During the past couple of years, it has come to the attention of many health groups, women’s NGOs, and human rights groups, that maternal health care for Indian women is drawing major human rights violations. Caste discrimination, gender discrimination, and a general lack of stability within the health care system and government have all been contributing factors to this occurrence. In 2009, Human Rights Watch released a report claiming that “tens of thousands of Indian women and girls are dying during pregnancy, in childbirth, and in the weeks after giving birth, despite government programs guaranteeing free obstetric health care”[1]. With more reports like this, the Indian government has seen the need for change in their system and have begun to hold hospitals more accountable for their actions and proper treatment, however, there have still been some shortcomings in potential health care programs.
During 2005, India created a flagship program called the National Rural Health Mission (NRHM) that was aimed at improving rural health, and specifically focused on maternal health care. This program showed good intensions as it promised to provide free care before and during childbirth, more accessible emergency services, postnatal care, and better referral in case of complications. However, in the 2009 Human Rights Watch report, this program was deemed ineffective, as its promises were not being upheld.[2] According to the human rights watch, one of the gaps in this program was found in the failure to account for details on injuries and pregnancy complications, and whether or not these women were gaining access to emergency care[3].
Along with the inability of the government to implement programs that hold to their promises, we are seeing an occurrence of vast class discrimination in health care services to pregnant women. In 2007, a study was published on CBCnews that showed in six north Indian states, 61 percent of maternal deaths were among “untouchables,” and that many upper class health care workers refused to visit “untouchable” communities, withholding the necessary supplements that maternal women need[4]. Those women that are denied proper treatment in large, government hospitals are forced to turn to unsafe deliveries at home by untrained physicians or midwives, and many of these women die during child birth. In 2008, a story emerged about an untouchable couple who were seeking emergency care for the pregnant wife at a large hospital, they were bribed 500 Rs for admission, and not being able to pay this they were forced to give birth outside the hospital’s gates. The hospital later tried to cover up the occurrence.[5] These maternal health care issues are a relevant issue that must not be overlooked. “Globally half a million maternal deaths occur every year. South Asia and Africa are the regions where most of these deaths take place. India accounts for close to 100,000 such deaths. This means one woman is dying every five minutes in India”[6]. This is a scary fact that is crying out for government intervention.
Though the Human Rights Watch picked out some of the gaps in the NRHM program, this does not mean that it did not bring some help along the way. A local Indian organization that pairs with NGOs, called Save a Mother, pointed out some of the positives that were brought with NRHM. According the Save a Mother, the greatest success of NRHM has been a program called Janani Suraksha Yojana. This is a cash exchange program from the government that gives incentives for both mothers and health workers to enable pregnant women to seek health facilities to give birth and ensures them proper health treatment. “In just five years, the number of women who have benefited from the program’s incentives has increased 13-fold, from 750,000 in 2005-2006 to nearly 10 million in 2009-2010”[7]. This is a great step for the Indian government, proving that their initiatives can work, however, this is not yet a full success story. There is still a need for the program to help reduce infant mortality rates and address the needs post-partum mothers[8]. As we can see, the government is not completely ignoring these human rights issues, we just continue to see problems in the ability of the government to hold to their plans. This gap of implementation and accountability is the primary issue that needs to be addressed. If the Indian government is only following through with half of their promises, it is likely that people will begin to loose faith in their abilities.
The picture below was taken outside a hospital in Srinagar, India and posted on cbc.ca news. The pain and anxiety seen in the mothers face can be used to address all the emotions and scares of Indian mothers, wondering if they will face pregnancy complications and if both them and their baby will make it through the birth. As these wait in line outside of the hospital, who knows what sort of health issues these women posses and what they are further exposing themselves, and their babies, to outside in the filth of the streets. Similarly, it is disturbing to wonder which of these women will live through the next couple of months. With the high mother mortality rate, it is possibly that at least one of these women will face discrimination, or inadequate medical treatment, leading them to their death.
http://www.cbc.ca/news/health/story/2009/10/07/maternal-deaths-india.html
[1] “India: Too Many women Dying in Childbirth,” Human Rights Watch, (October, 2009), http://www.hrw.org/en/news/2009/10/07/india-too-many-women-dying-childbirth.
[4] “Preventable Maternal Deaths Kill Thousands in Inida,” CBCnews: Health, (October, 2009), http://www.cbc.ca/news/health/story/2009/10/07/maternal-deaths-india.html.
[5] Rajender Singh Negi, “Social exclusion rampant in India’s maternal healthcare,” One World South Asia, (Septmeber, 2008), http://southasia.oneworld.net/todaysheadlines/social-exclusion-rampant-in-india2019s-maternal-healthcare.
[6] Ibid., http://southasia.oneworld.net/todaysheadlines/social-exclusion-rampant-in-india2019s-maternal-healthcare.
[7] Katie Malizia, “New Report shows skilled healthcare activists critical to transforming maternal and child health in India,” Save A Mother, (February, 2011) http://www.saveamother.org/new-report-shows-skilled-healthcare-activists-critical-to-transforming-maternal-and-child-health-in-india/.
[8] Ibid., http://www.saveamother.org/new-report-shows-skilled-healthcare-activists-critical-to-transforming-maternal-and-child-health-in-india/.
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