India is failing its women and children and is crawling towards the Millennium Development Goal (MDG), which targets to cut child death rates by two-thirds and maternal mortality by three-quarters between 1990-2015.
According to a report that tracks the progress made by 68 priority countries, which account for 97% of maternal and child deaths worldwide, only 16 (24%) were on track to meet the MDG compared to 7 of 60 (12%) in 2005. India, however, is not one of them.
In fact, India's progress towards MDG target in child mortality, in the report 'The Countdown to 2015: Maternal, Newborn and Child Survival' published in the medical journal 'Lancet', has been found to be "insufficient" and its level of maternal mortality has been termed "high".
While India's target under the MDG for mortality of children under age 5 is 38 per 1,000 live births, the number of children who die before their fifth birthday stands at 76 at present.
Infant mortality rate in India stands at 57 per 1,000 live births while neonatal mortality rate - deaths in the first month of life - stands at 43 per 1,000 live births.
Early initiation of breastfeeding benefits both mother and newborns. Yet, only 46% infants under six months are being exclusively breastfed. Also, only 41% births have been registered.
Speaking to TOI from Cape Town, Dr Francisco Songane, director of WHO's partnership for maternal, newborn and child health, said: "India, along with Bangladesh, Pakistan and Indonesia, contribute over 50% of all maternal and child deaths globally. What's worse, India is not making sufficient progress. India's population is massive and even if the ratio of maternal and child mortality may not be high, the numbers are staggering."
Dr Songane added: "India is among the 26 countries in the list of 68 where progress has been found to be insufficient. India has to scale up its interventions. Coverage rate will also have to be increased drastically as at present, pockets of population are not reached."
According to the report, brought out by the International Partnership for Maternal, Newborn and Child Health (MNCH), an umbrella organisation comprising about 240 members such as Unicef, WHO and Save the Children, India's average annual rate of reduction of child deaths between 1990-2006 has been just 2.6%.
If India wants to achieve the agreed targets by 2015, the required rate to reduce child and maternal mortality will have to be 7.6% from 2007-2015.
The report also identifies a series of missed opportunities. It says only one-third of women in the 68 priority countries are using a modern contraceptive method - a proven means of boosting maternal and infant survival.
Only 50% women and newborns benefit from a skilled birth attendant at the time of birth globally. Only about one-third of children with pneumonia, the biggest single killer of children, get treatment while under nutrition has been the underlying cause of 3.5 million child deaths annually, and as many as 20% of maternal deaths.
source - Times of India
Sunday, April 20, 2008
Sunday, March 09, 2008
For better health, let's stick to the basics
The Economic Times, Gireesh Chandra Prasad, TNN
Given the state of affairs, the Economic Survey’s recommendations on healthcare might sound like truisms. But then, the truth does need to be oft-repeated. Not surprisingly, the Survey says that the central and state governments should make health insurance affordable to people and urgently improve the quality of basic services like drinking water and sanitation to address the poor health indicators of a nation of 112 crore.
Health insurance is critical in this scenario, given that it’s the poor service in state-run hospitals that forces people to seek expensive private treatment. It also is imperative that the delivery of public health services is improved. In fact, the Survey says a strategic focus on these areas should be the cornerstone of a successful policy framework for healthcare, given that state-funded healthcare for all still seems a distant dream.
India has one of the highest out-of-the-pocket household expenditures for healthcare. Then there’s the additional burden of user charges at state-run hospitals. Therefore, it is vital that innovative risk-pooling mechanisms are designed to improve access to healthcare, the Survey has said.
The data makes for depressing news. The latest figures on indicators like under-five mortality and maternal mortality rate shows that India fares worse than its more populous neighbour, China. Vector-borne diseases and epidemics are not under control.
In 2007, 940 deaths and about 10 lakh positive cases of malaria, filariasis, kala-azar, Japanese encephalitis, dengue and chikungunya were reported. Up to December 2007, 64 dengue deaths and over 5,000 positive cases have been reported while suspected chikungunya cases were more than half a lakh. Elimination of that old enemy, polio, is still not in sight with 471 reported cases last year.
Besides, there is a wide disparity among different states and urban and rural areas in access to healthcare. Life expectancy in Madhya Pradesh, Assam, Orissa, UP and Bihar, for instance, is noticeably lower than that in states like Kerala, Punjab, Maharashtra, Himachal Pradesh and Tamil Nadu.
This applies to infrastructure and medical staff too. Infant mortality rate is the highest in Madhya Pradesh while it is the lowest in Kerala. Most of the public health centres had operation theatres in Andhra Pradesh, Rajasthan and Maharashtra while the opposite was the case in UP, West Bengal and Chhattisgarh.
The Survey has recommended that there should be strategic focus on eliminating vector-borne and epidemic diseases, providing public health education, improving the urban and rural drainage system, providing clean drinking water and sanitation and a well organised garbage collection and disposal system. Mainstreaming traditional medicine would ease some burden on public health facilities.
Above all, good governance is very important in healthcare delivery. The 11th Five-year Plan envisages an investment of Rs 11.02 lakh crore at the central and state levels on social sectors. But greater allocation would not amount to much unless leakages in the system are plugged. Finance minister P Chidambaram had said on various occasions that outlay is not a constraint so long as it ensures outcomes. The government now needs to walk the talk.
Given the state of affairs, the Economic Survey’s recommendations on healthcare might sound like truisms. But then, the truth does need to be oft-repeated. Not surprisingly, the Survey says that the central and state governments should make health insurance affordable to people and urgently improve the quality of basic services like drinking water and sanitation to address the poor health indicators of a nation of 112 crore.
Health insurance is critical in this scenario, given that it’s the poor service in state-run hospitals that forces people to seek expensive private treatment. It also is imperative that the delivery of public health services is improved. In fact, the Survey says a strategic focus on these areas should be the cornerstone of a successful policy framework for healthcare, given that state-funded healthcare for all still seems a distant dream.
India has one of the highest out-of-the-pocket household expenditures for healthcare. Then there’s the additional burden of user charges at state-run hospitals. Therefore, it is vital that innovative risk-pooling mechanisms are designed to improve access to healthcare, the Survey has said.
The data makes for depressing news. The latest figures on indicators like under-five mortality and maternal mortality rate shows that India fares worse than its more populous neighbour, China. Vector-borne diseases and epidemics are not under control.
In 2007, 940 deaths and about 10 lakh positive cases of malaria, filariasis, kala-azar, Japanese encephalitis, dengue and chikungunya were reported. Up to December 2007, 64 dengue deaths and over 5,000 positive cases have been reported while suspected chikungunya cases were more than half a lakh. Elimination of that old enemy, polio, is still not in sight with 471 reported cases last year.
Besides, there is a wide disparity among different states and urban and rural areas in access to healthcare. Life expectancy in Madhya Pradesh, Assam, Orissa, UP and Bihar, for instance, is noticeably lower than that in states like Kerala, Punjab, Maharashtra, Himachal Pradesh and Tamil Nadu.
This applies to infrastructure and medical staff too. Infant mortality rate is the highest in Madhya Pradesh while it is the lowest in Kerala. Most of the public health centres had operation theatres in Andhra Pradesh, Rajasthan and Maharashtra while the opposite was the case in UP, West Bengal and Chhattisgarh.
The Survey has recommended that there should be strategic focus on eliminating vector-borne and epidemic diseases, providing public health education, improving the urban and rural drainage system, providing clean drinking water and sanitation and a well organised garbage collection and disposal system. Mainstreaming traditional medicine would ease some burden on public health facilities.
Above all, good governance is very important in healthcare delivery. The 11th Five-year Plan envisages an investment of Rs 11.02 lakh crore at the central and state levels on social sectors. But greater allocation would not amount to much unless leakages in the system are plugged. Finance minister P Chidambaram had said on various occasions that outlay is not a constraint so long as it ensures outcomes. The government now needs to walk the talk.
Sick state of health in Madhya Pradesh!
View point Central Chronicle, Bhopal
Indore, Feb 16: Shivraj Singh government may receive laurels for his governance and pushing the state on the path of development, everything is not well as far as state of health in Madhya Pradesh is concerned. If one goes by the latest human development report of Madhya Pradesh, the state of health in Madhya Pradesh is far from satisfactory.
This is reflected from the latest estimate for longevity, measured as life expectancy at birth, which was 59 years for males and 58 years for females (corresponding to period 2002-06). As per the latest estimate on longevity as quoted in the Human Development Report 2007, the life expectancy for males and females in Madhya Pradesh was the lowest among all the major states in India and a good four to eight years lower than the national average.
States like Assam, Bihar, Gujarat, Haryana, Karnatakka and Kerala have better life expectancy at birth as compared to Madhya Pradesh. Even the state of Bihar which is counted among one of the most backward states in the country, life expectancy at birth for males and females (2001-06) stood at 65.66 years and 64.79 years respectively, much higher than that of Madhya Pradesh.
What has been found to be more surprising that while naturally female life expectancy should be more than male life expectancy, it is just the opposite in Madhya Pradesh, pointing towards discriminatory practices against both the girl child and women, leading to higher mortality rate.
Similarly, state's performance on the infant mortality rate (IMR) and the maternal mortality rate (MMR), is far below than the national average. IMR is related to combination of factors including poor nutrition for their mothers while pregnant, inadequate immunization of mothers from tetanus and lack of hemoglobin in their bodies, poor sanitary and health care conditions at birth, poor care during deliveries, etc.
The infant mortality in the state in 2004 was estimated at 79 (84 for rural areas and 56 for urban areas) as against national IMR of 58, the highest among all states in the country. Between 2000 and 2004, while the national IMR reduced from 68 to 58, the IMR of Madhya Pradesh dropped from 87 to just 79.
As far as maternal mortality rate is concerned, though the state had witnessed a significant reduction in MMR at 498/1000 (as per the National Family Health Survey - II) to 379/1000 as per the MMR data released in 2003, it was still far higher than the national MMR of 301/1000.
The public health infrastructure in the state is also far from satisfactory. As per the Human Development Report 2007, the state had a shortage of 26% in primary health centers, the very basis of primary health. The poor deliveries of primary health services in the state has primarily been attributed to doctors' unwillingness to serve in rural areas. Though the state has adopted an innovative approach of mobile health dispensaries through public private partnership and other health schemes, its impact on primary health is yet to be evaluated.
As per 2001 census, 22 per cent of the state population were directly at risk of water borne diseases as they did not have access to safe drinking water. As far as condition of sanitation is concerned, the state ranks far below than the national average. As per the survey carried out by the Ministry of Rural Development, Government of India, only 9.7% of rural households in Madhya Pradesh had a toilet in 2005, which is abysmally low even compared to the national average of 23.7%.
Krishna K Jha
Indore, Feb 16: Shivraj Singh government may receive laurels for his governance and pushing the state on the path of development, everything is not well as far as state of health in Madhya Pradesh is concerned. If one goes by the latest human development report of Madhya Pradesh, the state of health in Madhya Pradesh is far from satisfactory.
This is reflected from the latest estimate for longevity, measured as life expectancy at birth, which was 59 years for males and 58 years for females (corresponding to period 2002-06). As per the latest estimate on longevity as quoted in the Human Development Report 2007, the life expectancy for males and females in Madhya Pradesh was the lowest among all the major states in India and a good four to eight years lower than the national average.
States like Assam, Bihar, Gujarat, Haryana, Karnatakka and Kerala have better life expectancy at birth as compared to Madhya Pradesh. Even the state of Bihar which is counted among one of the most backward states in the country, life expectancy at birth for males and females (2001-06) stood at 65.66 years and 64.79 years respectively, much higher than that of Madhya Pradesh.
What has been found to be more surprising that while naturally female life expectancy should be more than male life expectancy, it is just the opposite in Madhya Pradesh, pointing towards discriminatory practices against both the girl child and women, leading to higher mortality rate.
Similarly, state's performance on the infant mortality rate (IMR) and the maternal mortality rate (MMR), is far below than the national average. IMR is related to combination of factors including poor nutrition for their mothers while pregnant, inadequate immunization of mothers from tetanus and lack of hemoglobin in their bodies, poor sanitary and health care conditions at birth, poor care during deliveries, etc.
The infant mortality in the state in 2004 was estimated at 79 (84 for rural areas and 56 for urban areas) as against national IMR of 58, the highest among all states in the country. Between 2000 and 2004, while the national IMR reduced from 68 to 58, the IMR of Madhya Pradesh dropped from 87 to just 79.
As far as maternal mortality rate is concerned, though the state had witnessed a significant reduction in MMR at 498/1000 (as per the National Family Health Survey - II) to 379/1000 as per the MMR data released in 2003, it was still far higher than the national MMR of 301/1000.
The public health infrastructure in the state is also far from satisfactory. As per the Human Development Report 2007, the state had a shortage of 26% in primary health centers, the very basis of primary health. The poor deliveries of primary health services in the state has primarily been attributed to doctors' unwillingness to serve in rural areas. Though the state has adopted an innovative approach of mobile health dispensaries through public private partnership and other health schemes, its impact on primary health is yet to be evaluated.
As per 2001 census, 22 per cent of the state population were directly at risk of water borne diseases as they did not have access to safe drinking water. As far as condition of sanitation is concerned, the state ranks far below than the national average. As per the survey carried out by the Ministry of Rural Development, Government of India, only 9.7% of rural households in Madhya Pradesh had a toilet in 2005, which is abysmally low even compared to the national average of 23.7%.
Krishna K Jha
Tuesday, December 18, 2007
Helping hands
Women and men helping pregnant women at Guna's district hospital to get her down from trolley on which she came to the hospital to show to the medical doctor. (pic courtesy - anil gulati)
Wednesday, December 05, 2007
Concern over delivery deaths
Editorial, Central Chronicle, Nov 30, 2007
Despite of spending crores of rupees for improving the health of women, the continuing deaths of women, in the State, during delivery is a cause of concern. Answering a question in the State Vidhan Sabha, the Public Health Minister himself admitted that there were 3359 cases of mother-child death between the period January 1, 2006 and October 2007. Of these maximum 224 cases pertain to Shahdol. It may be noted that for publicity of National Rural Health Mission and RCH a whopping sum of Rs 8.36 crore was spent during the last two years. At the same time an amount of Rs 620.36 crore was allotted under National Rural Health Mission and RCH for the years 2006-07 and 2007-08. The break-up of deaths of women/kids at other places is- Guna 145, Shivpuri 105, Sidhi 169, Sagar 137, Jhabua 149, Dindori 138, Balaghat 135, Chhindwara 101 and Mandla 101. It is learnt that awareness is even now lacking in these places for performing deliveries at health centres. It is a matter of grave concern that even after spending Rs 8.5 crores in publicity of National Rural Health Mission and RCH during the years 2006-07 and 2007-08 the death rate could not be brought down. Hence it is essential that awareness be created in right earnest among the intended class to curb mother-child deaths. For this purpose, participation of literate people of villages and youths could be sought for. With rapid advancement in communication technologies and opening of health centres in rural areas, the maternal mortality could be minimised.
Despite of spending crores of rupees for improving the health of women, the continuing deaths of women, in the State, during delivery is a cause of concern. Answering a question in the State Vidhan Sabha, the Public Health Minister himself admitted that there were 3359 cases of mother-child death between the period January 1, 2006 and October 2007. Of these maximum 224 cases pertain to Shahdol. It may be noted that for publicity of National Rural Health Mission and RCH a whopping sum of Rs 8.36 crore was spent during the last two years. At the same time an amount of Rs 620.36 crore was allotted under National Rural Health Mission and RCH for the years 2006-07 and 2007-08. The break-up of deaths of women/kids at other places is- Guna 145, Shivpuri 105, Sidhi 169, Sagar 137, Jhabua 149, Dindori 138, Balaghat 135, Chhindwara 101 and Mandla 101. It is learnt that awareness is even now lacking in these places for performing deliveries at health centres. It is a matter of grave concern that even after spending Rs 8.5 crores in publicity of National Rural Health Mission and RCH during the years 2006-07 and 2007-08 the death rate could not be brought down. Hence it is essential that awareness be created in right earnest among the intended class to curb mother-child deaths. For this purpose, participation of literate people of villages and youths could be sought for. With rapid advancement in communication technologies and opening of health centres in rural areas, the maternal mortality could be minimised.
Sunday, December 02, 2007
Madhya Pradesh’s IMR and MMR still very high
Despite the figures of institutional deliveries for the current year in the state being quite impressive, Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) do not show the corresponding improvement. Furthermore, utter unavailability of specialist gynecologists and pediatricians in
In the current year, the rate of institutional delivery is 58 % as against 50.3% of 2006-07. The figures have constantly shown an improvement from year 2000-01 when it was a mere 26.2%. Cleary, the rate of institutional delivery has more than doubled since, if figures are anything to go by.
The figures do not show the institutional delivery in urban and rural areas separately and insiders say most of the institutional deliveries giving push to the figure are being done in urban areas. Second thing they reveal is that government has included private sector hospitals in its schemes to enhance institutional deliveries among below poverty line (BPL) mothers and pay them for each delivery. Most of these hospitals are in urban and semi-urban areas. "It's not necessary the data of institutional delivery provided by a certified hospital conducting free delivery of BPL mothers under a government scheme and receiving the due money from government is true," says an insider. "It might be exaggerated by certain means to claim more money from government."
Needless to mention, under the arrangement certified private hospitals are extending facilities of Janani Express Yojana, Janan Sahayogi Yojana and other health welfare schemes to card holders. Talking of rural areas, state is short of 478 PHCs and 188 CHCs as per a report of Ministry of Health and Family Welfare of Government of India released on March 2006. To add to this, just 13 gynecologists and 12 pediatricians are working in 229 existing CHCs of the state.Around 216 gynecologists and 217 pediatricians are required in these health centers. State government's attempts to post specialists in rural areas have met with failure over the years and dais conducting traditional deliveries has been banned around a year ago, leaving villagers with no option but to go for totally unsafe, unprofessional delivery at home.
Saturday, November 10, 2007
Let men do their bit
The Pioneer, Sunday November 11, 2007
Shailaja Chandra
For 30 years, vasectomy has been a political taboo, and the entire burden of family planning has been on women. But modern vasectomy techniques are a success in the West. India needs to try them
According to the projection of the Registrar General of India, India's most populous State, Uttar Pradesh, will account for 22 per cent of India's population by 2026. Half of India's demographic growth will occur in Uttar Pradesh and Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan - certainly a huge jump. Fertility rates here are destined to take decades to reach replacement levels. In contrast, the south (Andhra Pradesh, Karnataka, Kerala and Tamil Nadu) is forecast to jointly account for only 13 per cent of the population increase during the same period, having already achieved the target fertility rate of 2.1 optimally projected for 2010 for the country.
Currently, 42 per cent of India's population produces three or more children. Of 188 million couples requiring contraceptive coverage, only 53 per cent are using contraceptives. The percentage of women having more than three children is 57 per cent in Uttar Pradesh, 54 per cent in Bihar and 49 per cent in Madhya Pradesh. Almost half the girls there are under 18 at marriage and soon become mothers.
With half the population in the reproductive group using no contraceptives, there is urgent need to push up the age of marriage, delay the birth of the first child and widen the scope for spacing and limiting families. Vasectomy is a feasible way of enlarging services for a simple, safe and effective terminal method.
Unfortunately, any large-scale efforts to limit population are attacked by critics as an invasion of "human rights". Added to this, given the cultural ethos of the northern States, such goals are dumped as "unacceptable" and "impossible" and invariably shunned by many politicians who thrive on the continued ignorance of populations.
The Millennium Development Goals do not envision family planning strategies as the direct route to improving maternal and child health. This acts as a deterrent to do-gooder international or national organisations from getting involved overtly.
Concentration on maternal and child health services has unwittingly excluded men. Counselling on vasectomy is just not their business. In India, men have ceased to be the direct object of the family planning programme ever since eight million male sterilisations were conducted -- six times more than in a normal year -- coercively and haphazardly during the draconian Emergency.
Even now horror stories of three decades gone by give shudders to politicians, especially in the Hindi belt. With no other terminal option available, millions of women have perforce to undergo tubal ligations having already borne the brunt of unwanted pregnancies and repeated childbirths, not to speak of often dangerous induced abortions.
Against this background, the recent resurrection of the vasectomy programme comes as a welcome surprise. Madhya Pradesh has doubled vasectomies in the span of just one year from 7,000 operations in 2003-04 to over 15,000 the year after. An orthodox State like Haryana has steadily shown higher and higher performance each passing year. Its neighbour Punjab has quadrupled the number of vasectomies in a matter of one year. Likewise conservative Rajasthan has upped the vasectomy performance from just 1,700 during 2003-04 by almost five-times.
