Uttar Pradesh tops in pregnancy related deaths

LUCKNOW - Uttar Pradesh tops the list in pregnancy related deaths in the country, a study by a human rights watchdog said.

A US-based international organisation, Human Rights Watch (HRW) arrived at the conclusion after carrying out a case study across certain districts, culminating in a report that was released here Wednesday.

Releasing the report, former Lucknow University vice-chancellor Roop Rekha Verma expressed deep concern over the prevailing situation and called upon the state government to take note of the recommendations made by HRW to arrest the trend.

According to the report prepared by HRW’s Asia researcher Aruna Kashyap, “India alone contributes to a little under a fourth of the world’s maternal mortality, with a maternal mortality ratio (MMR) of 450 maternal deaths per 100,000 live births.”

The report points out that “Uttar Pradesh has one the highest MMR, that was nearly three times that of Tamil Nadu, and more than 60 percent of the maternal deaths occurred in Dalit and tribal communities.”

It said: “While health authorities are upgrading public health facilities, they have a long way to go. Currently, a majority of public health facilities that are supposed to provide basic and comprehensive emergency obstetric care have yet to do so.”

The study points out that most health staff in the community health centres of Uttar Pradesh conducted only normal deliveries. Women with complications were referred to another health facility with little or no referral support.

It goes on to add: “Less than a third of the existing community health centres (CHCs) in the state have an obstetrician or gynaecologist and almost 45 percent do not have funds to operate even the one ambulance they have. In practice, roughly only one in 20 first referral units offer caesarrean facilities and barely one in a hundred have blood storage facility.”

According to statements of the staff at the CHCs and at district hospitals, women with pregnancy complications were often referred to facilities available at not less than 100 km distance.

The report also seeks to draw the attention of the Uttar Pradesh authorities to the poor post-natal care in the government facilities in the rural areas. “Poor continuity of care over the crucial ante-natal and post-natal periods has remained a persistent problem in Uttar Pradesh”, the report said.

Embarking upon the “financial barriers” faced by women, it talks about the rampant corruption in the implementation of various schemes whereby the government guarantees free services and incentives, which are rarely made available to the target beneficiary without having to give away “cuts” to the officials.

The report alleges that “many health workers in hospitals and clinics made unlawful demands for money or payment as a condition for care.” Often this is sought to be justified by them as a customary practice of giving gifts to celebrate the birth, particularly in case of a male child.

The report pointedly stresses upon the need for accountability in maternal health care, to ensure that the official efforts aimed at improving access to proper maternal health care bear fruit.

“As many as thee in every four maternal deaths could be prevented in this manner,” the report points out.