Inadequate monitoring of maternal deaths in India: HRW

New Delhi, Nov 4 (PTI) Inadequate monitoring of maternal
deaths following child birth is coming in the way of India
meeting international standards in obstetric care, an
international human rights body has said.
According to Human Rights Watch, the government counts
the number of births in health clinics and hospitals, but
these are often woefully under-resourced and under-staffed.
Many women die or suffer serious injury after giving birth.
"The Indian government does not monitor what happens to
women after childbirth, especially in the first 24 to 72
critical hours, when the chances of dying are the highest,"
the report by the rights body said.
Without this information, it cannot save women who go
back home and die or develop long-lasting complications, it
added.
"The Indian government should change its approach to
monitoring and examine whether women with pregnancy-related
complications are in fact getting the kind of treatment they
need and whether they are surviving childbirth in the
postpartum period," it said.
The government's new Health Management Information System
includes some of this data for monitoring, but it remains to
be seen whether this data will be consistently collected and
utilised for maternal health care programming at district and
state levels.
Citing the example of northern state Uttar Pradesh, the
HRW says, though the state has the second highest maternal
mortality rate in the country, government health records in
some districts showed "zero" deaths.
The Human Rights Watch documented cases in which women
died after childbirth even though they gave birth in health
facilities.
The Indian government promotes giving birth in public
health facilities, using cash incentives for poor women, with
the goal of providing access to skilled care.
But there is little systemic information on whether rural
clinics and district hospitals are able to provide adequate
and timely care to save women with pregnancy-related
complications.
The government treats the huge increase of clinic-based
deliveries as progress. Twenty million women gave birth in
health facilities across India between mid-2005 and March
2009.
However, there is no reliable information on what
percentage of these 20 million women actually survived after
childbirth or suffered complications after being discharged.
"Skilled birth attendance and quality of care are two
sides of the same coin," Aruna Kashyap, researcher for the
Women's Rights Division of Human Rights Watch, said.
"Unless India can draw up a time-bound plan of action for
independent certification and monitoring of public and private
health facilities as 'quality care providers', there is no
guarantee that women giving birth in health facilities are
receiving the skilled birth attendance needed to save them,"
he added. PTI SPC
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