During a recent visit to Gujarat, I noted how vasectomy operations had increased six-fold in one year with 6,200 operations conducted in just two months inviting the headline, "Vasectomy with a Vengeance", from a national newspaper. On October 6, in a single district, Vadodara, nearly 900 vasectomies were performed and hundreds of men had clearly come willingly for this outpatient procedure.
At every health facility, ANMs in white saris and smart name tags, anganwadi workers and village women togged up in their best attire escorted the "acceptors" for vasectomy. Even the drivers and sweepers had jumped on the vasectomy bandwagon and motivated between five and 15 young men each. Surgeries progressed speedily and while the patients lounged on beds, waiting their turn, paranthas, enthusiastic counselling and a bag full of condoms were kept in readiness to complete the day's work.
Whether the carrot was the Rs 200 motivation money or the Rs 1,000 compensation for acceptors, an enormous response was clearly evident. But despite occasional peaks, India's annual vasectomy total remains less than a 10th of the pre-Emergency levels, despite hundreds of surgeons having acquired the Chinese non-scalpel skill taught largely by a veteran, Dr RM Kaza of Delhi's Maulana Azad Medical College.
In the United States, United Kingdom, Canada and New Zealand vasectomies are expensive and it is the more educated people who opt for the procedure, gently encouraged to do so by sophisticated advertisements. In India, as in Bangladesh, Sri Lanka, and Thailand, vasectomies are treated as the poor man's option. In some Latin American countries like Brazil, Colombia and Mexico, vasectomy has been presented as an alternative to female sterilisation, and by involving wives in decision-making the outturns improved.
What is needed is for decision-makers outside the health sector to stop worrying about resurrecting the ghost of 1975 and understand that our population growth is having a direct and detrimental effect on maternal and infant mortality, the birth of underweight children and their future growth and survival. In all fairness to women, it is time to revitalise vasectomy.
Shailaja Chandra
For 30 years, vasectomy has been a political taboo, and the entire burden of family planning has been on women. But modern vasectomy techniques are a success in the West. India needs to try them
According to the projection of the Registrar General of India, India's most populous State, Uttar Pradesh, will account for 22 per cent of India's population by 2026. Half of India's demographic growth will occur in Uttar Pradesh and Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan - certainly a huge jump. Fertility rates here are destined to take decades to reach replacement levels. In contrast, the south (Andhra Pradesh, Karnataka, Kerala and Tamil Nadu) is forecast to jointly account for only 13 per cent of the population increase during the same period, having already achieved the target fertility rate of 2.1 optimally projected for 2010 for the country.
Currently, 42 per cent of India's population produces three or more children. Of 188 million couples requiring contraceptive coverage, only 53 per cent are using contraceptives. The percentage of women having more than three children is 57 per cent in Uttar Pradesh, 54 per cent in Bihar and 49 per cent in Madhya Pradesh. Almost half the girls there are under 18 at marriage and soon become mothers.
With half the population in the reproductive group using no contraceptives, there is urgent need to push up the age of marriage, delay the birth of the first child and widen the scope for spacing and limiting families. Vasectomy is a feasible way of enlarging services for a simple, safe and effective terminal method.
Unfortunately, any large-scale efforts to limit population are attacked by critics as an invasion of "human rights". Added to this, given the cultural ethos of the northern States, such goals are dumped as "unacceptable" and "impossible" and invariably shunned by many politicians who thrive on the continued ignorance of populations.
The Millennium Development Goals do not envision family planning strategies as the direct route to improving maternal and child health. This acts as a deterrent to do-gooder international or national organisations from getting involved overtly.
Concentration on maternal and child health services has unwittingly excluded men. Counselling on vasectomy is just not their business. In India, men have ceased to be the direct object of the family planning programme ever since eight million male sterilisations were conducted -- six times more than in a normal year -- coercively and haphazardly during the draconian Emergency.
Even now horror stories of three decades gone by give shudders to politicians, especially in the Hindi belt. With no other terminal option available, millions of women have perforce to undergo tubal ligations having already borne the brunt of unwanted pregnancies and repeated childbirths, not to speak of often dangerous induced abortions.
Against this background, the recent resurrection of the vasectomy programme comes as a welcome surprise. Madhya Pradesh has doubled vasectomies in the span of just one year from 7,000 operations in 2003-04 to over 15,000 the year after. An orthodox State like Haryana has steadily shown higher and higher performance each passing year. Its neighbour Punjab has quadrupled the number of vasectomies in a matter of one year. Likewise conservative Rajasthan has upped the vasectomy performance from just 1,700 during 2003-04 by almost five-times.
During a recent visit to Gujarat, I noted how vasectomy operations had increased six-fold in one year with 6,200 operations conducted in just two months inviting the headline, "Vasectomy with a Vengeance", from a national newspaper. On October 6, in a single district, Vadodara, nearly 900 vasectomies were performed and hundreds of men had clearly come willingly for this outpatient procedure.
At every health facility, ANMs in white saris and smart name tags, anganwadi workers and village women togged up in their best attire escorted the "acceptors" for vasectomy. Even the drivers and sweepers had jumped on the vasectomy bandwagon and motivated between five and 15 young men each. Surgeries progressed speedily and while the patients lounged on beds, waiting their turn, paranthas, enthusiastic counselling and a bag full of condoms were kept in readiness to complete the day's work.
Whether the carrot was the Rs 200 motivation money or the Rs 1,000 compensation for acceptors, an enormous response was clearly evident. But despite occasional peaks, India's annual vasectomy total remains less than a 10th of the pre-Emergency levels, despite hundreds of surgeons having acquired the Chinese non-scalpel skill taught largely by a veteran, Dr RM Kaza of Delhi's Maulana Azad Medical College.
In the United States, United Kingdom, Canada and New Zealand vasectomies are expensive and it is the more educated people who opt for the procedure, gently encouraged to do so by sophisticated advertisements. In India, as in Bangladesh, Sri Lanka, and Thailand, vasectomies are treated as the poor man's option. In some Latin American countries like Brazil, Colombia and Mexico, vasectomy has been presented as an alternative to female sterilisation, and by involving wives in decision-making the outturns improved.
What is needed is for decision-makers outside the health sector to stop worrying about resurrecting the ghost of 1975 and understand that our population growth is having a direct and detrimental effect on maternal and infant mortality, the birth of underweight children and their future growth and survival. In all fairness to women, it is time to revitalise vasectomy.
Thursday, November 08, 2007
Mothers and children in MP: Survival questioned
Sachin K Jain
Source - www.merinews.com
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
SANGRAM SINGH of Khatia-Narangi village in Baiga-tribal dominated Mandla district of Madhya Pradesh is not able to open his eyes despite many efforts. His eyelids collapse instantly and his eyes close. His skin is getting contracted. There are several questions about the chances of his survival. The weight of this 50-day child is just 2.2 kg. If such young children are capable of thinking, then Sangram Singh must be surely thinking about the unjust character of the society. He is still in critical situation and Government of Madhya Pradesh has ordered an enquiry in the Shivkali’s, his mother, death case. The term of reference of this enquiry does not contain any point to investigate the violation of child rights. They will only do a formality of investigation of death, not the violation of rights.
Sangram Singh is not just any child but a character of the story that is common for the 7700 children who are born every year in Madhya Pradesh. These are those children who do not have the good luck of receiving mother’s milk and the warmth and sensitivity of her lap. The tragic aspect is that the negligence of government and society becomes the biggest reason for the maternal deaths during childbirth.
If a woman dies within 42 days of childbirth, then the death is considered as maternal mortality. Shivkali died within 11 days of childbirth, yet the state government did not consider it as maternal mortality. As per the Health Department Mandla district did not record a single maternal death during April 2007, which means that along with life of Shivkali, the government is also denying her death. After the death of his mother, the life of Sangram is also in dire straits. At birth, his weight was 2.4 kg, which means that his development has been stunted. In such circumstances, the local health workers have refused to treat the child. Finally with the help of local social workers, Sangram was taken to a doctor Mukesh Rutela in Nainpur on May 22. Here it was diagnosed that Sangram was already entered in grade IV malnutrition category and is also suffering from various infections. At the time of birth he was not severely malnourished and if his treatment is not carried out very intensively, the chances of his survival are poor. The family is full of anger and sadness, but they are now not ready to go to government hospital.
Baiga tribal woman Shivkali had given birth to Sangram Singh on April 4 in her hutment. Local traditional midwife Jethibai assisted the childbirth. There is a primary health centre in this village. Interestingly, the village is not away from the mainstream of system. It is located just by the main gate of Kanha National Park. Ironically the objective of the Primary Health Centre located at the Khatiya village has been to take care of the national and international level tourists rather than the villagers. The PHC has now got a beautiful building, but only three to four villagers reach the PHC every day. When we reached the centre, out of the 15 member staff including four nurses, doctor, ANM and sanitary workers, only one nurse was present. Son Sai of Khatia village says that whenever one approached the centre, the message is that majority of staff have gone to block or district headquarters for some meeting. In such circumstances people are forced to go to Bicchia or Mandla. It is incomprehensible as to why the government is denying that the Baiga tribal (whom former Prime Minister Indira Gandhi had described as national people) live in a traditional setting. Because forest rights were taken away from them, they have also lost access to traditional medicines owing to which women and children are dying, but the modern medicine system is far out of their reach. If the future of the children is to be safeguarded then the government should have brought the Baigas close to modern treatment facilities in a sincere and sensitive manner.
The maternal and child mortality cannot be contained only by writing slogans on the walls or presenting unbelievable statistics. Isn’t it a serious fact that around 10 million children die every year before celebrating first birthday in Madhya Pradesh?
The effort for protection of life is also the responsibility of anganbadis, but it could only be called unfortunate that the name of Shivkali was not registered in the list of pregnant women in the local anganbadi. Naturally this pregnant woman from a poor family could not get enough nutrition to sustain herself and her foetus. However, after her death, the local anganbadi worker Shashikanta Thakur took possession of her mother-child card and filled up all details regarding completion of immunization doses. Similarly the district hospital took possession of all medical documents related to Shivkali and Sangram Singh. The amount of efforts taken to destroy evidence if taken previously could have saved lives of Shivkali and Sangram. Shashikanta waves off her responsibility saying that the tribal people do not want to get immunized or treated. “Khushiyal Singh (Shivkali’s husband) should have been more responsible. We cannot go home to home checking upon people,’’ she says. Thus the victim has been made the accused by the system. It is very unfortunate that the woman who could not even express her health problems or pains has been made responsible for her own death.
Ten per cent of the populace in MP is that of tribal communities including three primitive tribal – Baiga, Bharia and Saharia. But the state government does not have any work plan to change the innate behavioural patterns or gaining confidence of these communities. Not only this, but the 51000 odd traditional midwives (dais) who could have brought these people closer to modern medicine system have been banned from offering their services. On one hand the government is not able to provide proper health services and on the other hand it is scrapping the traditional and alternative systems.
The situation in Khatia is very unusual. Shivkali never received even a single health check up during her pregnancy period and did not get a single immunization dose. During last two years, the state government started as many as seven schemes to prevent maternal and child morbidity and mortality, of which the Vijayaraje Janani Bima Kalyan Yojana was closed down on May 11, 2007. The logic given was that the women were getting enough benefits under other schemes and thus this was not necessary. The truth is that during last year, 56 women and 807 kids perished in Mandla. Government touts that institutional childbirth is the best way to safe motherhood and that the responsibility to encourage community for this falls on health administration.
The sub-health centers and the primary health centers have to ensure that every pregnant woman should be registered within 12 weeks of pregnancy so that the regular health check up, immunization, nutritional needs and emergency treatment facilities could be ensured for her. The basic thing is that government will have to take care that health services and health workers should reach the needy people like Shivkali and Sangram. It should not be expected that women and children bearing pain and burdened by exploitation would reach the health centers and demand services.
As per the guidelines of the Government of India, all the primary health centers should have refrigerator and deep freezer to store the medicines, but at the Khatia PHC, the medicines and equipments were lying openly at temperature of 43 degrees. There are no standard arrangements of storing medicines in the 7300 sub-health centers in MP, owing to which the treatment of patients becomes risky in itself.
The issue of health demands sensitive behaviour and attitude, which means that it should be ensured that the people suffering from pains could be provided humane touch. It is a well-proven fact that total cure of any pain is not possible only through medicines. For Shivkali and Sangram, this belief could not prove to be positive.
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
Sangram was born into tattered unclean rags at home, but after this the health of Shivkali started deteriorating. Then Shivkali’s father Mangal Singh started looking for the ANM and the health worker. As it was evening time, Jagat Singh Pande and Subhadra Pande did not pay attention to the issue and asked that Shivkali be taken to Mandla, which is 65 kms from Khatia. Under one scheme of the government, financial assistance is provided to pregnant women facing problems for reaching the health services, but Shivkali did not receive any such assistance. Mangal Singh rented a private vehicle for Rs 1200 and took her to district hospital, Mandla. They had the Deendayal Antyodaya Treatment Card, but the doctors did not pay attention to it. The lady doctor in the hospital asked for Rs 3000 from Mangal Singh for the treatment. Since it was matter of life and death for his daughter and grandson, Mangal Singh requested the doctor to start the treatment, although he had only Rs 30 left with him after paying the rent of the vehicle. Even this Rs 30 was taken away by the doctor. Mangal is also the chief of the Baiga Adiwasi Sangathan of Mandla and thus he lodged a complaint with the District Collector regarding this exploitation. Inquiry was conducted and pressure was created on the hospital administration.
But the inhumane face of the doctors came to the fore. As soon as the district administration official left the hospital, the hospital authorities refused to treat Shivkali and referred her to Jabalpur. Doctor said to Mangal Singh that, “you are a leader and only your leadership can save your daughter.” Thus Shivkali had to pay for her poverty as well as for demanding her rights, although indirectly. Left with no option, Mangal Singh decided to take Shivkali back to village, but she succumbed even before reaching the village.
Now Mangal Singh is facing a debt of Rs 5500, which he would have to repay at the interest rate of 10 per cent per month. Leave aside treatment and medicine; the family did not even receive any consolation. It is natural that no sacrifice is expected from the health workers, but could not they be expected to at least fulfill the responsibilities allotted to them.
Health worker Jagat Singh says that it is compulsory to attend meetings every month. Since targets are fixed, thus information has to be provided regularly, even if it means that there is no time left for fulfilling the targets. The health workers also have their limits; Jagat Singh says adding that what would have happened if Shivkali had died while the nurse was trying to treat her. If there are no doctors available permanently, how women like Shivkali could be saved.
Every year about 17 lakh childbirths are carried out in the State and of them 53 per cent are in BPL, tribal and dalit families. In such situation, 99 out of 137 posts of obstetricians and gynecologists are vacant. About 648 out of 4607 posts of doctors are vacant and of the rest 3133 medical officers are posted in urban and semi-urban areas. Shivkali needed blood, but although getting blood is easy for people of higher economic classes, she could not get blood. There was hospital, medicine, anganbadi as well as motorable road, yet Shivkali had to die and little Sangram is struggling for survival.
In Madhya Pradesh out of the 1000 children born, 70 perish before their first birthday. According to this rate, in year 2006-07 as many as 1.19 lakh infants could not be saved. This proved that still at the societal, political and governmental level, the right to honorable life right is a much neglected issue.
Despite efforts by the government, as many as 8.56 lakh childbirths in MP in 2006-07 occurred at homes. There are certainly efforts to rid the society of evil of maternal death through institutional childbirth. But the situation of the health centers and the inhumane behaviour meted out there is still a big challenge. In Indore, a nurse physically assaulted a pregnant woman while in Mandsaur a woman had to undergo childbirth on the road as she could not pay bribe to health workers. In Ashok Nagar, Nevabai became a victim to negligence of doctors and when the community demanded inquiry of the incident, the health administration boycotted Nevabai’s village Nidanpur. Due to this boycott, Phoolkunwar died on the road. Seems to me that the bigger reasons for maternal and infant deaths are selfishness and ego of the expert medical practitioners.
Source - www.merinews.com
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
SANGRAM SINGH of Khatia-Narangi village in Baiga-tribal dominated Mandla district of Madhya Pradesh is not able to open his eyes despite many efforts. His eyelids collapse instantly and his eyes close. His skin is getting contracted. There are several questions about the chances of his survival. The weight of this 50-day child is just 2.2 kg. If such young children are capable of thinking, then Sangram Singh must be surely thinking about the unjust character of the society. He is still in critical situation and Government of Madhya Pradesh has ordered an enquiry in the Shivkali’s, his mother, death case. The term of reference of this enquiry does not contain any point to investigate the violation of child rights. They will only do a formality of investigation of death, not the violation of rights.
Sangram Singh is not just any child but a character of the story that is common for the 7700 children who are born every year in Madhya Pradesh. These are those children who do not have the good luck of receiving mother’s milk and the warmth and sensitivity of her lap. The tragic aspect is that the negligence of government and society becomes the biggest reason for the maternal deaths during childbirth.
If a woman dies within 42 days of childbirth, then the death is considered as maternal mortality. Shivkali died within 11 days of childbirth, yet the state government did not consider it as maternal mortality. As per the Health Department Mandla district did not record a single maternal death during April 2007, which means that along with life of Shivkali, the government is also denying her death. After the death of his mother, the life of Sangram is also in dire straits. At birth, his weight was 2.4 kg, which means that his development has been stunted. In such circumstances, the local health workers have refused to treat the child. Finally with the help of local social workers, Sangram was taken to a doctor Mukesh Rutela in Nainpur on May 22. Here it was diagnosed that Sangram was already entered in grade IV malnutrition category and is also suffering from various infections. At the time of birth he was not severely malnourished and if his treatment is not carried out very intensively, the chances of his survival are poor. The family is full of anger and sadness, but they are now not ready to go to government hospital.
Baiga tribal woman Shivkali had given birth to Sangram Singh on April 4 in her hutment. Local traditional midwife Jethibai assisted the childbirth. There is a primary health centre in this village. Interestingly, the village is not away from the mainstream of system. It is located just by the main gate of Kanha National Park. Ironically the objective of the Primary Health Centre located at the Khatiya village has been to take care of the national and international level tourists rather than the villagers. The PHC has now got a beautiful building, but only three to four villagers reach the PHC every day. When we reached the centre, out of the 15 member staff including four nurses, doctor, ANM and sanitary workers, only one nurse was present. Son Sai of Khatia village says that whenever one approached the centre, the message is that majority of staff have gone to block or district headquarters for some meeting. In such circumstances people are forced to go to Bicchia or Mandla. It is incomprehensible as to why the government is denying that the Baiga tribal (whom former Prime Minister Indira Gandhi had described as national people) live in a traditional setting. Because forest rights were taken away from them, they have also lost access to traditional medicines owing to which women and children are dying, but the modern medicine system is far out of their reach. If the future of the children is to be safeguarded then the government should have brought the Baigas close to modern treatment facilities in a sincere and sensitive manner.
The maternal and child mortality cannot be contained only by writing slogans on the walls or presenting unbelievable statistics. Isn’t it a serious fact that around 10 million children die every year before celebrating first birthday in Madhya Pradesh?
The effort for protection of life is also the responsibility of anganbadis, but it could only be called unfortunate that the name of Shivkali was not registered in the list of pregnant women in the local anganbadi. Naturally this pregnant woman from a poor family could not get enough nutrition to sustain herself and her foetus. However, after her death, the local anganbadi worker Shashikanta Thakur took possession of her mother-child card and filled up all details regarding completion of immunization doses. Similarly the district hospital took possession of all medical documents related to Shivkali and Sangram Singh. The amount of efforts taken to destroy evidence if taken previously could have saved lives of Shivkali and Sangram. Shashikanta waves off her responsibility saying that the tribal people do not want to get immunized or treated. “Khushiyal Singh (Shivkali’s husband) should have been more responsible. We cannot go home to home checking upon people,’’ she says. Thus the victim has been made the accused by the system. It is very unfortunate that the woman who could not even express her health problems or pains has been made responsible for her own death.
Ten per cent of the populace in MP is that of tribal communities including three primitive tribal – Baiga, Bharia and Saharia. But the state government does not have any work plan to change the innate behavioural patterns or gaining confidence of these communities. Not only this, but the 51000 odd traditional midwives (dais) who could have brought these people closer to modern medicine system have been banned from offering their services. On one hand the government is not able to provide proper health services and on the other hand it is scrapping the traditional and alternative systems.
