one side and shunning by hospital authorities with negligent, cruel and corrupt attitude on the other side and thus they keep on dying during childbirth.
To improve
the status of institutional deliveries in real sense & thereby
benefiting the poor women to enjoy safe motherhood, the healthcare
system in the state need to be updated with expansion of bed capacities
& enhanced facilities of the health institution along with filling
up of all vacant post of medical staff.
