Skip to content
MHTF logo

Maternal Health Task Force

  • Facebook
  • Twitter
  • Vimeo
  • Flickr
  • Email
  • About
  • Topics
  • Resources
  • Buzz
    • People’s Choice Buzz
  • Blog
MHTF Blog ›

Moving Beyond the Numbers

Posted on January 24, 2014November 7, 2016

By: Renuka Motihar, Independent Consultant and member of the Executive Committee of the White Ribbon Alliance India

As we approach the 2015 deadline for the Millennium Development Goals, what does the future hold for international maternal mortality targets? The MHTF is pleased to be hosting a blog series on post-2015 maternal mortality goal setting. Over the next several weeks, we will be featuring responses and reactions to proposed targets from around the world. Please share your thoughts with us!

In India, there has been considerable economic progress, but the country is still grappling with inequities and the basic right to safe childbirth. There are about 30 million pregnancies; 27 million deliveries and about 56,000 women are lost in childbirth each year. This accounts for 19 percent of maternal deaths around the world. Most of these can be prevented. India still has a way to go to reach MDG 5, which would require reducing the maternal mortality ratio (MMR)  to 109 deaths per 100,000 births  by 2015. There has been some progress in the country in the last decade. The MMR has fallen from about 390 to 212 deaths per 100,000 live births in about 10 years, approximately 67 percent decrease. There are some areas in the country, such as states of Assam, Rajasthan, Uttar Pradesh/Uttarakhand that still have MMRs greater than 300 deaths per 100,000 live births. Social determinants such as early age of marriage and early and repeated childbearing are also contributing factors. Thirty-six percent of Indian women are malnourished and about 55 percent are anemic. Bodies are ill prepared to handle childbirth with poor nutrition, stunting with negative outcomes for maternal health. The main causes of death in India have been found to be heavy bleeding (hemorrhage) and eclampsia (high blood pressure).

The Government of India has policies and programs to improve outcomes for maternal health. Janani Suraksha Yojana, a safe motherhood cash assistance scheme, and now the Janani Shishu Suraksha Karyakarm (JSSK) have facilitated the shift of births from homes to health facilities. Births in clinics and hospitals have increased over 75 percent in the last 5 years; however the maternal mortality ratios have only declined by approximately 25 percent. But the question arises: Are the health facilities equipped with the desired quality to handle the onset of numbers? Is there adequate inter-partum care and emergency care for complicated deliveries? Is the poorest woman being able to reach services? Is it inclusive and equitable?

To address quality of care issues, quality protocols are being developed — for the labor room, antenatal care and postnatal care by the government and there is an effort to standardize. There is an attempt to strengthen supportive supervision, task shifting (reduce dependence on doctors and train a cadre of health workers for providing services), strategic skilling, respectful maternal care and maternal death reviews. However, challenges still remain: India is a vast country, and problems of supplies of essential drugs, medicines, inadequate human resources, inaccessible terrain, socio-cultural factors, and translating policies/programs into action persist. The government of India is grappling with all these issues and is focusing on improving quality of services. There is a realization that only looking at numbers is not enough. Improving quality of services is critical. As Anuradha Gupta, Additional Secretary, Ministry of Health and Family Welfare (MOHFW), Government of India and Mission Director, National Rural Health Mission has said in a recent meeting, “We need a shift in the focus on achieving numbers to achieving quality of care”.

The global targets for preventing maternal deaths are useful in providing goals to aspire for a country. They have acted as a catalyst to accelerate progress. However, the targets currently only reflect maternal mortality. They do not reflect maternal morbidities or the fact that for every woman dying in childbirth, many more women suffer long-lasting and debilitating illnesses, which are now being neglected. For countries, a relative or percentage target may be more useful; and those countries that are on track should also examine the reaching of targets sub-nationally. However, within countries, focusing only on numbers is not enough. Efforts need to go beyond numbers to reflect on enhancing the quality of services, and, in turn, improving the lives of women and children.

If you would like to submit a guest post for to our ongoing series exploring potential goals for maternal health in the post-MDG development agenda, please contact Andrea Goetschius: goetschi@hsph.harvard.edu

Share this:FacebookTwitterLinkedInReddit
CATEGORIESCATEGORIES: Contributor Posts MMR Post-2015 Targets Series
TOPICSTOPICS: Facility-based Births Health Systems Maternal Mortality Policy & Advocacy Quality of Care SDG Social Accountability
GEOGRAPHIESGEOGRAPHIES: India

Looking for something specific?

Blog Series

  • Improving Maternal Health Measurement
  • Noncommunicable Diseases and Maternal Health
  • The Global Maternal Health Workforce
  • Quality of Maternal Health Care
  • See more>>

Archives

Blogs we follow

  • Healthy Newborn Network
  • Jacaranda Health
  • Jhpiego Field Notes
  • MamaYe
  • Maternal and Child Survival
  • NPR Goats and Soda
  • White Ribbon Alliance
  • Women Deliver

MHTF Disclaimer

The posts on this blog do not necessarily reflect the views of the Maternal Health Task Force. Our objective is to provide a platform for our Editorial Committee and other experts to post a myriad of data and evidence, as well as opinions/views that exist in the field which will contribute to expanding the maternal health dialogue.
  • About
  • Topics
  • Resources
  • Buzz
    • People’s Choice Buzz
  • Blog

MATERNAL HEALTH TASK FORCE

Harvard Chan School Center of Excellence in Maternal and Child Health
677 Huntington Avenue
Boston, MA 02115
MHTF@hsph.harvard.edu

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
  • About
    • Key Facts
    • Renaming the School
    • Office of the Dean
    • Location and Facilities
    • Administrative Offices
    • Contact Information
  • Admissions
    • Office of Admissions
    • Harvard Chan Viewbook
    • Financial Aid
    • Registrar’s Office
    • Summer at the School
  • Academics
    • Departments
    • Degrees
    • Online Degree Program
    • Programs and Requirements
    • Executive/Summer Programs
    • Interdisciplinary Concentrations
    • Office of Education
    • Division of Biological Sciences
    • Division of Policy Translation and Leadership Development
    • Executive and Continuing Professional Education
    • Fellowships and Residencies
    • Academic Calendar
    • Harvard Chan Viewbook
  • Exec Ed
  • Research
    • Office of Research Strategy and Development
    • Harvard Longwood Campus Research Administration
    • Office of Regulatory Affairs and Research Compliance
    • Office of Human Research Administration
    • Centers & Institutes
    • Researchers Directory
    • Postdoctoral Research Fellows
    • Export Controls
    • International Research
  • Faculty
    • Office of Faculty Affairs
    • Office of Diversity and Inclusion
    • Faculty Directory
    • Faculty Searches
  • Students
    • Student Life Main
    • Academic Calendar
    • Career Advancement
    • Countway Library
    • Housing
    • Student News
    • Office for Student Affairs
    • Office of Education
    • Office of Diversity and Inclusion
    • Office of Financial Aid
    • Registrar’s Office
    • Student Billing
    • Orientation
    • Commencement
  • Alumni
  • News
    • News Main
    • Press Releases
    • Harvard Public Health Magazine
    • Explore Research by Topic
    • Mailing Lists
    • Multimedia
    • Office of Communications
  • Make a Gift
    • Campaign for Harvard Chan School
  • Facebook
  • Twitter
  • Vimeo
  • Flickr
  • Email
Maternal Health Task Force Proudly powered by WordPress
 

Loading Comments...