The situation in Khatia is very unusual. Shivkali never received even a single health check up during her pregnancy period and did not get a single immunization dose. During last two years, the state government started as many as seven schemes to prevent maternal and child morbidity and mortality, of which the Vijayaraje Janani Bima Kalyan Yojana was closed down on May 11, 2007. The logic given was that the women were getting enough benefits under other schemes and thus this was not necessary. The truth is that during last year, 56 women and 807 kids perished in Mandla. Government touts that institutional childbirth is the best way to safe motherhood and that the responsibility to encourage community for this falls on health administration.
The sub-health centers and the primary health centers have to ensure that every pregnant woman should be registered within 12 weeks of pregnancy so that the regular health check up, immunization, nutritional needs and emergency treatment facilities could be ensured for her. The basic thing is that government will have to take care that health services and health workers should reach the needy people like Shivkali and Sangram. It should not be expected that women and children bearing pain and burdened by exploitation would reach the health centers and demand services.
As per the guidelines of the Government of India, all the primary health centers should have refrigerator and deep freezer to store the medicines, but at the Khatia PHC, the medicines and equipments were lying openly at temperature of 43 degrees. There are no standard arrangements of storing medicines in the 7300 sub-health centers in MP, owing to which the treatment of patients becomes risky in itself.
The issue of health demands sensitive behaviour and attitude, which means that it should be ensured that the people suffering from pains could be provided humane touch. It is a well-proven fact that total cure of any pain is not possible only through medicines. For Shivkali and Sangram, this belief could not prove to be positive.
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
Sangram was born into tattered unclean rags at home, but after this the health of Shivkali started deteriorating. Then Shivkali’s father Mangal Singh started looking for the ANM and the health worker. As it was evening time, Jagat Singh Pande and Subhadra Pande did not pay attention to the issue and asked that Shivkali be taken to Mandla, which is 65 kms from Khatia. Under one scheme of the government, financial assistance is provided to pregnant women facing problems for reaching the health services, but Shivkali did not receive any such assistance. Mangal Singh rented a private vehicle for Rs 1200 and took her to district hospital, Mandla. They had the Deendayal Antyodaya Treatment Card, but the doctors did not pay attention to it. The lady doctor in the hospital asked for Rs 3000 from Mangal Singh for the treatment. Since it was matter of life and death for his daughter and grandson, Mangal Singh requested the doctor to start the treatment, although he had only Rs 30 left with him after paying the rent of the vehicle. Even this Rs 30 was taken away by the doctor. Mangal is also the chief of the Baiga Adiwasi Sangathan of Mandla and thus he lodged a complaint with the District Collector regarding this exploitation. Inquiry was conducted and pressure was created on the hospital administration.
But the inhumane face of the doctors came to the fore. As soon as the district administration official left the hospital, the hospital authorities refused to treat Shivkali and referred her to Jabalpur. Doctor said to Mangal Singh that, “you are a leader and only your leadership can save your daughter.” Thus Shivkali had to pay for her poverty as well as for demanding her rights, although indirectly. Left with no option, Mangal Singh decided to take Shivkali back to village, but she succumbed even before reaching the village.
Now Mangal Singh is facing a debt of Rs 5500, which he would have to repay at the interest rate of 10 per cent per month. Leave aside treatment and medicine; the family did not even receive any consolation. It is natural that no sacrifice is expected from the health workers, but could not they be expected to at least fulfill the responsibilities allotted to them.
Health worker Jagat Singh says that it is compulsory to attend meetings every month. Since targets are fixed, thus information has to be provided regularly, even if it means that there is no time left for fulfilling the targets. The health workers also have their limits; Jagat Singh says adding that what would have happened if Shivkali had died while the nurse was trying to treat her. If there are no doctors available permanently, how women like Shivkali could be saved.
Every year about 17 lakh childbirths are carried out in the State and of them 53 per cent are in BPL, tribal and dalit families. In such situation, 99 out of 137 posts of obstetricians and gynecologists are vacant. About 648 out of 4607 posts of doctors are vacant and of the rest 3133 medical officers are posted in urban and semi-urban areas. Shivkali needed blood, but although getting blood is easy for people of higher economic classes, she could not get blood. There was hospital, medicine, anganbadi as well as motorable road, yet Shivkali had to die and little Sangram is struggling for survival.
In Madhya Pradesh out of the 1000 children born, 70 perish before their first birthday. According to this rate, in year 2006-07 as many as 1.19 lakh infants could not be saved. This proved that still at the societal, political and governmental level, the right to honorable life right is a much neglected issue.
Despite efforts by the government, as many as 8.56 lakh childbirths in MP in 2006-07 occurred at homes. There are certainly efforts to rid the society of evil of maternal death through institutional childbirth. But the situation of the health centers and the inhumane behaviour meted out there is still a big challenge. In Indore, a nurse physically assaulted a pregnant woman while in Mandsaur a woman had to undergo childbirth on the road as she could not pay bribe to health workers. In Ashok Nagar, Nevabai became a victim to negligence of doctors and when the community demanded inquiry of the incident, the health administration boycotted Nevabai’s village Nidanpur. Due to this boycott, Phoolkunwar died on the road. Seems to me that the bigger reasons for maternal and infant deaths are selfishness and ego of the expert medical practitioners.
Monday, October 22, 2007
Fategarh health centre in Guna, MP helps save lives
Anil Gulati
Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.
PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.
The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.
Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.
The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.
The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.
“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.
Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.
Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.
PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.
The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.
Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.
The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.
The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.
“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.
Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.
Fategarh health centre in Guna, MP helps save lives
Anil Gulati
Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.
PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.
The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.
Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.
The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.
The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.
“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.
Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.
Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.
PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.
The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.
Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.
The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.
The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.
“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.
Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.
Sunday, October 14, 2007
Empowering Women
By M V Kamath, The Organiser, Sept 30, 2007
Irrespective of whether a woman is elected President or not, there are certain things that not just a woman President but all political parties should attend to—and it is the rights of women. Not just in India, but all over the world women have been the greatest sufferers. About three quarters of the world’s 20 million refugees are women and their dependents. Women and children account for more than 80 per cent of those living in refugee camps and that is seldom acknowledged. Things are no better, specifically in India.
According to The Indian National Crimes Records Bureau (NCRB) quoted by a distinguished human rights expert, D.R. Kaarthikeyan, there were 9,518 cases of rape in India in 1990 which rose to 9,793 in 1991 and to 15,468 cases in 1999. Similarly, there were 4,836 dowry deaths cases in 1990, which rose to 5,157 in 1991 and to an all-time high of 6,699 in 1999. Cases of torture of women have to be enumerated to be believed. There were 13,450 cases in 1990, as many as 15,949 in 1991 and an unbelievable 43,823 cases in 1999.
In his book on human rights, Mr Kaarthikeyan writes: “Research has shown that for millions of women, their homes are dens of terror and that a huge chunk of violence that is perpetrated against women is committed by their own family members.” Not only that, but such violence cuts across income, class and culture and these incidents are rarely reported and even if they are reported “they are reported when it is too late to change the situation”.
It is frightening to think that every 26 minutes a women is molested, every 34 minutes a rape takes place, every 42 minutes a sexual harassment incident occurs, every 43 minutes a woman is kidnapped and almost every hour a woman is burnt to death over dowry, 25 per cent of rapes involving girls in the age of 16. This is India. The spiral of violence against women is apparently rising “at an alarming rate”—and this is where just not a woman president, not just a government in power, but all political parties irrespective of their ideology must come in, to fight for social reform, for enlightenment of people and for raising our ancient culture to higher levels. Gender violence comes in many forms with which most of us are familiar. They include foeticide, food deprivation, emotional abuse, forced marriage, sati, rape, sexual assault, harassment of all sorts, trafficking, forced sterilisation, torture and finally dowry deaths, the cruellest of all.
There are, of course, legal provisions to fight gender violence but none of these have truly been effective. Jawaharlal Nehru once said: “You can tell the condition of a nation by looking at the status of its women.” On the one hand, India has the world’s largest number of professionally qualified women which may come as a surprise to many to know. India reportedly has more women doctors, surgeons, scientists and professors than even the United States of America. Similarly, India has more working women than any other country in the world and they are notable for their skills whether as surgeons, airline pilots or even bus conductors and menial workers. That should be a legitimate matter of pride.
But then think of this: India has the largest population of non-school going working girls, maternal mortality rates in rural areas are among the world’s highest and of the 15 million baby girls born in India each year, nearly 25 per cent of them do not live to see their 15th birthday.
Compared to baby boys, they get less food, less care and less attention, which is a disgrace to the country. Indians who boast of the panch kanyas, Ahalya, Draupadi, Sita, Tara and Mandodari, and insist that if these are smare nityam, maha pathaka nashanam (the greatest sins are destroyed if they are daily remembered), have no hesitation in resorting to foeticide if the foetus shows that it is that of a girl. What can be more shameful?
In India, female foeticide, sex selective abortion and child prostitution are only too common and few voices are raised against them. Laws are for textbooks, not for application. The Dowry Prohibition Act has been in existence for over 33 years, but how effective has it ever been? Domestic violence is recognised by existing civil law, according to Kaarthikeyan, but only in the context of dissolution of a marriage, and as being conduct amounting to cruelty, and therefore, ground for divorce. Is that all we want? With female foeticide becoming almost routine, we are coming to a stage when young men in some states, especially in the north and west, will have to search for brides elsewhere in the country. In the latest Census, the number of female child births has come down to 93.7 for every hundred male children. The anti-girl child bias has to be fought at the ground level and this is not a party issue: It is a national issue. We need a new set of Raja Ram Mohan Roys to act as social reformers who have the courage to speak out and speak persuasively. Sadly, we don’t have them. We only have cheap politicians for ever dwelling on secularism as their moola mantra which is an easy way to attain political applause.
When did any member of the present UPA government ever speak about these matters? When one realises that women form half of that world’s population—as indeed half of the population in almost any given state—it is shocking to learn that women perform two-third of the world’s work and receive only one-tenth of its income and less than one hundredth of its property. In reality, this is a man’s world. And men are notorious for the ways they treat women—not outsiders—but those in their own homes. In India, the states most notorious for the ill-treatment of women are Rajasthan, Madhya Pradesh and Delhi. Female foeticide is most rampant in Haryana and Punjab. Does anybody care? Trafficking in women and children, according to Kaarthikeyan, is one of the worst and most brazen abuses of human rights. According to him, at least 25,000 children are engaged in prostitution in India’s metropolitan cities, which is a low figure compared to other sources which put the figure as high as 500,000 girl children below the age of 18 years.
These are issues for our political parties lacking vision to give their attention to. But what can a parliament do which reportedly has some 119 MPs with criminal charges against them? What vision can one expect from them? We are not only a wild nation, but additionally we are also a blind nation. Our only national interest is politics, not people and politics, too, of the blindest variety. We speak about the common man, but it would be nice if we occasionally hear about the travails of the ordinary woman who is the lifeline of our society.
Irrespective of whether a woman is elected President or not, there are certain things that not just a woman President but all political parties should attend to—and it is the rights of women. Not just in India, but all over the world women have been the greatest sufferers. About three quarters of the world’s 20 million refugees are women and their dependents. Women and children account for more than 80 per cent of those living in refugee camps and that is seldom acknowledged. Things are no better, specifically in India.
According to The Indian National Crimes Records Bureau (NCRB) quoted by a distinguished human rights expert, D.R. Kaarthikeyan, there were 9,518 cases of rape in India in 1990 which rose to 9,793 in 1991 and to 15,468 cases in 1999. Similarly, there were 4,836 dowry deaths cases in 1990, which rose to 5,157 in 1991 and to an all-time high of 6,699 in 1999. Cases of torture of women have to be enumerated to be believed. There were 13,450 cases in 1990, as many as 15,949 in 1991 and an unbelievable 43,823 cases in 1999.
In his book on human rights, Mr Kaarthikeyan writes: “Research has shown that for millions of women, their homes are dens of terror and that a huge chunk of violence that is perpetrated against women is committed by their own family members.” Not only that, but such violence cuts across income, class and culture and these incidents are rarely reported and even if they are reported “they are reported when it is too late to change the situation”.
It is frightening to think that every 26 minutes a women is molested, every 34 minutes a rape takes place, every 42 minutes a sexual harassment incident occurs, every 43 minutes a woman is kidnapped and almost every hour a woman is burnt to death over dowry, 25 per cent of rapes involving girls in the age of 16. This is India. The spiral of violence against women is apparently rising “at an alarming rate”—and this is where just not a woman president, not just a government in power, but all political parties irrespective of their ideology must come in, to fight for social reform, for enlightenment of people and for raising our ancient culture to higher levels. Gender violence comes in many forms with which most of us are familiar. They include foeticide, food deprivation, emotional abuse, forced marriage, sati, rape, sexual assault, harassment of all sorts, trafficking, forced sterilisation, torture and finally dowry deaths, the cruellest of all.
There are, of course, legal provisions to fight gender violence but none of these have truly been effective. Jawaharlal Nehru once said: “You can tell the condition of a nation by looking at the status of its women.” On the one hand, India has the world’s largest number of professionally qualified women which may come as a surprise to many to know. India reportedly has more women doctors, surgeons, scientists and professors than even the United States of America. Similarly, India has more working women than any other country in the world and they are notable for their skills whether as surgeons, airline pilots or even bus conductors and menial workers. That should be a legitimate matter of pride.
But then think of this: India has the largest population of non-school going working girls, maternal mortality rates in rural areas are among the world’s highest and of the 15 million baby girls born in India each year, nearly 25 per cent of them do not live to see their 15th birthday.
Compared to baby boys, they get less food, less care and less attention, which is a disgrace to the country. Indians who boast of the panch kanyas, Ahalya, Draupadi, Sita, Tara and Mandodari, and insist that if these are smare nityam, maha pathaka nashanam (the greatest sins are destroyed if they are daily remembered), have no hesitation in resorting to foeticide if the foetus shows that it is that of a girl. What can be more shameful?
In India, female foeticide, sex selective abortion and child prostitution are only too common and few voices are raised against them. Laws are for textbooks, not for application. The Dowry Prohibition Act has been in existence for over 33 years, but how effective has it ever been? Domestic violence is recognised by existing civil law, according to Kaarthikeyan, but only in the context of dissolution of a marriage, and as being conduct amounting to cruelty, and therefore, ground for divorce. Is that all we want? With female foeticide becoming almost routine, we are coming to a stage when young men in some states, especially in the north and west, will have to search for brides elsewhere in the country. In the latest Census, the number of female child births has come down to 93.7 for every hundred male children. The anti-girl child bias has to be fought at the ground level and this is not a party issue: It is a national issue. We need a new set of Raja Ram Mohan Roys to act as social reformers who have the courage to speak out and speak persuasively. Sadly, we don’t have them. We only have cheap politicians for ever dwelling on secularism as their moola mantra which is an easy way to attain political applause.
When did any member of the present UPA government ever speak about these matters? When one realises that women form half of that world’s population—as indeed half of the population in almost any given state—it is shocking to learn that women perform two-third of the world’s work and receive only one-tenth of its income and less than one hundredth of its property. In reality, this is a man’s world. And men are notorious for the ways they treat women—not outsiders—but those in their own homes. In India, the states most notorious for the ill-treatment of women are Rajasthan, Madhya Pradesh and Delhi. Female foeticide is most rampant in Haryana and Punjab. Does anybody care? Trafficking in women and children, according to Kaarthikeyan, is one of the worst and most brazen abuses of human rights. According to him, at least 25,000 children are engaged in prostitution in India’s metropolitan cities, which is a low figure compared to other sources which put the figure as high as 500,000 girl children below the age of 18 years.
These are issues for our political parties lacking vision to give their attention to. But what can a parliament do which reportedly has some 119 MPs with criminal charges against them? What vision can one expect from them? We are not only a wild nation, but additionally we are also a blind nation. Our only national interest is politics, not people and politics, too, of the blindest variety. We speak about the common man, but it would be nice if we occasionally hear about the travails of the ordinary woman who is the lifeline of our society.
Saturday, October 06, 2007
Madhya Pradesh nowhere near reaching key development goals
The authors of the Triple 7 report said the picture in the field of primary education was equally bleak, due to lack of trained teachers and of basic facilities such as drinking water and toilets in the schools.
By S Sharma, IANS - Madhya Pradesh is nowhere near reaching the UN Millennium Development Goals - by the 2015 deadline, if a mid-term evaluation report prepared by voluntary groups is anything to go by.
And this in a state where a world record 3.3 million people across 42 districts took part in a government-sponsored 'Stand Up Against Poverty' campaign in October to achieve the MDGs - reducing poverty, achieving universal primary education, promoting gender equality, reducing child mortality, improving maternal health and ensuring environmental sustainability.
Now voluntary groups in the state have prepared what they call the 'Triple 7 Report' - after a mid-term evaluation of how far the state is from achieving the MDGs.
The report says Madhya Pradesh - where 4.5 million families live below the poverty line - has been found wanting on all fronts.
'Malnutrition is a problem that has always been brushed under the carpet by politicians but the dire conditions in Madhya Pradesh now definitely call for some mandated moves', says Sachin Jain of Vikas Samvad, one of the groups behind the report.
In Madhya Pradesh 82.6 percent of all children under the age of three are anaemic, according to the government's own recent National Family Health Survey - III. The corresponding figure for 1998-99, when NFHS II was carried out, was a low 54 percent.
Sixty percent of all children under the age of three in the state are underweight, 51 percent are stunted and 20 percent are wasted, says the Triple 7 report.
Data collected during the state government's recent growth monitoring drive and Bal Sanjeevni Abhiyaan shows that 80,000 children are suffering from most severe malnutrition and are on the verge of death, the authors of the report say.
According to NFHS III, only 22.4 percent of the children below the age of two have full immunisation coverage.
The Triple 7 report says only 23 percent of the children are registered in Anganwadis -.
In a state where 24 women die in childbirth every day, the maternal mortality rate is 379 per 100,000 live births - third highest in the country.
The infant mortality rate - which counts children who die before the first birthday - stands at 76 per 1,000 live births.
'Though the state has introduced many schemes to help combat maternal and infant deaths, they are not yielding the desired results due to bureaucratic hassles and corruption,' say activists responsible for the Triple 7 report.
The activists refer to a recent report of the Comptroller and Auditor General of India that benefits of the schemes do not reach 52-62 percent of the children and 46-59 percent of the pregnant and lactating mothers.
And it is not as if private healthcare is stepping into the breach. The activists point out that expenditure on health has declined from 5.1 percent of total expenditure in 2000-01 to 3.4 percent in 2004-05.
This is a state where 38 percent of the rural population do not have access to safe drinking water. Madhya Pradesh accounts for 40 percent falciparum malaria cases in the country.
The authors of the Triple 7 report said the picture in the field of primary education was equally bleak, due to lack of trained teachers and of basic facilities such as drinking water and toilets in the schools.
The authorities also had to address issues such as the distance to the nearest school, midday meals and scholarships, the activists added.
By S Sharma, IANS - Madhya Pradesh is nowhere near reaching the UN Millennium Development Goals - by the 2015 deadline, if a mid-term evaluation report prepared by voluntary groups is anything to go by.
And this in a state where a world record 3.3 million people across 42 districts took part in a government-sponsored 'Stand Up Against Poverty' campaign in October to achieve the MDGs - reducing poverty, achieving universal primary education, promoting gender equality, reducing child mortality, improving maternal health and ensuring environmental sustainability.
Now voluntary groups in the state have prepared what they call the 'Triple 7 Report' - after a mid-term evaluation of how far the state is from achieving the MDGs.
The report says Madhya Pradesh - where 4.5 million families live below the poverty line - has been found wanting on all fronts.
'Malnutrition is a problem that has always been brushed under the carpet by politicians but the dire conditions in Madhya Pradesh now definitely call for some mandated moves', says Sachin Jain of Vikas Samvad, one of the groups behind the report.
In Madhya Pradesh 82.6 percent of all children under the age of three are anaemic, according to the government's own recent National Family Health Survey - III. The corresponding figure for 1998-99, when NFHS II was carried out, was a low 54 percent.
Sixty percent of all children under the age of three in the state are underweight, 51 percent are stunted and 20 percent are wasted, says the Triple 7 report.
Data collected during the state government's recent growth monitoring drive and Bal Sanjeevni Abhiyaan shows that 80,000 children are suffering from most severe malnutrition and are on the verge of death, the authors of the report say.
According to NFHS III, only 22.4 percent of the children below the age of two have full immunisation coverage.
The Triple 7 report says only 23 percent of the children are registered in Anganwadis -.
In a state where 24 women die in childbirth every day, the maternal mortality rate is 379 per 100,000 live births - third highest in the country.
The infant mortality rate - which counts children who die before the first birthday - stands at 76 per 1,000 live births.
'Though the state has introduced many schemes to help combat maternal and infant deaths, they are not yielding the desired results due to bureaucratic hassles and corruption,' say activists responsible for the Triple 7 report.
The activists refer to a recent report of the Comptroller and Auditor General of India that benefits of the schemes do not reach 52-62 percent of the children and 46-59 percent of the pregnant and lactating mothers.
And it is not as if private healthcare is stepping into the breach. The activists point out that expenditure on health has declined from 5.1 percent of total expenditure in 2000-01 to 3.4 percent in 2004-05.
This is a state where 38 percent of the rural population do not have access to safe drinking water. Madhya Pradesh accounts for 40 percent falciparum malaria cases in the country.
The authors of the Triple 7 report said the picture in the field of primary education was equally bleak, due to lack of trained teachers and of basic facilities such as drinking water and toilets in the schools.
The authorities also had to address issues such as the distance to the nearest school, midday meals and scholarships, the activists added.
Saturday, August 25, 2007
Engaging India: A matter of national shame
Amy Yee, Financial Times
At a health centre in India’s Madhya Pradesh state, three-year-old Rajkumar clings to his mother, a woman named Anita whose youth is hinted at only when a smile cracks her weathered face. Rajkumar wails when his mother moves away slightly, standing by himself on the cot where she sits.
I am unsure whether he is crying for his mother or because it is painful to stand: his legs are matchstick thin – merely the width of two of my fingers. Rajkumar weights only 5.9 kg (13 pounds) when he should weigh 12 kg. His hair is brittle, light brown – another tell-tale sign of malnourishment.
Nearby, another mother looks on from amid the rows of cots lined up across the large room. She cradles her baby, whose head dwarfs his frail, doll-like body.
Severely malnourished children like Rajkumar and their mothers are sent to health centres like this one by government health workers who work, with assistance from Unicef, in surrounding villages at ”anganwadi” – half-day pre-schools where children are fed, immunised, weighed, and monitored. If left untreated, children at this stage are likely to die from infections that plague their weakened bodies. Indeed, more than half of all deaths among under-fives are linked to malnutrition, says the World Health Organisation. At the health centres, launched by Unicef and the Madhya Pradesh state government a few years ago, mothers are counseled on nutrition and hygiene. At this town clinic in Shivpuri district, about five hours from Delhi by train, children and their mothers are fed and monitored for two weeks.
At an anganwadi in a small hamlet miles from the health centre, children sing cheerful songs and crowd the floor of a simple shack. There they eat a daily lunch prepared from local ingredients on a wood-burning hearth. Today it is a meal of soy, groundnuts, rice, potato, onion, mint, oil and salt. The anganwadi also acts as a resource centre for mothers: its walls bear posters with bright cartoons that warn of polio and anemia.
Government-run anganwadi have been in place for three decades. The network has been expanded as part of a national plan to improve children’s health. In recent years Unicef has stepped up its presence in landlocked Madhya Pradesh, or ”Middle State”, which has some of the worst levels of malnutrition among already alarming national numbers.
An astonishing 46.3 per cent of all children under the age of three in India are malnourished, and nearly 80 per cent are anemic, according to the government’s National Health and Family Survey of 2005-06. There has been marginal improvement since 1992-93, when 51 per cent of under-threes were underweight. But in Madhya Pradesh, figures have worsened from 55 per cent in 1998-1999 to 60 per cent in 2005-2006.
The statistics are stupefying given India’s ambition of becoming a global power. It is hard to take that aspiration seriously with almost half the country’s infants malnourished during critical years of cognitive and physical development. Even if Rajkumar lives to adulthood, he may be mentally and physically stunted. One wonders how India will reap the much-touted ”demographic dividend” of its youth where half of its 1.1bn population is under the age of 25.
Aid agencies say it is difficult to fund projects to combat the pervasive problem of malnutrition because of ’fatigue’ among donors. But India’s malnutrition ranks far worse than sub-Saharan Africa’s average rate of 27 per cent for children under the age of five, an ugly fact that rouses officials from complacency.
Manmohan Singh, India’s prime minister, condemned malnutrition as ”a matter of national shame” in his Independence Day address last week. Mr Singh ambitiously urged eradicating malnutrition in five years, and said communities must help ensure that corruption does not divert funds from the needy.
Of course, this is all much easier said then done. The challenges are starkly laid out during this visit to Madhya Pradesh. The state’s large population of 60m is scattered across thousands of villages with dirt roads and limited or no electricity, making them difficult and expensive for health workers to reach. Low literacy of 60 per cent makes it is hard to spread knowledge through pamphlets and posters.
Many mothers simply don’t know how to care for infants in the absence of adequate education. Only 55 per cent of mothers in Madhya Pradesh deliver in hospitals – though that’s an improvement from 26 per cent a few years ago – so most lack advice from healthcare professionals from the start. Anita, for example, says she didn’t know Rajkumar was malnourished in spite of his emaciated state.
Most rural diets are dominated by grain, which is inadequate for a growing child who needs protein, vitamins and minerals. Lunch at the anganwadi cannot compensate for a paltry diet at home.
But even if they have money, accessing better food is a major challenge for rural families. The nearest open-air markets are miles away and transport is not readily available. Supermarkets, so ubiquitous in the developed world, seem like a bizarre fantasy while standing among the low, mud-walled homes in this village in Shivapur. Superstitions and taboos also are deeply ingrained in local culture. Anita admits she did not breastfeed her son in the first critical days after her birth because her mother-in-law discouraged her.
Yet there are glimmers of hope. Back at the town health centre, a casual labourer named Papku sits with his 10-month old son who is stricken with diarrhea. Sleeping next to the infant on the cot is Papku’s three-year-old son, Krishna, who was admitted to the centre a year ago weighing just 6 kg. After his parents were counseled on proper nutrition, Krishna’s weight has doubled to 12 kg (26.5 pounds) in a year. The boy looks robust and meaty although his father earns only Rs60 ($1.50) a day to support his family of six, which includes his wife and three young daughters.
Given his modest means why did Papku have five children? Papku matter-of-factly states that even after his eldest son was born, he wanted two sons in case one died. It is a jarring explanation. But the pragmatic answer reflects life for Papku and his family – and hundreds of millions like them across India.
At a health centre in India’s Madhya Pradesh state, three-year-old Rajkumar clings to his mother, a woman named Anita whose youth is hinted at only when a smile cracks her weathered face. Rajkumar wails when his mother moves away slightly, standing by himself on the cot where she sits.
I am unsure whether he is crying for his mother or because it is painful to stand: his legs are matchstick thin – merely the width of two of my fingers. Rajkumar weights only 5.9 kg (13 pounds) when he should weigh 12 kg. His hair is brittle, light brown – another tell-tale sign of malnourishment.
Nearby, another mother looks on from amid the rows of cots lined up across the large room. She cradles her baby, whose head dwarfs his frail, doll-like body.
Severely malnourished children like Rajkumar and their mothers are sent to health centres like this one by government health workers who work, with assistance from Unicef, in surrounding villages at ”anganwadi” – half-day pre-schools where children are fed, immunised, weighed, and monitored. If left untreated, children at this stage are likely to die from infections that plague their weakened bodies. Indeed, more than half of all deaths among under-fives are linked to malnutrition, says the World Health Organisation. At the health centres, launched by Unicef and the Madhya Pradesh state government a few years ago, mothers are counseled on nutrition and hygiene. At this town clinic in Shivpuri district, about five hours from Delhi by train, children and their mothers are fed and monitored for two weeks.
At an anganwadi in a small hamlet miles from the health centre, children sing cheerful songs and crowd the floor of a simple shack. There they eat a daily lunch prepared from local ingredients on a wood-burning hearth. Today it is a meal of soy, groundnuts, rice, potato, onion, mint, oil and salt. The anganwadi also acts as a resource centre for mothers: its walls bear posters with bright cartoons that warn of polio and anemia.
Government-run anganwadi have been in place for three decades. The network has been expanded as part of a national plan to improve children’s health. In recent years Unicef has stepped up its presence in landlocked Madhya Pradesh, or ”Middle State”, which has some of the worst levels of malnutrition among already alarming national numbers.
An astonishing 46.3 per cent of all children under the age of three in India are malnourished, and nearly 80 per cent are anemic, according to the government’s National Health and Family Survey of 2005-06. There has been marginal improvement since 1992-93, when 51 per cent of under-threes were underweight. But in Madhya Pradesh, figures have worsened from 55 per cent in 1998-1999 to 60 per cent in 2005-2006.
The statistics are stupefying given India’s ambition of becoming a global power. It is hard to take that aspiration seriously with almost half the country’s infants malnourished during critical years of cognitive and physical development. Even if Rajkumar lives to adulthood, he may be mentally and physically stunted. One wonders how India will reap the much-touted ”demographic dividend” of its youth where half of its 1.1bn population is under the age of 25.
Aid agencies say it is difficult to fund projects to combat the pervasive problem of malnutrition because of ’fatigue’ among donors. But India’s malnutrition ranks far worse than sub-Saharan Africa’s average rate of 27 per cent for children under the age of five, an ugly fact that rouses officials from complacency.
Manmohan Singh, India’s prime minister, condemned malnutrition as ”a matter of national shame” in his Independence Day address last week. Mr Singh ambitiously urged eradicating malnutrition in five years, and said communities must help ensure that corruption does not divert funds from the needy.
Of course, this is all much easier said then done. The challenges are starkly laid out during this visit to Madhya Pradesh. The state’s large population of 60m is scattered across thousands of villages with dirt roads and limited or no electricity, making them difficult and expensive for health workers to reach. Low literacy of 60 per cent makes it is hard to spread knowledge through pamphlets and posters.
Many mothers simply don’t know how to care for infants in the absence of adequate education. Only 55 per cent of mothers in Madhya Pradesh deliver in hospitals – though that’s an improvement from 26 per cent a few years ago – so most lack advice from healthcare professionals from the start. Anita, for example, says she didn’t know Rajkumar was malnourished in spite of his emaciated state.
Most rural diets are dominated by grain, which is inadequate for a growing child who needs protein, vitamins and minerals. Lunch at the anganwadi cannot compensate for a paltry diet at home.
But even if they have money, accessing better food is a major challenge for rural families. The nearest open-air markets are miles away and transport is not readily available. Supermarkets, so ubiquitous in the developed world, seem like a bizarre fantasy while standing among the low, mud-walled homes in this village in Shivapur. Superstitions and taboos also are deeply ingrained in local culture. Anita admits she did not breastfeed her son in the first critical days after her birth because her mother-in-law discouraged her.
Yet there are glimmers of hope. Back at the town health centre, a casual labourer named Papku sits with his 10-month old son who is stricken with diarrhea. Sleeping next to the infant on the cot is Papku’s three-year-old son, Krishna, who was admitted to the centre a year ago weighing just 6 kg. After his parents were counseled on proper nutrition, Krishna’s weight has doubled to 12 kg (26.5 pounds) in a year. The boy looks robust and meaty although his father earns only Rs60 ($1.50) a day to support his family of six, which includes his wife and three young daughters.
Given his modest means why did Papku have five children? Papku matter-of-factly states that even after his eldest son was born, he wanted two sons in case one died. It is a jarring explanation. But the pragmatic answer reflects life for Papku and his family – and hundreds of millions like them across India.
A women dies every 7 minutes in India
One woman dies every 7 minutes in the country due to complications related to pregnancy and childbirth, the government today admitted in the Rajya Sabha. In a written reply, Minister of State for Health Panabaka Lakshmi said estimates of the Registrar General of India has revealed that the maternal mortality ratio for India is 301 per 10,000 live births which translates into 77,000 per year or one woman dying every seven minutes. Both Uttar Pradesh and Uttaranchal have a maximum MMR of 517, followed by Assam 490, Rajasthan 445, Madhya Pradesh and Chhattisgarh 379, Bihar and Jharkhand have MMR of 371 and Orissa 358, she said. The reasons for such high level of maternal mortality in the country was hemorrhage (38 percent), sepsis 11 percent, abortion 8 percent, obstructed labour 5 percent, hypertensive disorders 5 percent and others 34 percent, she added. The centre has launched the National Rural Health Mission to increase the access of quality health care including services of safe motherhood in rural areas.
Under NRHM and RCH phase II, one of the goals was to achieve a reduction in MMR to 100 per 100,000 live births, she said. Services are being strengthened through Janani Suraksha Yojna which promotes institutional delivery for reducing MMR and infant mortality rate by providing quality maternal care during pregnancy, delivery period with appropriate referral transport system along with cash assistance to pregnant women with special focus on BPL women and SC/ST population. Moreover, ASHAs are being appointed and a number of other steps being taken to reduce maternal mortality, she added.
Bureau Report
Under NRHM and RCH phase II, one of the goals was to achieve a reduction in MMR to 100 per 100,000 live births, she said. Services are being strengthened through Janani Suraksha Yojna which promotes institutional delivery for reducing MMR and infant mortality rate by providing quality maternal care during pregnancy, delivery period with appropriate referral transport system along with cash assistance to pregnant women with special focus on BPL women and SC/ST population. Moreover, ASHAs are being appointed and a number of other steps being taken to reduce maternal mortality, she added.
Bureau Report
Thursday, July 19, 2007
Iron and Iodised Fortified Salt for Expectant Mothers in MP
Minister for Public Health and Family Welfare, Government of Madhya Pradesh, Ajay Vishnoi informed media yesterday state government has decided to supply fortified salt (Iron + Iodine) to all the expectant and nursing mothers of 23 tribal predominant districts of the state. The fortified salt would be distributed through 26 thousand 691 aaganbadis functioning in these districts.
The districts where fortified salt is to be distributed includes Dhar, Jhabua, Badwani, Khargone, Ratlam, Shahdol, Anuppur, Umaria, Betul, Mandla, Dindori, Balaghat, Chhindwara, Sheopur, Hoshangabad, Burhanpur, Seoni, Sidhi, Jabalpur, Dewas, Khandwa, Harda and Katni. Instructions have been issued by the government to all the district collectors, chief medical and health officers, district woman and child development officers in this regard. These officers will also ensure monitoring, storage, utilisation of the salt besides its proper distribution to the beneficiaries through aaganwadis and undertake reporting. The medicated salt will be distributed in ratio of one kilogram per beneficiaries per month as per the take home ration system, which can be utilised by the beneficiaries for her use and family as well.
The districts where fortified salt is to be distributed includes Dhar, Jhabua, Badwani, Khargone, Ratlam, Shahdol, Anuppur, Umaria, Betul, Mandla, Dindori, Balaghat, Chhindwara, Sheopur, Hoshangabad, Burhanpur, Seoni, Sidhi, Jabalpur, Dewas, Khandwa, Harda and Katni. Instructions have been issued by the government to all the district collectors, chief medical and health officers, district woman and child development officers in this regard. These officers will also ensure monitoring, storage, utilisation of the salt besides its proper distribution to the beneficiaries through aaganwadis and undertake reporting. The medicated salt will be distributed in ratio of one kilogram per beneficiaries per month as per the take home ration system, which can be utilised by the beneficiaries for her use and family as well.
Thursday, July 05, 2007
Mothers and children in MP: Survival questioned
Sachin K Jain
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
SANGRAM SINGH of Khatia-Narangi village in Baiga-tribal dominated Mandla district of Madhya Pradesh is not able to open his eyes despite many efforts. His eyelids collapse instantly and his eyes close. His skin is getting contracted. There are several questions about the chances of his survival. The weight of this 50-day child is just 2.2 kg. If such young children are capable of thinking, then Sangram Singh must be surely thinking about the unjust character of the society. He is still in critical situation and Government of Madhya Pradesh has ordered an enquiry in the Shivkali’s, his mother, death case. The term of reference of this enquiry does not contain any point to investigate the violation of child rights. They will only do a formality of investigation of death, not the violation of rights.
Sangram Singh is not just any child but a character of the story that is common for the 7700 children who are born every year in Madhya Pradesh. These are those children who do not have the good luck of receiving mother’s milk and the warmth and sensitivity of her lap. The tragic aspect is that the negligence of government and society becomes the biggest reason for the maternal deaths during childbirth.
If a woman dies within 42 days of childbirth, then the death is considered as maternal mortality. Shivkali died within 11 days of childbirth, yet the state government did not consider it as maternal mortality. As per the Health Department Mandla district did not record a single maternal death during April 2007, which means that along with life of Shivkali, the government is also denying her death. After the death of his mother, the life of Sangram is also in dire straits. At birth, his weight was 2.4 kg, which means that his development has been stunted. In such circumstances, the local health workers have refused to treat the child. Finally with the help of local social workers, Sangram was taken to a doctor Mukesh Rutela in Nainpur on May 22. Here it was diagnosed that Sangram was already entered in grade IV malnutrition category and is also suffering from various infections. At the time of birth he was not severely malnourished and if his treatment is not carried out very intensively, the chances of his survival are poor. The family is full of anger and sadness, but they are now not ready to go to government hospital.
Baiga tribal woman Shivkali had given birth to Sangram Singh on April 4 in her hutment. Local traditional midwife Jethibai assisted the childbirth. There is a primary health centre in this village. Interestingly, the village is not away from the mainstream of system. It is located just by the main gate of Kanha National Park. Ironically the objective of the Primary Health Centre located at the Khatiya village has been to take care of the national and international level tourists rather than the villagers. The PHC has now got a beautiful building, but only three to four villagers reach the PHC every day. When we reached the centre, out of the 15 member staff including four nurses, doctor, ANM and sanitary workers, only one nurse was present. Son Sai of Khatia village says that whenever one approached the centre, the message is that majority of staff have gone to block or district headquarters for some meeting. In such circumstances people are forced to go to Bicchia or Mandla. It is incomprehensible as to why the government is denying that the Baiga tribal (whom former Prime Minister Indira Gandhi had described as national people) live in a traditional setting. Because forest rights were taken away from them, they have also lost access to traditional medicines owing to which women and children are dying, but the modern medicine system is far out of their reach. If the future of the children is to be safeguarded then the government should have brought the Baigas close to modern treatment facilities in a sincere and sensitive manner.
The maternal and child mortality cannot be contained only by writing slogans on the walls or presenting unbelievable statistics. Isn’t it a serious fact that around 10 million children die every year before celebrating first birthday in Madhya Pradesh?
The effort for protection of life is also the responsibility of anganbadis, but it could only be called unfortunate that the name of Shivkali was not registered in the list of pregnant women in the local anganbadi. Naturally this pregnant woman from a poor family could not get enough nutrition to sustain herself and her foetus. However, after her death, the local anganbadi worker Shashikanta Thakur took possession of her mother-child card and filled up all details regarding completion of immunization doses. Similarly the district hospital took possession of all medical documents related to Shivkali and Sangram Singh. The amount of efforts taken to destroy evidence if taken previously could have saved lives of Shivkali and Sangram. Shashikanta waves off her responsibility saying that the tribal people do not want to get immunized or treated. “Khushiyal Singh (Shivkali’s husband) should have been more responsible. We cannot go home to home checking upon people,’’ she says. Thus the victim has been made the accused by the system. It is very unfortunate that the woman who could not even express her health problems or pains has been made responsible for her own death.
Ten per cent of the populace in MP is that of tribal communities including three primitive tribal – Baiga, Bharia and Saharia. But the state government does not have any work plan to change the innate behavioural patterns or gaining confidence of these communities. Not only this, but the 51000 odd traditional midwives (dais) who could have brought these people closer to modern medicine system have been banned from offering their services. On one hand the government is not able to provide proper health services and on the other hand it is scrapping the traditional and alternative systems.
The situation in Khatia is very unusual. Shivkali never received even a single health check up during her pregnancy period and did not get a single immunization dose. During last two years, the state government started as many as seven schemes to prevent maternal and child morbidity and mortality, of which the Vijayaraje Janani Bima Kalyan Yojana was closed down on May 11, 2007. The logic given was that the women were getting enough benefits under other schemes and thus this was not necessary. The truth is that during last year, 56 women and 807 kids perished in Mandla. Government touts that institutional childbirth is the best way to safe motherhood and that the responsibility to encourage community for this falls on health administration.
The sub-health centers and the primary health centers have to ensure that every pregnant woman should be registered within 12 weeks of pregnancy so that the regular health check up, immunization, nutritional needs and emergency treatment facilities could be ensured for her. The basic thing is that government will have to take care that health services and health workers should reach the needy people like Shivkali and Sangram. It should not be expected that women and children bearing pain and burdened by exploitation would reach the health centers and demand services.
As per the guidelines of the Government of India, all the primary health centers should have refrigerator and deep freezer to store the medicines, but at the Khatia PHC, the medicines and equipments were lying openly at temperature of 43 degrees. There are no standard arrangements of storing medicines in the 7300 sub-health centers in MP, owing to which the treatment of patients becomes risky in itself.
The issue of health demands sensitive behaviour and attitude, which means that it should be ensured that the people suffering from pains could be provided humane touch. It is a well-proven fact that total cure of any pain is not possible only through medicines. For Shivkali and Sangram, this belief could not prove to be positive.
Sangram was born into tattered unclean rags at home, but after this the health of Shivkali started deteriorating. Then Shivkali’s father Mangal Singh started looking for the ANM and the health worker. As it was evening time, Jagat Singh Pande and Subhadra Pande did not pay attention to the issue and asked that Shivkali be taken to Mandla, which is 65 kms from Khatia. Under one scheme of the government, financial assistance is provided to pregnant women facing problems for reaching the health services, but Shivkali did not receive any such assistance. Mangal Singh rented a private vehicle for Rs 1200 and took her to district hospital, Mandla. They had the Deendayal Antyodaya Treatment Card, but the doctors did not pay attention to it. The lady doctor in the hospital asked for Rs 3000 from Mangal Singh for the treatment. Since it was matter of life and death for his daughter and grandson, Mangal Singh requested the doctor to start the treatment, although he had only Rs 30 left with him after paying the rent of the vehicle. Even this Rs 30 was taken away by the doctor. Mangal is also the chief of the Baiga Adiwasi Sangathan of Mandla and thus he lodged a complaint with the District Collector regarding this exploitation. Inquiry was conducted and pressure was created on the hospital administration.
But the inhumane face of the doctors came to the fore. As soon as the district administration official left the hospital, the hospital authorities refused to treat Shivkali and referred her to Jabalpur. Doctor said to Mangal Singh that, “you are a leader and only your leadership can save your daughter.” Thus Shivkali had to pay for her poverty as well as for demanding her rights, although indirectly. Left with no option, Mangal Singh decided to take Shivkali back to village, but she succumbed even before reaching the village.
Now Mangal Singh is facing a debt of Rs 5500, which he would have to repay at the interest rate of 10 per cent per month. Leave aside treatment and medicine; the family did not even receive any consolation. It is natural that no sacrifice is expected from the health workers, but could not they be expected to at least fulfill the responsibilities allotted to them.
Health worker Jagat Singh says that it is compulsory to attend meetings every month. Since targets are fixed, thus information has to be provided regularly, even if it means that there is no time left for fulfilling the targets. The health workers also have their limits; Jagat Singh says adding that what would have happened if Shivkali had died while the nurse was trying to treat her. If there are no doctors available permanently, how women like Shivkali could be saved.
Every year about 17 lakh childbirths are carried out in the State and of them 53 per cent are in BPL, tribal and dalit families. In such situation, 99 out of 137 posts of obstetricians and gynecologists are vacant. About 648 out of 4607 posts of doctors are vacant and of the rest 3133 medical officers are posted in urban and semi-urban areas. Shivkali needed blood, but although getting blood is easy for people of higher economic classes, she could not get blood. There was hospital, medicine, anganbadi as well as motorable road, yet Shivkali had to die and little Sangram is struggling for survival.
In Madhya Pradesh out of the 1000 children born, 70 perish before their first birthday. According to this rate, in year 2006-07 as many as 1.19 lakh infants could not be saved. This proved that still at the societal, political and governmental level, the right to honorable life right is a much neglected issue.
Despite efforts by the government, as many as 8.56 lakh childbirths in MP in 2006-07 occurred at homes. There are certainly efforts to rid the society of evil of maternal death through institutional childbirth. But the situation of the health centers and the inhumane behaviour meted out there is still a big challenge. In Indore, a nurse physically assaulted a pregnant woman while in Mandsaur a woman had to undergo childbirth on the road as she could not pay bribe to health workers. In Ashok Nagar, Nevabai became a victim to negligence of doctors and when the community demanded inquiry of the incident, the health administration boycotted Nevabai’s village Nidanpur. Due to this boycott, Phoolkunwar died on the road. Seems to me that the bigger reasons for maternal and infant deaths are selfishness and ego of the expert medical practitioners.
In MP, of the 1000 children born, 70 perish before their first birthday and as many as 8.56 lakh childbirths in 2006-07 occurred at homes. The negligence of the government and society is the biggest reason for the deaths of mothers and children.
SANGRAM SINGH of Khatia-Narangi village in Baiga-tribal dominated Mandla district of Madhya Pradesh is not able to open his eyes despite many efforts. His eyelids collapse instantly and his eyes close. His skin is getting contracted. There are several questions about the chances of his survival. The weight of this 50-day child is just 2.2 kg. If such young children are capable of thinking, then Sangram Singh must be surely thinking about the unjust character of the society. He is still in critical situation and Government of Madhya Pradesh has ordered an enquiry in the Shivkali’s, his mother, death case. The term of reference of this enquiry does not contain any point to investigate the violation of child rights. They will only do a formality of investigation of death, not the violation of rights.
Sangram Singh is not just any child but a character of the story that is common for the 7700 children who are born every year in Madhya Pradesh. These are those children who do not have the good luck of receiving mother’s milk and the warmth and sensitivity of her lap. The tragic aspect is that the negligence of government and society becomes the biggest reason for the maternal deaths during childbirth.
If a woman dies within 42 days of childbirth, then the death is considered as maternal mortality. Shivkali died within 11 days of childbirth, yet the state government did not consider it as maternal mortality. As per the Health Department Mandla district did not record a single maternal death during April 2007, which means that along with life of Shivkali, the government is also denying her death. After the death of his mother, the life of Sangram is also in dire straits. At birth, his weight was 2.4 kg, which means that his development has been stunted. In such circumstances, the local health workers have refused to treat the child. Finally with the help of local social workers, Sangram was taken to a doctor Mukesh Rutela in Nainpur on May 22. Here it was diagnosed that Sangram was already entered in grade IV malnutrition category and is also suffering from various infections. At the time of birth he was not severely malnourished and if his treatment is not carried out very intensively, the chances of his survival are poor. The family is full of anger and sadness, but they are now not ready to go to government hospital.
Baiga tribal woman Shivkali had given birth to Sangram Singh on April 4 in her hutment. Local traditional midwife Jethibai assisted the childbirth. There is a primary health centre in this village. Interestingly, the village is not away from the mainstream of system. It is located just by the main gate of Kanha National Park. Ironically the objective of the Primary Health Centre located at the Khatiya village has been to take care of the national and international level tourists rather than the villagers. The PHC has now got a beautiful building, but only three to four villagers reach the PHC every day. When we reached the centre, out of the 15 member staff including four nurses, doctor, ANM and sanitary workers, only one nurse was present. Son Sai of Khatia village says that whenever one approached the centre, the message is that majority of staff have gone to block or district headquarters for some meeting. In such circumstances people are forced to go to Bicchia or Mandla. It is incomprehensible as to why the government is denying that the Baiga tribal (whom former Prime Minister Indira Gandhi had described as national people) live in a traditional setting. Because forest rights were taken away from them, they have also lost access to traditional medicines owing to which women and children are dying, but the modern medicine system is far out of their reach. If the future of the children is to be safeguarded then the government should have brought the Baigas close to modern treatment facilities in a sincere and sensitive manner.
The maternal and child mortality cannot be contained only by writing slogans on the walls or presenting unbelievable statistics. Isn’t it a serious fact that around 10 million children die every year before celebrating first birthday in Madhya Pradesh?
The effort for protection of life is also the responsibility of anganbadis, but it could only be called unfortunate that the name of Shivkali was not registered in the list of pregnant women in the local anganbadi. Naturally this pregnant woman from a poor family could not get enough nutrition to sustain herself and her foetus. However, after her death, the local anganbadi worker Shashikanta Thakur took possession of her mother-child card and filled up all details regarding completion of immunization doses. Similarly the district hospital took possession of all medical documents related to Shivkali and Sangram Singh. The amount of efforts taken to destroy evidence if taken previously could have saved lives of Shivkali and Sangram. Shashikanta waves off her responsibility saying that the tribal people do not want to get immunized or treated. “Khushiyal Singh (Shivkali’s husband) should have been more responsible. We cannot go home to home checking upon people,’’ she says. Thus the victim has been made the accused by the system. It is very unfortunate that the woman who could not even express her health problems or pains has been made responsible for her own death.
Ten per cent of the populace in MP is that of tribal communities including three primitive tribal – Baiga, Bharia and Saharia. But the state government does not have any work plan to change the innate behavioural patterns or gaining confidence of these communities. Not only this, but the 51000 odd traditional midwives (dais) who could have brought these people closer to modern medicine system have been banned from offering their services. On one hand the government is not able to provide proper health services and on the other hand it is scrapping the traditional and alternative systems.
The situation in Khatia is very unusual. Shivkali never received even a single health check up during her pregnancy period and did not get a single immunization dose. During last two years, the state government started as many as seven schemes to prevent maternal and child morbidity and mortality, of which the Vijayaraje Janani Bima Kalyan Yojana was closed down on May 11, 2007. The logic given was that the women were getting enough benefits under other schemes and thus this was not necessary. The truth is that during last year, 56 women and 807 kids perished in Mandla. Government touts that institutional childbirth is the best way to safe motherhood and that the responsibility to encourage community for this falls on health administration.
The sub-health centers and the primary health centers have to ensure that every pregnant woman should be registered within 12 weeks of pregnancy so that the regular health check up, immunization, nutritional needs and emergency treatment facilities could be ensured for her. The basic thing is that government will have to take care that health services and health workers should reach the needy people like Shivkali and Sangram. It should not be expected that women and children bearing pain and burdened by exploitation would reach the health centers and demand services.
As per the guidelines of the Government of India, all the primary health centers should have refrigerator and deep freezer to store the medicines, but at the Khatia PHC, the medicines and equipments were lying openly at temperature of 43 degrees. There are no standard arrangements of storing medicines in the 7300 sub-health centers in MP, owing to which the treatment of patients becomes risky in itself.
The issue of health demands sensitive behaviour and attitude, which means that it should be ensured that the people suffering from pains could be provided humane touch. It is a well-proven fact that total cure of any pain is not possible only through medicines. For Shivkali and Sangram, this belief could not prove to be positive.
Sangram was born into tattered unclean rags at home, but after this the health of Shivkali started deteriorating. Then Shivkali’s father Mangal Singh started looking for the ANM and the health worker. As it was evening time, Jagat Singh Pande and Subhadra Pande did not pay attention to the issue and asked that Shivkali be taken to Mandla, which is 65 kms from Khatia. Under one scheme of the government, financial assistance is provided to pregnant women facing problems for reaching the health services, but Shivkali did not receive any such assistance. Mangal Singh rented a private vehicle for Rs 1200 and took her to district hospital, Mandla. They had the Deendayal Antyodaya Treatment Card, but the doctors did not pay attention to it. The lady doctor in the hospital asked for Rs 3000 from Mangal Singh for the treatment. Since it was matter of life and death for his daughter and grandson, Mangal Singh requested the doctor to start the treatment, although he had only Rs 30 left with him after paying the rent of the vehicle. Even this Rs 30 was taken away by the doctor. Mangal is also the chief of the Baiga Adiwasi Sangathan of Mandla and thus he lodged a complaint with the District Collector regarding this exploitation. Inquiry was conducted and pressure was created on the hospital administration.
But the inhumane face of the doctors came to the fore. As soon as the district administration official left the hospital, the hospital authorities refused to treat Shivkali and referred her to Jabalpur. Doctor said to Mangal Singh that, “you are a leader and only your leadership can save your daughter.” Thus Shivkali had to pay for her poverty as well as for demanding her rights, although indirectly. Left with no option, Mangal Singh decided to take Shivkali back to village, but she succumbed even before reaching the village.
Now Mangal Singh is facing a debt of Rs 5500, which he would have to repay at the interest rate of 10 per cent per month. Leave aside treatment and medicine; the family did not even receive any consolation. It is natural that no sacrifice is expected from the health workers, but could not they be expected to at least fulfill the responsibilities allotted to them.
Health worker Jagat Singh says that it is compulsory to attend meetings every month. Since targets are fixed, thus information has to be provided regularly, even if it means that there is no time left for fulfilling the targets. The health workers also have their limits; Jagat Singh says adding that what would have happened if Shivkali had died while the nurse was trying to treat her. If there are no doctors available permanently, how women like Shivkali could be saved.
Every year about 17 lakh childbirths are carried out in the State and of them 53 per cent are in BPL, tribal and dalit families. In such situation, 99 out of 137 posts of obstetricians and gynecologists are vacant. About 648 out of 4607 posts of doctors are vacant and of the rest 3133 medical officers are posted in urban and semi-urban areas. Shivkali needed blood, but although getting blood is easy for people of higher economic classes, she could not get blood. There was hospital, medicine, anganbadi as well as motorable road, yet Shivkali had to die and little Sangram is struggling for survival.
In Madhya Pradesh out of the 1000 children born, 70 perish before their first birthday. According to this rate, in year 2006-07 as many as 1.19 lakh infants could not be saved. This proved that still at the societal, political and governmental level, the right to honorable life right is a much neglected issue.
Despite efforts by the government, as many as 8.56 lakh childbirths in MP in 2006-07 occurred at homes. There are certainly efforts to rid the society of evil of maternal death through institutional childbirth. But the situation of the health centers and the inhumane behaviour meted out there is still a big challenge. In Indore, a nurse physically assaulted a pregnant woman while in Mandsaur a woman had to undergo childbirth on the road as she could not pay bribe to health workers. In Ashok Nagar, Nevabai became a victim to negligence of doctors and when the community demanded inquiry of the incident, the health administration boycotted Nevabai’s village Nidanpur. Due to this boycott, Phoolkunwar died on the road. Seems to me that the bigger reasons for maternal and infant deaths are selfishness and ego of the expert medical practitioners.
Tuesday, June 12, 2007
`Woman in labour turned away from hospital'
Central Chronicle Bhopal, June 11
A woman in labour was turned away from a government hospital, tribal farmers were put in a debt trap by showing them as loanees for the lift irrigation pump that did not work even for a single day and electric supply was erratic in rural areas.
These were among a host of complaints found true after Chief Minister Shivraj Singh Chouhan ordered spot verification of the grievances raised by the common people during his 'Jan Darshan' programme in the tribal-dominated Jhabua district in the last two days. Chouhan ordered suspension of at least half a dozen officials, including engineers, and issuing of show cause notices to two executive engineers of Public Works and Water Resources departments, official sources said. A nurse was suspended following complaint that she did not admit a woman in labour who had turned up at the government hospital at Meghnagar for institutional delivery.
Jhabua block panchayat Chief Executive Officer S T Madhavacharya and Sub-Engineer Dinesh Lodhi were suspended for irregularities in the construction of water bodies in farmer's land at village Antarvelia. Two Sub-Engineers SN Chouhan and KK Saxena were suspended for irregularities in rural employment guarantee scheme, the sources said.
Chouhan had instructed the Indore Divisional Commissioner to scrutinise the tender system in all Works departments in the district and black-list the contractors who were found not up to the mark. ''Rural people were not satisfied with the electricity distribution system'', he said while reviewing the working of the Power Distribution Company (Discom) and suggested to improve the system to ensure that farmers got power supply on schedule.
Taking a serious note of the lift irrigation schemes, he stated that only 600 of the total 1100 LIS were functional. Many schemes did not function even for a single day and the farmers were labelled as loanees, the Chief Minister said.
A woman in labour was turned away from a government hospital, tribal farmers were put in a debt trap by showing them as loanees for the lift irrigation pump that did not work even for a single day and electric supply was erratic in rural areas.
These were among a host of complaints found true after Chief Minister Shivraj Singh Chouhan ordered spot verification of the grievances raised by the common people during his 'Jan Darshan' programme in the tribal-dominated Jhabua district in the last two days. Chouhan ordered suspension of at least half a dozen officials, including engineers, and issuing of show cause notices to two executive engineers of Public Works and Water Resources departments, official sources said. A nurse was suspended following complaint that she did not admit a woman in labour who had turned up at the government hospital at Meghnagar for institutional delivery.
Jhabua block panchayat Chief Executive Officer S T Madhavacharya and Sub-Engineer Dinesh Lodhi were suspended for irregularities in the construction of water bodies in farmer's land at village Antarvelia. Two Sub-Engineers SN Chouhan and KK Saxena were suspended for irregularities in rural employment guarantee scheme, the sources said.
Chouhan had instructed the Indore Divisional Commissioner to scrutinise the tender system in all Works departments in the district and black-list the contractors who were found not up to the mark. ''Rural people were not satisfied with the electricity distribution system'', he said while reviewing the working of the Power Distribution Company (Discom) and suggested to improve the system to ensure that farmers got power supply on schedule.
Taking a serious note of the lift irrigation schemes, he stated that only 600 of the total 1100 LIS were functional. Many schemes did not function even for a single day and the farmers were labelled as loanees, the Chief Minister said.
Saturday, June 09, 2007
Delivery in running bus
Shivpuri (MP), Jun 9, UNI reports :
A tribal woman gave birth to an infant in a running bus.After waiting for a vehicle, Ruby, wife of Mangilal, walked about 3 Km to reach the nearest bus stop to reach Shivpuri, 25 Km away.Her relatives said she gave birth to the child in the private bus itself before reaching Shivpuri hospital, where she was later admitted.Mangilal, a resident of Mohammadpur Khutela village, said they had information about the government schemes Janani Express and Janani Suraksha Yojana to promote institutional delivery and free transport facility.After contacting the office concerned, they waited for the elusive transport facility. Later, they mustered courage to take the woman in labour to the hospital by the first available bus.
A tribal woman gave birth to an infant in a running bus.After waiting for a vehicle, Ruby, wife of Mangilal, walked about 3 Km to reach the nearest bus stop to reach Shivpuri, 25 Km away.Her relatives said she gave birth to the child in the private bus itself before reaching Shivpuri hospital, where she was later admitted.Mangilal, a resident of Mohammadpur Khutela village, said they had information about the government schemes Janani Express and Janani Suraksha Yojana to promote institutional delivery and free transport facility.After contacting the office concerned, they waited for the elusive transport facility. Later, they mustered courage to take the woman in labour to the hospital by the first available bus.
Friday, May 25, 2007
Women's health on the AIRwaves
AIR’s 14 radio stations in Madhya Pradesh ran a 15 to 20 minute episode daily on the issue of women's health.
Anil Gulati in Bhopal
Ten percent of maternal deaths in India take place in the state of Madhya Pradesh. Maternal death audits as undertaken by the state reveal that how timely medical attention still is a challenge for many pregnant women. Lack of awareness on recognition of danger signs, issue of transport, access to proper medical facilities, poverty are still some of the many challenges which needed to be overcome. Though the Government of Madhya Pradesh has launched many schemes to promote institutional deliveries and to combat maternal mortality, with special focus for below the poverty line and those belonging to scheduled castes and tribes, but a lot remains to be done.
Media and civil society are helping to raise concern and create awareness on the issue. All India Radio with its vast network in the state particularly in rural Madhya Pradesh contributed its bit by using air waves for the cause by addressing issues of immediate concern to its audiences.
All India Radio in collaboration with the state government and UNICEF, supported by Department of International Development (DFID), strategically used its programme options to engage communities on the issue of safe motherhood and help voice their concern by its people - policy interface. It also used its news network to give voice to state and civil society on the issue. Content analysis of last few months i.e. June 2006 - Feb 2007 AIR news reports tell us that the issue has been in focus and is spread evenly. News pertaining to government proclamations, schemes, and events took the major share but the news network also relayed statements of various experts and people working on the issue, which is a positive trend.
AIR has a strong presence especially in rural areas vide its fourteen radio stations across the state. It ran a 15 to 20 minute episode daily in form of a series from its network of radio stations on the issue of women's health. 35 such programmes were aired. Each programme had a local expert, often a medical professional to answer the questions and issues that were raised by the people from the district. It also provided information on how to recognize danger signs in pregnancy, stressed on the need of institutional delivery, care including nutrition of women during pregnancy, and issues related to anaemia. The purpose was to provide information and answers to the questions to the community by a local expert.
In addition to the same, the radio network also aired a series of seven one-hour live-phone in programmes on its afternoon prime time slot each month. It was a 'people - policy maker interface'. As part of the same programme a political representative or a representative from the state department was present in the studio to answer questions raised by callers on the issue. For the first time the issue of maternal health was addressed in this forum. The initiative by its very nature strengthened the community - system interface.
In the first programme the State Health & Family Welfare Minister answered questions from various rural parts of the state. Callers from far off villages in districts like Rewa, Tikamgarh, Sagar and Hoshangabad, brought to the notice of Health Minister the problems they face when it comes to the functioning of the health delivery system at the primary health centre level. The common grievance was that the doctors and nurses were absent from the duty. Questions were also raised the benefits of schemes not accruing and the types of health schemes available. On similar lines representatives from State's Women Commission, Human Rights Commission, Women and Child development department, Rural Development and Public Relations department were involved. Fifteen to twenty questions were asked in each programme.
In the last of the series the Chief Minister of the state answered queries of people in the state on the issue. Though the programme focused on women's health and safe motherhood, issues of education especially of girls, grant of scholarships to girls as provided by the state and violence against women also came up. In turn the programme offered an opportunity for people to get answers to their grievances by their elected representative on issues which many times get neglected in the political process.
Anil Gulati in Bhopal
Ten percent of maternal deaths in India take place in the state of Madhya Pradesh. Maternal death audits as undertaken by the state reveal that how timely medical attention still is a challenge for many pregnant women. Lack of awareness on recognition of danger signs, issue of transport, access to proper medical facilities, poverty are still some of the many challenges which needed to be overcome. Though the Government of Madhya Pradesh has launched many schemes to promote institutional deliveries and to combat maternal mortality, with special focus for below the poverty line and those belonging to scheduled castes and tribes, but a lot remains to be done.
Media and civil society are helping to raise concern and create awareness on the issue. All India Radio with its vast network in the state particularly in rural Madhya Pradesh contributed its bit by using air waves for the cause by addressing issues of immediate concern to its audiences.
All India Radio in collaboration with the state government and UNICEF, supported by Department of International Development (DFID), strategically used its programme options to engage communities on the issue of safe motherhood and help voice their concern by its people - policy interface. It also used its news network to give voice to state and civil society on the issue. Content analysis of last few months i.e. June 2006 - Feb 2007 AIR news reports tell us that the issue has been in focus and is spread evenly. News pertaining to government proclamations, schemes, and events took the major share but the news network also relayed statements of various experts and people working on the issue, which is a positive trend.
AIR has a strong presence especially in rural areas vide its fourteen radio stations across the state. It ran a 15 to 20 minute episode daily in form of a series from its network of radio stations on the issue of women's health. 35 such programmes were aired. Each programme had a local expert, often a medical professional to answer the questions and issues that were raised by the people from the district. It also provided information on how to recognize danger signs in pregnancy, stressed on the need of institutional delivery, care including nutrition of women during pregnancy, and issues related to anaemia. The purpose was to provide information and answers to the questions to the community by a local expert.
In addition to the same, the radio network also aired a series of seven one-hour live-phone in programmes on its afternoon prime time slot each month. It was a 'people - policy maker interface'. As part of the same programme a political representative or a representative from the state department was present in the studio to answer questions raised by callers on the issue. For the first time the issue of maternal health was addressed in this forum. The initiative by its very nature strengthened the community - system interface.
In the first programme the State Health & Family Welfare Minister answered questions from various rural parts of the state. Callers from far off villages in districts like Rewa, Tikamgarh, Sagar and Hoshangabad, brought to the notice of Health Minister the problems they face when it comes to the functioning of the health delivery system at the primary health centre level. The common grievance was that the doctors and nurses were absent from the duty. Questions were also raised the benefits of schemes not accruing and the types of health schemes available. On similar lines representatives from State's Women Commission, Human Rights Commission, Women and Child development department, Rural Development and Public Relations department were involved. Fifteen to twenty questions were asked in each programme.
In the last of the series the Chief Minister of the state answered queries of people in the state on the issue. Though the programme focused on women's health and safe motherhood, issues of education especially of girls, grant of scholarships to girls as provided by the state and violence against women also came up. In turn the programme offered an opportunity for people to get answers to their grievances by their elected representative on issues which many times get neglected in the political process.
Sunday, May 06, 2007
A comment on two years of NHRM
Dr Sanjit Nayak at One World South Asia
Health being a state subject, states have used their own discretion to interpret and implement the National Rural Health Mission (NRHM). While this has resulted in some activities being implemented the broader goal of the NHRM to empower local communities has been lost. This has lead to the dilution of the agenda of placing people's health in people's hands. The current government approach is to mandate community participation by issuing government orders to its functionaries at the district level. In rural areas, village and district action plans based on community need assessment have remained a non starter and in urban areas the poor remain marginalized from this process. The NRHM talks about health sector reforms but the specific objectives of the reforms appear unrealistic and unlikely to result in the improvement of the health status of the individual or the community. In effect the Mission remains more target oriented with a disproportionate emphasis on inputs rather than focused on output or performance. The concept of Accredited Social Health Activist (ASHA), which forms the core through which the NRHM will be operationalised, cannot be described as being an innovation but rather is old wine in a new bottle. In earlier versions of the health programme similar human resource mechanisms have been proposed - for example the community health worker, link worker, multi- purpose worker amongst other things. In India, the polices, plans and schemes have often been comprehensive but the implementation has remained poor and as a result the desired result as envisaged by policies and programmes has never been actualised. The ASHA as has been mentioned earlier forms the core implementation mechanism for NRHM, who will undertake the bulk of the activities at the community level.
Inspite of playing this critical role, women who are selected are seen to be volunteers and the programme itself does not define any type of financial compensation for the work they will undertake. Recent findings show that it is proving to be extremely difficult to motivate individuals to undertake the work where no remuneration is forthcoming. As part of the ASHA scheme an incentive system has been proposed under the supervision of Sarpanch and Auxiliary Nurse Midwife. This has lead to non-integration (architectural correction) of all the other health programmes at the community level. Furthermore, there is an extremely high expectation from ASHA whose envisaged work profile does little justice as a part time worker.
The ASHA work under severe constraints with regard to infrastructure as a result ASHAs often have to resort to referring their patients to private service providers. In addition, ASHA has replaced the male health worker. ASHA's work profile is different and primarily to support the ANM. The numbers of male MPWs is already reduced and it is likely that their role will soon be written out of health programmes. It is important to point out that MPWs have a key role to play in other programmes e.g. prevention of communicable diseases and undertaking surveillance, none of which can be undertaken by ASHA. As part of the reform process of the health sector, which remains an important component of NRHM, the strengthening of public-private partnership has been mooted.
However, many health activists feel this is the governments' way of shirking responsibility to provide health services in particular primary health care as has been envisaged in the Constitution. The government is now trying to even privatize primary health care and does not want to invest in improving the public health sector. Upgrading infrastructure, especially PHC to FRU/ UPHC in un- served and underserved areas with doctors unwilling to provide service will further privatise primary health care. Contracts to private practitioners will be the only solution to man these PHC. Indian Public Health Standards (IPHS) to provide quality health care in the public health system by ensuring minimum requirements of infrastructure, accountability of doctors, the need for standard treatment protocols and social audit through rogi kalyan samiti (RKS) has been a non- starter. This has been the scenario previously as such policy directions have not translated into action. T
he guidelines for IPHS do not address the real issue which requires an analysis of failure of previous schemes. An attempt was made by the National Commission of Health and Macro-economics but its recommendations are gathering dust. NRHM aim is to reduce infant mortality and maternal mortality by improving access through the ASHA and the Janani Suraksha Yojana (JSY) scheme by strengthening Community Health Centres. The emphasis is on technology alone. It has failed to address the correlates to nutrition and thus to poverty. The belief that reducing total fertility will reduce infant mortality ignores the links between the socio-economic status of the community especially that of women and health of an infant. It is important to note that access to care is also linked to discrimination as well. Additionally unskilled human resource and poor infrastructure in un-served and under-served areas compound the problem. Targets to reduce infant mortality rate (IMR) and maternal mortality ratio (MMR) by only increasing health sector expenditure needs to address issues of equitable distribution and resource allocation. Conceptual problems do exits in NRHM. Much of NRHM today depends on public- private partnership and not on strengthening the public health system. By outsourcing and contracting we have subscribed to privatisation of the health care delivery system. It is also difficult to comprehend how ASHA can bring about inter- sectoral coordination. In conclusion the link between poverty and ill-health are cursorily mentioned and are ignored in the actual implementation plan laid out as part of the NRHM. Based on the above analysis it might be fair to say that attainment of the goals envisaged by NRHM by 2012 remains wishful thinking.
The author is a public health specialist with the Population Foundation of India New Delhi. The views expressed are that of his owns as an activist and not that of the foundation
Health being a state subject, states have used their own discretion to interpret and implement the National Rural Health Mission (NRHM). While this has resulted in some activities being implemented the broader goal of the NHRM to empower local communities has been lost. This has lead to the dilution of the agenda of placing people's health in people's hands. The current government approach is to mandate community participation by issuing government orders to its functionaries at the district level. In rural areas, village and district action plans based on community need assessment have remained a non starter and in urban areas the poor remain marginalized from this process. The NRHM talks about health sector reforms but the specific objectives of the reforms appear unrealistic and unlikely to result in the improvement of the health status of the individual or the community. In effect the Mission remains more target oriented with a disproportionate emphasis on inputs rather than focused on output or performance. The concept of Accredited Social Health Activist (ASHA), which forms the core through which the NRHM will be operationalised, cannot be described as being an innovation but rather is old wine in a new bottle. In earlier versions of the health programme similar human resource mechanisms have been proposed - for example the community health worker, link worker, multi- purpose worker amongst other things. In India, the polices, plans and schemes have often been comprehensive but the implementation has remained poor and as a result the desired result as envisaged by policies and programmes has never been actualised. The ASHA as has been mentioned earlier forms the core implementation mechanism for NRHM, who will undertake the bulk of the activities at the community level.
Inspite of playing this critical role, women who are selected are seen to be volunteers and the programme itself does not define any type of financial compensation for the work they will undertake. Recent findings show that it is proving to be extremely difficult to motivate individuals to undertake the work where no remuneration is forthcoming. As part of the ASHA scheme an incentive system has been proposed under the supervision of Sarpanch and Auxiliary Nurse Midwife. This has lead to non-integration (architectural correction) of all the other health programmes at the community level. Furthermore, there is an extremely high expectation from ASHA whose envisaged work profile does little justice as a part time worker.
The ASHA work under severe constraints with regard to infrastructure as a result ASHAs often have to resort to referring their patients to private service providers. In addition, ASHA has replaced the male health worker. ASHA's work profile is different and primarily to support the ANM. The numbers of male MPWs is already reduced and it is likely that their role will soon be written out of health programmes. It is important to point out that MPWs have a key role to play in other programmes e.g. prevention of communicable diseases and undertaking surveillance, none of which can be undertaken by ASHA. As part of the reform process of the health sector, which remains an important component of NRHM, the strengthening of public-private partnership has been mooted.
However, many health activists feel this is the governments' way of shirking responsibility to provide health services in particular primary health care as has been envisaged in the Constitution. The government is now trying to even privatize primary health care and does not want to invest in improving the public health sector. Upgrading infrastructure, especially PHC to FRU/ UPHC in un- served and underserved areas with doctors unwilling to provide service will further privatise primary health care. Contracts to private practitioners will be the only solution to man these PHC. Indian Public Health Standards (IPHS) to provide quality health care in the public health system by ensuring minimum requirements of infrastructure, accountability of doctors, the need for standard treatment protocols and social audit through rogi kalyan samiti (RKS) has been a non- starter. This has been the scenario previously as such policy directions have not translated into action. T
he guidelines for IPHS do not address the real issue which requires an analysis of failure of previous schemes. An attempt was made by the National Commission of Health and Macro-economics but its recommendations are gathering dust. NRHM aim is to reduce infant mortality and maternal mortality by improving access through the ASHA and the Janani Suraksha Yojana (JSY) scheme by strengthening Community Health Centres. The emphasis is on technology alone. It has failed to address the correlates to nutrition and thus to poverty. The belief that reducing total fertility will reduce infant mortality ignores the links between the socio-economic status of the community especially that of women and health of an infant. It is important to note that access to care is also linked to discrimination as well. Additionally unskilled human resource and poor infrastructure in un-served and under-served areas compound the problem. Targets to reduce infant mortality rate (IMR) and maternal mortality ratio (MMR) by only increasing health sector expenditure needs to address issues of equitable distribution and resource allocation. Conceptual problems do exits in NRHM. Much of NRHM today depends on public- private partnership and not on strengthening the public health system. By outsourcing and contracting we have subscribed to privatisation of the health care delivery system. It is also difficult to comprehend how ASHA can bring about inter- sectoral coordination. In conclusion the link between poverty and ill-health are cursorily mentioned and are ignored in the actual implementation plan laid out as part of the NRHM. Based on the above analysis it might be fair to say that attainment of the goals envisaged by NRHM by 2012 remains wishful thinking.
The author is a public health specialist with the Population Foundation of India New Delhi. The views expressed are that of his owns as an activist and not that of the foundation
Maternal Deaths In Madhya Pradesh Denial Is The Best Policy
by Sachin Kumar Jain
Village Sarari Khurd, Sheopur - has a primary health centre but no doctor. Since when it does not have doctor, even villagers can't remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipments and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometers of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily). And there is nothing to take care of a pregnant women and children. Even in case of unavailability of medicines, village level health staff is sailing the various kind of medicines to the Villagers.
There are 533 villages in the Saheriya primitive tribe dominated Sheopur district with a population of 5.60 lakhs. The total number of bed available at the one district hospital and other hospitals is only 166, of which 148 beds have not been changed during the last 13 years. During the last two years, several big claims have been made about promoting safe motherhood but just like last six years, three out of four posts of doctors in the Karahal block are still vacant. There was no improvement in the medical facilities during this period and even a single gynecologist and obstetrician could not be posted.
Anganbadi worker from Gothra Kapura village of the district, Bilasi Devi speaks from experience and asks as to why should one go to hospital? No one even speaks properly there and everyone right from doctors to nurses to sanitary workers asks for money to take any action. Government claims that anyone going for institutional childbirth would get Rs 1700 worth financial aid, transport fare and free medicines, but Babhuti was taken for childbirth to a hospital and her family had to pawn their land for completing the process.
In such situation, the Government of India has recently released figures related to maternal mortality for the first time since 1998, which claims that the Maternal Mortality Rate (MMR) has gone down from 498 (per lakh childbirth) to 379 during the period. But the report of the GoI (Maternal Mortality in India: Trends, causes and risk factors - 1997-2003) is itself facing some basic technical questions. The biggest question is as to whether the government is trying to veil the ground situation by some statistics under some pressure.
One important point is that this study of MMR has been conducted by considering only limited number of cases in specific situation. The survey was conducted over a period of six years and the low MMR is reported in MP and Chhattisgarh (365) although during this period about 103000 cases of maternal mortality were reported in the two states. The second point is that all these cases (365) are those that have been registered in official records while analyses tell that only one out of three maternal deaths get officially recorded. The problem is that in the district hospitals, community health centers and the lower level of health set up, the deaths during childbirth are recorded as general mortality.
The next question is that the Madhya Pradesh Government (GoMP) had in 2003 pointed out through the State Family Health Evaluation made it clear that in the rural areas of the state, the MMR is as high as 763, which clearly tells that the situation is far graver than the analysis by the union government. This study by the GoMP was done on 25 percent populace of each district and not only a selected group yet the union government is releasing contradictory figures for the same period.
The controversy should not remain limited to statistics because the health facility condition in state clearly brings forth the ugly face of the situation. The analysis of recent efforts of state government does not bring any good news.
In the state, only one hospital bed is available per two villages. Total 17 lakh childbirth occur in the state every year and 40 percent of state populace is below poverty line, yet the government provides only Rs 150 per person per year as health budget of which Rs 126 is spend on salary-allowances and other infrastructure costs. Only 137 posts of gynecologists and obstetricians are approved in entire state and of these 38 are vacant since several years. After a long battle, the government started the process of filling up the vacancies last year but no doctors are willing to take up government jobs owing to lack of facilities including diagnostic implements, medicines and general sanitary facilities. In such situation, doctors often have to face the wrath of the family members of the patient in case of death.
Government started the process for filling up 78 posts of gynecologists and obstetricians but only 31 applications were received. A total 112 posts of anesthetists were to be filled up but only 12 took up the job. Corruption at all levels is making conditions far more dangerous for the pregnant women. Corruption has begun in the medicine purchase under the new medicine policy, as now in the new medicine policy all the purchase will be done centrally and the Rs 700 of financial support under Janani Suraksha Yojana is all spent in giving bribe to the local health staff.
Despite unreliable data, statistics say that out of 1.47 lakh maternal deaths in the country every year, 97000 are contributed by the five BIMARU states and the three newly carved states. The World Health Organization also accepts this. The half of the maternal deaths in South Asia are contributed by the states of Rajasthan, MP, Bihar, UP and Orissa in India.
In such situation the statistics need to be manipulated to show lower MMP so that the policies foreign investments and privatization of services could be justified. MMR is directly related to social disparity, exploitation and poverty. The government has limited the scope of poverty around hunger and this has limited the rights of the women for safe motherhood. On one had health services have been hugely privatized and on other government's accountability for rights of community to health has reduced. Due to poverty, more than 40 percent below poverty line families are not able to seek benefit of private health services.
Actually this is the time to sincerely implement the efforts for safe motherhood. A political debate has started on the issue but lack of commitment is easily perceptible. The fear is that the rights of women might get entangles into a web of schemes. Government provides cheaper food grains but it is ironic that a women suffering from childbirth pains has to prove that she is poor as per government guidelines to get free medical care and medicines. The government needs to chalk out a comprehensive policy and coordinated effort for child and maternal health and not keep churning out irresponsible and discrepant schemes just to please some political leaders.
Village Sarari Khurd, Sheopur - has a primary health centre but no doctor. Since when it does not have doctor, even villagers can't remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipments and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometers of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily). And there is nothing to take care of a pregnant women and children. Even in case of unavailability of medicines, village level health staff is sailing the various kind of medicines to the Villagers.
There are 533 villages in the Saheriya primitive tribe dominated Sheopur district with a population of 5.60 lakhs. The total number of bed available at the one district hospital and other hospitals is only 166, of which 148 beds have not been changed during the last 13 years. During the last two years, several big claims have been made about promoting safe motherhood but just like last six years, three out of four posts of doctors in the Karahal block are still vacant. There was no improvement in the medical facilities during this period and even a single gynecologist and obstetrician could not be posted.
Anganbadi worker from Gothra Kapura village of the district, Bilasi Devi speaks from experience and asks as to why should one go to hospital? No one even speaks properly there and everyone right from doctors to nurses to sanitary workers asks for money to take any action. Government claims that anyone going for institutional childbirth would get Rs 1700 worth financial aid, transport fare and free medicines, but Babhuti was taken for childbirth to a hospital and her family had to pawn their land for completing the process.
In such situation, the Government of India has recently released figures related to maternal mortality for the first time since 1998, which claims that the Maternal Mortality Rate (MMR) has gone down from 498 (per lakh childbirth) to 379 during the period. But the report of the GoI (Maternal Mortality in India: Trends, causes and risk factors - 1997-2003) is itself facing some basic technical questions. The biggest question is as to whether the government is trying to veil the ground situation by some statistics under some pressure.
One important point is that this study of MMR has been conducted by considering only limited number of cases in specific situation. The survey was conducted over a period of six years and the low MMR is reported in MP and Chhattisgarh (365) although during this period about 103000 cases of maternal mortality were reported in the two states. The second point is that all these cases (365) are those that have been registered in official records while analyses tell that only one out of three maternal deaths get officially recorded. The problem is that in the district hospitals, community health centers and the lower level of health set up, the deaths during childbirth are recorded as general mortality.
The next question is that the Madhya Pradesh Government (GoMP) had in 2003 pointed out through the State Family Health Evaluation made it clear that in the rural areas of the state, the MMR is as high as 763, which clearly tells that the situation is far graver than the analysis by the union government. This study by the GoMP was done on 25 percent populace of each district and not only a selected group yet the union government is releasing contradictory figures for the same period.
The controversy should not remain limited to statistics because the health facility condition in state clearly brings forth the ugly face of the situation. The analysis of recent efforts of state government does not bring any good news.
In the state, only one hospital bed is available per two villages. Total 17 lakh childbirth occur in the state every year and 40 percent of state populace is below poverty line, yet the government provides only Rs 150 per person per year as health budget of which Rs 126 is spend on salary-allowances and other infrastructure costs. Only 137 posts of gynecologists and obstetricians are approved in entire state and of these 38 are vacant since several years. After a long battle, the government started the process of filling up the vacancies last year but no doctors are willing to take up government jobs owing to lack of facilities including diagnostic implements, medicines and general sanitary facilities. In such situation, doctors often have to face the wrath of the family members of the patient in case of death.
Government started the process for filling up 78 posts of gynecologists and obstetricians but only 31 applications were received. A total 112 posts of anesthetists were to be filled up but only 12 took up the job. Corruption at all levels is making conditions far more dangerous for the pregnant women. Corruption has begun in the medicine purchase under the new medicine policy, as now in the new medicine policy all the purchase will be done centrally and the Rs 700 of financial support under Janani Suraksha Yojana is all spent in giving bribe to the local health staff.
Despite unreliable data, statistics say that out of 1.47 lakh maternal deaths in the country every year, 97000 are contributed by the five BIMARU states and the three newly carved states. The World Health Organization also accepts this. The half of the maternal deaths in South Asia are contributed by the states of Rajasthan, MP, Bihar, UP and Orissa in India.
In such situation the statistics need to be manipulated to show lower MMP so that the policies foreign investments and privatization of services could be justified. MMR is directly related to social disparity, exploitation and poverty. The government has limited the scope of poverty around hunger and this has limited the rights of the women for safe motherhood. On one had health services have been hugely privatized and on other government's accountability for rights of community to health has reduced. Due to poverty, more than 40 percent below poverty line families are not able to seek benefit of private health services.
Actually this is the time to sincerely implement the efforts for safe motherhood. A political debate has started on the issue but lack of commitment is easily perceptible. The fear is that the rights of women might get entangles into a web of schemes. Government provides cheaper food grains but it is ironic that a women suffering from childbirth pains has to prove that she is poor as per government guidelines to get free medical care and medicines. The government needs to chalk out a comprehensive policy and coordinated effort for child and maternal health and not keep churning out irresponsible and discrepant schemes just to please some political leaders.
Saturday, May 05, 2007
Hospital negligence claims woman's life in Bhopal
Story on NDTV.com
Salamat Ali is inconsolable. His 25-year-old wife Tajbunissa died at the Indira Gandhi Gas Relief hospital in Bhopal on Thursday afternoon and he wasn't even told until the evening.
Tajbunissa, two and a half months pregnant, had gone for an abortion and a tubectomy. But after the surgery, she never regained consciousness.
Salamat is sure his wife died due to negligence of the doctors.
''After the tubectomy operation, she never gained consciousness and when she started bleeding form her nose and mouth, I desperately tried to call the doctors but there was no one,'' said Salamat Ali, victim's husband.
Hospital authorities claim Tajbunissa died of pulmonary oedema or fluid in the lungs, followed by a cardiac arrest.
Callous attitude
An FIR has been filed and the police are investigating the death. Salamat also says he was asked to take his wife's body away without making a fuss. He says the hospital even offered him a compensation of Rs three lakh.
Other patients at the hospital say the incident has exposed the irregularities at the hospital where the staff is greedy and careless.
''Over here even the guards ask for money. Nurses say 'Give me Rs 500 only then I will change the bottle,'' said Avinash Jain, patient.
There are six hospitals in Bhopal to cater to all those affected by the Bhopal gas tragedy. There are also seven mini dispensaries.
But patients say most of them are severely understaffed and lack even the basic amenities.
''The gas relief hospitals are going form bad to worse. This is not simply a case of negligence or even criminal negligence, it's a case of criminal offence,'' said Abdul Jabber, Convener, Bhopal Gas Victims Organisation.
Already suffering from the after-effects of a disaster, these people seem to get little but apathy at these hospitals set up to help them.
Salamat Ali is inconsolable. His 25-year-old wife Tajbunissa died at the Indira Gandhi Gas Relief hospital in Bhopal on Thursday afternoon and he wasn't even told until the evening.
Tajbunissa, two and a half months pregnant, had gone for an abortion and a tubectomy. But after the surgery, she never regained consciousness.
Salamat is sure his wife died due to negligence of the doctors.
''After the tubectomy operation, she never gained consciousness and when she started bleeding form her nose and mouth, I desperately tried to call the doctors but there was no one,'' said Salamat Ali, victim's husband.
Hospital authorities claim Tajbunissa died of pulmonary oedema or fluid in the lungs, followed by a cardiac arrest.
Callous attitude
An FIR has been filed and the police are investigating the death. Salamat also says he was asked to take his wife's body away without making a fuss. He says the hospital even offered him a compensation of Rs three lakh.
Other patients at the hospital say the incident has exposed the irregularities at the hospital where the staff is greedy and careless.
''Over here even the guards ask for money. Nurses say 'Give me Rs 500 only then I will change the bottle,'' said Avinash Jain, patient.
There are six hospitals in Bhopal to cater to all those affected by the Bhopal gas tragedy. There are also seven mini dispensaries.
But patients say most of them are severely understaffed and lack even the basic amenities.
''The gas relief hospitals are going form bad to worse. This is not simply a case of negligence or even criminal negligence, it's a case of criminal offence,'' said Abdul Jabber, Convener, Bhopal Gas Victims Organisation.
Already suffering from the after-effects of a disaster, these people seem to get little but apathy at these hospitals set up to help them.
Wednesday, April 11, 2007
Madhya Pradesh Needs to Invest in Health
www.boloji.com
The theme of World Health Day on 7 April was 'Invest in Health – Build a Safe Future'. The above theme is more relevant in Madhya Pradesh, central part of India. The State urgently needs to invest in health to help save lives of its own people especially women and children.
The State of Madhya Pradesh has the highest rates of malnutrition among the children in India. As per the latest National Family Health Survey 60 % of its children in age group of 0 – 3 years are under nourished. Similarly as per the growth monitoring drive undertaken by the state 78,000 children in the state are severely malnourished, meaning they need immediate care. Though the state has set up nutritional rehabilitation centers in some of its districts to provide for medical and nutritional care and support to the parents of severely malnourished children but need is of more efforts in this direction or else many may die.
Madhya Pradesh has the highest infant mortality rate and 3rd highest maternal mortality ratio in the country. 76 out of every 1000 children born in the state die before their first birthday and approximately 24 women die everyday in the state. Though the state has introduced many schemes to help combat the same, but due to bureaucratic hassles and corruption the schemes are not yielding the desired results for children and women. As per state's health department web site Madhya Pradesh for its population of 60.38 million (as per 2001 census) has the following health infrastructure:
- District hospitals 48
- Civil hospitals 54
- Community health centers 270
- Primary health centers 1149
- Sub health centers 8834
- Sanctioned beds in district hospitals 8945
- Sanctioned beds in civil hospitals 2775
- Total licensed blood banks by state 41
A NGO namely Collective of Advocacy research and training which advocates on the issues of maternal and infant survival has been calling the issue to attention. They had undertaken an analysis of rural health infrastructure versus the population in the state. As per their statement there is just 'one bed per 5.6 villages' in the state which is alarming!. It is not only the issue of beds or buildings. Even where there are structures or health centers they lack basic minimum facilities as needed and defined by rules and are not sufficient enough to save lives or provide for better health care to its people.
As per Reproductive and Child Health District level household survey (2004) data, out of the 386 primary health centre's surveyed in the state only 224 had drinking water facility. This means that only 58.3 percent primary health centre's had drinking water while others have no such facility. Similarly in case of community health centre's out of the 46 surveyed only 10 had facility of drinking water. In case of vehicles like ambulances out of the 386 primary health centers surveyed only 35 had vehicles which were in running condition and out of 46 community health centre's surveyed 31 had vehicles in the running condition.
Infrastructure investment does not only mean building equipments etc. Human resource which is core in health needs to be focused upon. Not only to fulfill the vacancies of doctors, para-medics, nurses but also providing them with facilities to provide care for the people. When one raises concern on the issue of health there are numbers of different issues which impact lives of people including women and children in the state which needs attention. Probably state needs to revamp and transform its health system and look at the whole issue more holistically. The State needs to peg health of its people as priority number one, transform on immediate basis which is not only limited to public proclamations and announcing schemes but also delivering results at ground level.
anil gulati
(All views expressed in this piece are personal opinions of the writer)
The theme of World Health Day on 7 April was 'Invest in Health – Build a Safe Future'. The above theme is more relevant in Madhya Pradesh, central part of India. The State urgently needs to invest in health to help save lives of its own people especially women and children.
The State of Madhya Pradesh has the highest rates of malnutrition among the children in India. As per the latest National Family Health Survey 60 % of its children in age group of 0 – 3 years are under nourished. Similarly as per the growth monitoring drive undertaken by the state 78,000 children in the state are severely malnourished, meaning they need immediate care. Though the state has set up nutritional rehabilitation centers in some of its districts to provide for medical and nutritional care and support to the parents of severely malnourished children but need is of more efforts in this direction or else many may die.
Madhya Pradesh has the highest infant mortality rate and 3rd highest maternal mortality ratio in the country. 76 out of every 1000 children born in the state die before their first birthday and approximately 24 women die everyday in the state. Though the state has introduced many schemes to help combat the same, but due to bureaucratic hassles and corruption the schemes are not yielding the desired results for children and women. As per state's health department web site Madhya Pradesh for its population of 60.38 million (as per 2001 census) has the following health infrastructure:
- District hospitals 48
- Civil hospitals 54
- Community health centers 270
- Primary health centers 1149
- Sub health centers 8834
- Sanctioned beds in district hospitals 8945
- Sanctioned beds in civil hospitals 2775
- Total licensed blood banks by state 41
A NGO namely Collective of Advocacy research and training which advocates on the issues of maternal and infant survival has been calling the issue to attention. They had undertaken an analysis of rural health infrastructure versus the population in the state. As per their statement there is just 'one bed per 5.6 villages' in the state which is alarming!. It is not only the issue of beds or buildings. Even where there are structures or health centers they lack basic minimum facilities as needed and defined by rules and are not sufficient enough to save lives or provide for better health care to its people.
As per Reproductive and Child Health District level household survey (2004) data, out of the 386 primary health centre's surveyed in the state only 224 had drinking water facility. This means that only 58.3 percent primary health centre's had drinking water while others have no such facility. Similarly in case of community health centre's out of the 46 surveyed only 10 had facility of drinking water. In case of vehicles like ambulances out of the 386 primary health centers surveyed only 35 had vehicles which were in running condition and out of 46 community health centre's surveyed 31 had vehicles in the running condition.
Infrastructure investment does not only mean building equipments etc. Human resource which is core in health needs to be focused upon. Not only to fulfill the vacancies of doctors, para-medics, nurses but also providing them with facilities to provide care for the people. When one raises concern on the issue of health there are numbers of different issues which impact lives of people including women and children in the state which needs attention. Probably state needs to revamp and transform its health system and look at the whole issue more holistically. The State needs to peg health of its people as priority number one, transform on immediate basis which is not only limited to public proclamations and announcing schemes but also delivering results at ground level.
anil gulati
(All views expressed in this piece are personal opinions of the writer)
Friday, April 06, 2007
MP Convention on safemotherhood
The Hindu, Staff Correspondent
- Govt. to address women, child-related issues with urgency
- Meeting organised along with UNICEF to make the rural women aware of various schemes
`Govt. is determined to ensure that not a single woman dies due to delivery related complications'
Majhauli (Madhya Pradesh): Thousands of women braved the afternoon sun on Sunday and attended a huge women's convention organised here by the Madhya Pradesh Department of Public Health and Family Welfare and UNICEF to make the rural women aware of various schemes aimed at addressing the problem of maternal and infant mortality and other women and child related issues.
Addressing the convention on safe motherhood at this development block in Jabalpur district, the State health Minister, Ajay Vishnoi said that it is very important to save the life of every woman and child. He said that the State Government is determined to ensure that not a single woman died due to delivery related complications. The Government is committed and policies were being implemented with total urgency for the benefit of every mother and child in the State, he added. The women attending the convention clapped in approval when the Minister informed them about the incentives being given to women in Madhya Pradesh to promote institutionalised delivery and schemes like Bal Shakti and Ladli Lakshmi Yojna. Speaking on this occasion, UNICEF's State Representative, Hamid El-Bashir said that his organization would always work closely with the State Health Administration and other Government departments. He went on to observe: "We are proud of this partnership and were prepared to take it further". He added, "We are ready to work with every agency and organization tackling women and child related issues on priority". He also advised the women to raise their demands saying: "We are ready to listen" and further said: "We want to ensure that maternal and infant mortality is reduced in Madhya Pradesh. We also want to reduce levels of malnutrition and anaemia among infants, girls and women."
The State Director Public Health and Family Welfare, Yogiraj Sharma said in his speech that maternal mortality is very high in Madhya Pradesh and every hour one mother dies in the State. He said that every one was responsible for this grim scenario and that women would have to come forward and take the benefits of various schemes being implemented by the Government for their welfare, particularly the incentives being offered for institutionalised delivery. The Jabalpur Collector, Sanjay Dubey emphasised that all steps should be taken to protect the newly born and to combat the problem of infant mortality. He said that children should be protected from malnutrition and women should not be allowed to go through pregnancy related complications.
Ms. Alka Vishnoi, the State Health Minister' wife set the tone for the women's convention named as the "Saas-Bahu Sammelan" (convention of mothers-in-law and daughters-in-law).
- Govt. to address women, child-related issues with urgency
- Meeting organised along with UNICEF to make the rural women aware of various schemes
`Govt. is determined to ensure that not a single woman dies due to delivery related complications'
Majhauli (Madhya Pradesh): Thousands of women braved the afternoon sun on Sunday and attended a huge women's convention organised here by the Madhya Pradesh Department of Public Health and Family Welfare and UNICEF to make the rural women aware of various schemes aimed at addressing the problem of maternal and infant mortality and other women and child related issues.
Addressing the convention on safe motherhood at this development block in Jabalpur district, the State health Minister, Ajay Vishnoi said that it is very important to save the life of every woman and child. He said that the State Government is determined to ensure that not a single woman died due to delivery related complications. The Government is committed and policies were being implemented with total urgency for the benefit of every mother and child in the State, he added. The women attending the convention clapped in approval when the Minister informed them about the incentives being given to women in Madhya Pradesh to promote institutionalised delivery and schemes like Bal Shakti and Ladli Lakshmi Yojna. Speaking on this occasion, UNICEF's State Representative, Hamid El-Bashir said that his organization would always work closely with the State Health Administration and other Government departments. He went on to observe: "We are proud of this partnership and were prepared to take it further". He added, "We are ready to work with every agency and organization tackling women and child related issues on priority". He also advised the women to raise their demands saying: "We are ready to listen" and further said: "We want to ensure that maternal and infant mortality is reduced in Madhya Pradesh. We also want to reduce levels of malnutrition and anaemia among infants, girls and women."
The State Director Public Health and Family Welfare, Yogiraj Sharma said in his speech that maternal mortality is very high in Madhya Pradesh and every hour one mother dies in the State. He said that every one was responsible for this grim scenario and that women would have to come forward and take the benefits of various schemes being implemented by the Government for their welfare, particularly the incentives being offered for institutionalised delivery. The Jabalpur Collector, Sanjay Dubey emphasised that all steps should be taken to protect the newly born and to combat the problem of infant mortality. He said that children should be protected from malnutrition and women should not be allowed to go through pregnancy related complications.
Ms. Alka Vishnoi, the State Health Minister' wife set the tone for the women's convention named as the "Saas-Bahu Sammelan" (convention of mothers-in-law and daughters-in-law).
Tackling maternal mortality in MP
By Rashme Sehgal
Shivpuri and Guna districts in Madhya Pradesh have one of the highest maternal mortality rates in India. But in a PHC in Satanvara block, two young doctors have ensured not a single maternal death in 257 deliveries they’ve handled over one year
The ravines of Chambal have given birth to many legends woven around the lives of notorious dacoits. One such legend is being woven around Ram Babu Gadaria, a shepherd by profession, who became a dacoit after his wife was raped by upper-caste landlords.
What has Gadaria got to do with the pressing issue of maternal mortality in a backward state like Madhya Pradesh? He has almost brought the tottering health system to a halt with his Phoolan Devi-like antics. He is said to kidnap doctors and health workers for ransom, releasing them after receiving hefty amounts from their families. Recently he kidnapped two private doctors with sizeable practises and released them after being paid astronomical sums of money.
Two young women doctors in their mid-20s, Manisha Yadav and Sandhya Gupta, working at a primary health centre (PHC) in the Satanvara block of Shivpuri district, adjacent to the Chambal valley, are terrified of Gadaria and his gun-toting gang. Both Manisha and Sandhya have been working at this PHC for over a year and have already handled more than 257 deliveries. But since many of these deliveries take place at night, these young women have to make their way from their rented accommodation to the PHC in the dead of night.
“It's very scary. Both of us have studied in Gwalior and the very thought of coming face-to-face with a member of this gang is alarming. The local villagers have told us that the Gadaria gang are quite active here,” said Manisha.
Both these doctors decided to accept this challenging assignment because they would receive a starting salary of Rs 15,000 per month. Salaries of doctors willing to accept field postings were recently hiked by the state government which realised that several PHCs and district hospitals were inadequately staffed. These two doctors claim credit for not having had a single maternal death so far. “Of the 257 deliveries we have conducted so far, we have not had a single maternal death,” they say.
The birth of two female children the night before by two tribal women has boosted their confidence further. Both the mothers and their babies are sleeping in a room adjacent to the makeshift operation theatre. One of the reasons for the absence of maternal deaths could be that caesarean and other complicated delivery cases are directed from here to the district hospital. “We have had three cases of stillborn babies. One case was of a mother running continuous high-grade fever giving birth to seven-month-old twins. Fortunately, the mother survived,” Manisha pointed out.
The district of Shivpuri, which falls in the Gwalior-Chambal zone, has one of the highest maternal mortality rates in India . A maternal death audit conducted by Unicef and local NGOs has brought to light that while 50 maternal deaths took place in Shivpuri in 2006, the figure in Guna district was 56. Guna is the parliamentary constituency of the high-profile Congress MP Jyotiraditya Scindia. The deaths were reported by the ANMs (auxiliary nurse midwives) and by local NGOs.
Dr Ramani Atkuri, of Unicef, Bhopal , pointed out, “This is the tip of the iceberg. We believe many more women have died from childbirth but their deaths go unreported.”
“The majority of deaths take place because of haemorrhage, severe anaemia, eclampsia, malaria and sepsis,” Atkuri added.
Internal bleeding, eclampsia and obstructed labour are just some of the factors that are responsible for the high number of maternal mortality deaths in Madhya Pradesh. Every five minutes, India suffers one maternal death. The number of women who die due to pregnancy, childbirth and abortion-related complications is estimated at 60,630. The maternal mortality ratio (MMR) for India presently is 301 deaths per 100,000 live births. Uttar Pradesh alone accounts for close to 21,450 maternal deaths per year.
The maternal audit also highlighted that less than 25% of babies born to women who died have a chance of surviving. This was borne out in Guna district. Ram Swarup Batham sits outside his mud hut in Shivpuri village surrounded by his three young children all below the age of five. His wife Veeja died recently in a hospital in Gwalior while giving birth to her ninth child.
Describing how he tried to save her, Batham says, “I rushed her to the district hospital in Shivpuri. The doctor there informed me she needed to be taken to Gwalior . I took her to Gwalior Medical College but she died soon after being admitted there.”
Batham, a tribal, is fortunate to own 25 bighas of land. “I borrowed Rs 15,000 for her treatment. I'll sell my land if I cannot repay the loan,” he adds. One RNTCP official says: “The lack of integration between the TB programme and the general healthcare system is the main reason why the programme has not attained its goals. The PHC health staff do not support the TB programme because it does not offer cash incentives. These vertical programmes are creating distortions, and there is no collaboration in the implementation of programmes.”
The death of his wife has plunged their family into chaos. For one, the entire responsibility of looking after the children has fallen on his aged mother who admits she simply cannot cope. Sitting on the mud-caked floor in their front courtyard, the old woman mutters, “The doctors were completely callous. Veeja died within five minutes of being given an injection.”
The tragedy of Veeja's death is that it could have been easily prevented. Hamid al-Bashir, Unicef's state representative in Bhopal , believes, “Most maternal deaths could be prevented if women had access to appropriate healthcare during pregnancy, childbirth and immediately after delivery. When a mother dies during pregnancy, the family suffers a further increase in poverty.”
“One of the key methods to improve maternal survival would be to review all maternal deaths at the community level,” al-Bashir adds. The official explains that the situation has been repeatedly highlighted before RNTCP officials in Delhi. “But,” he says, “they are avoiding the issue and tell us to try solving the problem locally.”
Dr Aparajita Gogoi, National Coordinator for the White Ribbon Alliance India , describes these MMR deaths as a “silent tsunami”. “Over 200,000 families have been devastated by these deaths which have left 350,000 kids orphaned. Another 600,000 women have been left disabled because of pregnancy-related disorders.”
Gogoi says, “We have not been able to stem this tide of maternal deaths despite having 20,000 obstetricians, 5 lakh trained doctors and 25 lakh nurses and midwives.” Even poor countries like Bangladesh , Bolivia and Honduras have reduced MMR in similar resource settings. Countries like China , Indonesia and Sri Lanka have built up teams of skilled birth attendants and well-connected frontline providers.
The statistics in Madhya Pradesh are more alarming because in rural areas, local NGOs point out, for every 5.6 villages (average population of 2,000 per village) only one hospital bed is available. Over 82% of the children suffer from anaemia while 58% of pregnant women are also found to be anaemic.
Unicef believes one of the ways to strengthen community initiatives is by holding maternal death audits. Another such audit was recently held in Purulia in West Bengal between May 2005 and June 2006. It was found that of 55,000 deliveries there were 106 maternal deaths.
This figure was arrived at after interviewing family members of the deceased. It was believed that the number of deaths was actually around 140 since most families continue to under-report maternal deaths.
The audit revealed that the average age of marriage for girls in Purulia was 17. None of the girls interviewed had been to school while the average number of years their husbands had spent in school was four years. While 61% of deaths occurred in a health facility, 24% died at home and another 13% died en route to a health facility. The majority of deaths occurred during labour and in the post-partum period.
InfoChange News & Features, March 2007
Shivpuri and Guna districts in Madhya Pradesh have one of the highest maternal mortality rates in India. But in a PHC in Satanvara block, two young doctors have ensured not a single maternal death in 257 deliveries they’ve handled over one year
The ravines of Chambal have given birth to many legends woven around the lives of notorious dacoits. One such legend is being woven around Ram Babu Gadaria, a shepherd by profession, who became a dacoit after his wife was raped by upper-caste landlords.
What has Gadaria got to do with the pressing issue of maternal mortality in a backward state like Madhya Pradesh? He has almost brought the tottering health system to a halt with his Phoolan Devi-like antics. He is said to kidnap doctors and health workers for ransom, releasing them after receiving hefty amounts from their families. Recently he kidnapped two private doctors with sizeable practises and released them after being paid astronomical sums of money.
Two young women doctors in their mid-20s, Manisha Yadav and Sandhya Gupta, working at a primary health centre (PHC) in the Satanvara block of Shivpuri district, adjacent to the Chambal valley, are terrified of Gadaria and his gun-toting gang. Both Manisha and Sandhya have been working at this PHC for over a year and have already handled more than 257 deliveries. But since many of these deliveries take place at night, these young women have to make their way from their rented accommodation to the PHC in the dead of night.
“It's very scary. Both of us have studied in Gwalior and the very thought of coming face-to-face with a member of this gang is alarming. The local villagers have told us that the Gadaria gang are quite active here,” said Manisha.
Both these doctors decided to accept this challenging assignment because they would receive a starting salary of Rs 15,000 per month. Salaries of doctors willing to accept field postings were recently hiked by the state government which realised that several PHCs and district hospitals were inadequately staffed. These two doctors claim credit for not having had a single maternal death so far. “Of the 257 deliveries we have conducted so far, we have not had a single maternal death,” they say.
The birth of two female children the night before by two tribal women has boosted their confidence further. Both the mothers and their babies are sleeping in a room adjacent to the makeshift operation theatre. One of the reasons for the absence of maternal deaths could be that caesarean and other complicated delivery cases are directed from here to the district hospital. “We have had three cases of stillborn babies. One case was of a mother running continuous high-grade fever giving birth to seven-month-old twins. Fortunately, the mother survived,” Manisha pointed out.
The district of Shivpuri, which falls in the Gwalior-Chambal zone, has one of the highest maternal mortality rates in India . A maternal death audit conducted by Unicef and local NGOs has brought to light that while 50 maternal deaths took place in Shivpuri in 2006, the figure in Guna district was 56. Guna is the parliamentary constituency of the high-profile Congress MP Jyotiraditya Scindia. The deaths were reported by the ANMs (auxiliary nurse midwives) and by local NGOs.
Dr Ramani Atkuri, of Unicef, Bhopal , pointed out, “This is the tip of the iceberg. We believe many more women have died from childbirth but their deaths go unreported.”
“The majority of deaths take place because of haemorrhage, severe anaemia, eclampsia, malaria and sepsis,” Atkuri added.
Internal bleeding, eclampsia and obstructed labour are just some of the factors that are responsible for the high number of maternal mortality deaths in Madhya Pradesh. Every five minutes, India suffers one maternal death. The number of women who die due to pregnancy, childbirth and abortion-related complications is estimated at 60,630. The maternal mortality ratio (MMR) for India presently is 301 deaths per 100,000 live births. Uttar Pradesh alone accounts for close to 21,450 maternal deaths per year.
The maternal audit also highlighted that less than 25% of babies born to women who died have a chance of surviving. This was borne out in Guna district. Ram Swarup Batham sits outside his mud hut in Shivpuri village surrounded by his three young children all below the age of five. His wife Veeja died recently in a hospital in Gwalior while giving birth to her ninth child.
Describing how he tried to save her, Batham says, “I rushed her to the district hospital in Shivpuri. The doctor there informed me she needed to be taken to Gwalior . I took her to Gwalior Medical College but she died soon after being admitted there.”
Batham, a tribal, is fortunate to own 25 bighas of land. “I borrowed Rs 15,000 for her treatment. I'll sell my land if I cannot repay the loan,” he adds. One RNTCP official says: “The lack of integration between the TB programme and the general healthcare system is the main reason why the programme has not attained its goals. The PHC health staff do not support the TB programme because it does not offer cash incentives. These vertical programmes are creating distortions, and there is no collaboration in the implementation of programmes.”
The death of his wife has plunged their family into chaos. For one, the entire responsibility of looking after the children has fallen on his aged mother who admits she simply cannot cope. Sitting on the mud-caked floor in their front courtyard, the old woman mutters, “The doctors were completely callous. Veeja died within five minutes of being given an injection.”
The tragedy of Veeja's death is that it could have been easily prevented. Hamid al-Bashir, Unicef's state representative in Bhopal , believes, “Most maternal deaths could be prevented if women had access to appropriate healthcare during pregnancy, childbirth and immediately after delivery. When a mother dies during pregnancy, the family suffers a further increase in poverty.”
“One of the key methods to improve maternal survival would be to review all maternal deaths at the community level,” al-Bashir adds. The official explains that the situation has been repeatedly highlighted before RNTCP officials in Delhi. “But,” he says, “they are avoiding the issue and tell us to try solving the problem locally.”
Dr Aparajita Gogoi, National Coordinator for the White Ribbon Alliance India , describes these MMR deaths as a “silent tsunami”. “Over 200,000 families have been devastated by these deaths which have left 350,000 kids orphaned. Another 600,000 women have been left disabled because of pregnancy-related disorders.”
Gogoi says, “We have not been able to stem this tide of maternal deaths despite having 20,000 obstetricians, 5 lakh trained doctors and 25 lakh nurses and midwives.” Even poor countries like Bangladesh , Bolivia and Honduras have reduced MMR in similar resource settings. Countries like China , Indonesia and Sri Lanka have built up teams of skilled birth attendants and well-connected frontline providers.
The statistics in Madhya Pradesh are more alarming because in rural areas, local NGOs point out, for every 5.6 villages (average population of 2,000 per village) only one hospital bed is available. Over 82% of the children suffer from anaemia while 58% of pregnant women are also found to be anaemic.
Unicef believes one of the ways to strengthen community initiatives is by holding maternal death audits. Another such audit was recently held in Purulia in West Bengal between May 2005 and June 2006. It was found that of 55,000 deliveries there were 106 maternal deaths.
This figure was arrived at after interviewing family members of the deceased. It was believed that the number of deaths was actually around 140 since most families continue to under-report maternal deaths.
The audit revealed that the average age of marriage for girls in Purulia was 17. None of the girls interviewed had been to school while the average number of years their husbands had spent in school was four years. While 61% of deaths occurred in a health facility, 24% died at home and another 13% died en route to a health facility. The majority of deaths occurred during labour and in the post-partum period.
InfoChange News & Features, March 2007
Tuesday, March 13, 2007
Fragile Lives
FRONTLINE- Volume 24 - Issue 5 :: Mar. 10-23, 2007
By T.K. RAJALAKSHMI
The fundamental causes leading to high maternal mortality are yet to be addressed.
Mamta Bahelia, A tribal woman in Pathadeori village of Madhya Pradesh's Seoni district. Weighing 52 kg into the eighth month of her pregnancy, she continues to do laborious work.
ACCORDING to the Sample Registration Survey for 2001-03, around 78,050 pregnant women die in India every year. For every hundred thousand live births, there are 301 maternal deaths, the survey says. According to the White Ribbon Alliance of India (WRAI), a nationwide initiative that promotes safe motherhood, there has been no significant decline in India's maternal mortality rate (MMR) since the 1990s. Surveys of the causes of the high MMR show how inaccessible timely medical attention still is to many pregnant women. An inadequate health care system, lack of awareness, bad roads and, of course, poverty are some of the major factors that come in the way of safe deliveries for pregnant women. Surveys have also found that the maximum number of maternal deaths is recorded among the Scheduled Castes, the Scheduled Tribes and Other Backward Classes.
Bimla of Duhiya village in Murar block of Madhya Pradesh's Gwalior district is an Accredited Social Health Activist (ASHA). Madhya Pradesh is one of the 18 Empowered Action Group States covered under the National Rural Health Mission (NRHM); it is one of the "low-performing" States in terms of institutional deliveries, along with Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Chhattisgarh, Rajasthan, Orissa and Jammu and Kashmir. As an ASHA, Bimla gets Rs.600 for every pregnant woman she is able to take to a government hospital for delivery. Indeed, all she can remember of her "training" is that she, and others like her, were told that they would be paid if they took pregnant women to hospital.
But Bimla could not save the life of her own sister-in-law, Khiloni. The family says she died because there was no trained "birth attendant" in the village and the government hospital where they took her would not accept the case because it was complicated. Bimla's is a family of landless farm hands. Duhiya is a village of mainly Jatavs, though there are a few landed, upper-caste families too. Only a kutccha road links Duhiya to Gwalior city. Bimla does not seem fully aware of the provisions of the Janani Suraksha Yojana (JSY), operational since April 12, 2005, under which pregnant women get Rs.1,400 if they give birth in a government hospital and are also compensated if they give birth at home or in accredited private hospitals. Only two of the 25 women she took to a government hospital for delivery got paid under the JSY. Her own payment is often not on time and she is not paid for conveyance any way. She is supposed to serve a `population area' of 1,000, but she serves two panchayat areas with a total population of 2,000. Sometimes, she says, Auxiliary Nurse Midwives (ANMs) refuse even to "touch" pregnant women of lower castes, let alone attending to their needs. Vinita Kalra, an auxiliary nurse midwife, has been working for eight years in Mamodhan village of Rajasthan's Dholpur district. In this photograph, making a home visit for an antenatal check-up.
According to an activist from a rights organisation in Murar, there have been several cases in Duhiya where pregnant women were turned away from the government hospital and forced to spend small fortunes on treatment at private hospitals. "This also means that the ASHA does not get paid," she said. In an area where maternal mortality obviously needs more attention than it gets, priorities sometimes seem strangely misplaced. The medical officer in charge of the primary health centre (PHC) in Hastinapur town of Murar block, for instance, could only think of the missing boundary wall at his PHC when asked what problems he faced at work. The centre he runs has no blood bank or ambulance services, no female doctors, and its nurses are not trained in Emergency Obstetric Care Services (EmOC). It has a proper building but is understaffed. Local people say there is no one at the centre after evening though it has been converted into a 24-hour First Referral Unit under the NRHM. He denied that there had been any cases of maternal mortality at his PHC. But he added that the families of pregnant women were usually to blame for pregnancy-related deaths because they did not organise timely medical attention. By the time a pregnant woman was taken to a doctor, he said, it was usually too late. He also said that anaemia was a major cause of maternal mortality. At least on this last point, the National Family Health Survey III would agree with him. The survey data, released recently, show that nearly 82.6 per cent of the children in the age group of six to 35 months are anaemic; 40.1 per cent of women have a body mass index (BMI) below normal; 57.9 per cent of pregnant women and 57.6 per cent of women who were ever married are anaemic.
The Economic Survey (2005-06) says the NRHM is the chief vehicle for making good the promises made on health care in the National Common Minimum Programme. Commenting on the implementation of the NRHM so far, WRAI spokesperson Aparajita Gogoi said there was no arrangement for training midwives under the Mission. Most ANMs are at present involved with family planning and health care for children. Skilled assistance at childbirth is not easily available. Much of what happens in communities and in the hospitals goes unreported and there is little accountability for maternal deaths. Doctors are often not trained in emergency obstetric care services and nurses and midwives are not encouraged to carry out life-saving procedures. Gogoi also said that panchayats were entitled to Rs.5,000 from the Health Department for emergency obstetric care services, but most of them were not aware of it and did not use the money.
Lack of nutrition is also a problem. The Integrated Child Development Services centre at Duhiya functions from the home of an Anganwadi worker. The only diet supplement that children and pregnant and lactating mothers receive here is soya puffs.
EVEN A BASIC labour room like this one is not something women have easy access to in rural India. The government now offers cash incentives to encourage women to go to hospitals for delivery. The story is the same everywhere. Banjara Ka Pura, also in Murar, is a village dominated by Banjaras, a Scheduled Tribe. All families in the village are landless and daily wages do not exceed Rs.40. The entire village should have been categorised as Below Poverty Line, yet few residents hold BPL cards. Even the grain allotted for the BPL category is not sold at BPL prices. There are young widows and old destitute women in the village who are not covered under the Antyodaya scheme for foodgrain entitlement. Expenditure on health leads to bondage in the village.
One woman, Lakshmi, narrated how her pregnant daughter-in-law died of haemorrhage after a miscarriage because she did not get timely treatment. "We used to take her in a bullock cart every day to the PHC. But the centre refused to admit her. We spent Rs.800 on a jeep to bring her body back," she said. She added that the entire family now worked as bonded labourers for the local temple priest, who had lent them Rs.35,000. Lakshmi's second daughter-in-law was luckier; she delivered her child in a tractor.
A recent Maternal and Perinatal Death Inquiry (MAPEDI) study by the United Nations Children's Fund (UNICEF), in Guna and Shivpuri districts of Madhya Pradesh and Purulia district in West Bengal, says most maternal deaths occur within six to 24 hours of delivery, the immediate cause being hemorrhage. In most of the cases surveyed, the women were found to be severely anaemic, and had been so from adolescence. The MAPEDI study, based on interviews with families that had lost pregnant mothers, highlighted that the majority of the deaths were preventable and that people would access services if they could. Financial constraints and bad roads are among the factors that prevent pregnant women and their families from accessing medical attention during and after pregnancy. The fact that trained nurses and midwives are not available round the clock also pushes up maternal mortality.
In the Purulia study of nearly 106 maternal deaths, it was found that nearly 80 per cent of the women had sought formal care at some point of their illness and nearly 46 per cent had sought formal care after complications arose. Among the reasons for not seeking formal care, 23 per cent of the respondents (family members) felt that transportation was a leading cause. While 16 per cent felt that the person herself did not perceive she was sick enough, only a meagre 8 per cent felt that the problem required traditional care. Nine per cent could not pay for transport, while 10 per cent said transport was not available.
The study, presented by Sudha Balakrishan, indicated there was an awareness of the need to seek health care, just as there was in Madhya Pradesh. But while most respondents in Purulia could afford transport to hospitals and health centres, very few in the Madhya Pradesh case study said they could do so. Shahikala Nageshwar of Jawarkothi village in Seoni district belongs to a Scheduled Caste. Pregnant and underweight (43 kg) at 19, she was taken to hospital for her delivery on a bullock cart by a midwife.
Following the UNICEF study, the Government of West Bengal decided to review every maternal death. It also issued an order making all maternity beds in government hospitals free of cost. The problem is that despite heightened allocations for health care, the Central government continues to view health care as important "not only for reaping the demographic dividend, having a healthy productive workforce and general welfare, but also for attaining the goal of population stabilisation. Population stabilisation is proposed to be achieved by addressing issues like that of child survival, safe motherhood and contraception" (Economic Survey 2006-2007). Health activists have increasingly begun to de-link the goals of population stabilisation from MMR and infant mortality rate (IMR), the government's approach remains much the same.
The NFHS-III interviewed 230,000 women in the 15-49 age group and men in the 15-54 age group. It found that 44.5 per cent of the women were married before the age of 18. Jharkhand recorded most of the cases (61.2 per cent), followed by Bihar (60.3 per cent) Andhra Pradesh (54.7 per cent) and Rajasthan (57.1 per cent); the lowest numbers were reported from Himachal Pradesh (12.3 per cent), Jammu and Kashmir (14 per cent), Kerala (15.4 per cent) and Punjab (19.4 per cent).
The NFHS-III interviewed 230,000 women in the 15-49 age group and men in the 15-54 age group. It found that 44.5 per cent of the women were married before the age of 18. Jharkhand recorded most of the cases (61.2 per cent), followed by Bihar (60.3 per cent) Andhra Pradesh (54.7 per cent) and Rajasthan (57.1 per cent); the lowest numbers were reported from Himachal Pradesh (12.3 per cent), Jammu and Kashmir (14 per cent), Kerala (15.4 per cent) and Punjab (19.4 per cent).
There seems to have been a shift from a vertical approach to health care to a more decentralised one and the 2007-08 Budget proposals include higher allocations for health care. But there needs to be a greater emphasis on an inter-sectoral approach, especially on food security. It is not only a question of meeting the Millennium Development Goals any more, it is about being accountable and sensitive to the needs of one half of the nation's population.
Kudos to frontline on picking up this issue...
Monday, March 12, 2007
Anaemia a huge problem in India: NFHS-3
One World SouthAsia
82 % children anaemic in MP
India has among the highest number of cases of anaemia in the world, according to the National Family Health Survey recently undertaken. The reasons range from high cost of healthcare facilities, poor food quality and the low status of women As many as 79.1% of India’s children between the ages of three and six, and 56.2% of married women in the age-group 15-49 were found to be anaemic in 2006. The figure for the latter was 51.8% in 1999.
Releasing the official figures of the National Family Health Survey-3, Werner Schultink, chief of Unicef India, child health and nutrition, said, on February 21, that there were a number of reasons for India having the largest number of anaemic married women and children in the world. He cited the low social status of women, poor food quality, high cost of healthcare, and genetic problems as being responsible for the problem. NFHS-3 is published jointly by Unicef, the United Nations Population Fund, Britain’s Department for International Development (DFID) and Avahan, an initiative of the Bill and Melinda Gates Foundation. Schultink explained that about 20% of pregnant women in the US and Europe are anaemic. “Even in Indonesia the anaemia rate among women is 30-40%. The NFHS data suggests the rate of anaemia has gone up since 1999 in India.” The survey revealed that among the states, Assam is the worst affected with 72% of married women being anaemic, followed by Haryana (69.7%) and Jharkhand (68.4%). The prevalence of malaria in states like Assam was cited as one of the chief reasons for this sorry state of affairs.
Talking about the condition of children, M Babille, who heads the health division of Unicef India, said that the situation had worsened in 16 Indian states over the last seven years. Among the states worst hit, 79% of children in Andhra Pradesh suffer from anaemia. Rajasthan has a figure of 79.8% and Karnataka and Madhya Pradesh over 82%. Portraying a negative image of India’s growth trajectory in the health sector, Babille added that 33% of women in the 15-49 age-group were underweight. Among the states, 43% of women in Bihar are underweight, followed by Jharkhand (42.6%) and Chhattisgarh (41%). “Nearly 40% of children below the age of three in Maharashtra are underweight too,” he said. This latest National Family Health Survey, conducted in 2005-06, shows that the number of anaemia cases has increased among women, while there has been a slight decline in the case of children. Shockingly, even in the nation’s capital, Delhi, as many as 63.2% of children in the 3-6 age-group, and 43.4% of women between the ages of 15 and 49 years are anaemic, according to the survey. The last survey in 1998-99 showed 69% of children and 40.5% of women were anaemic in Delhi. According to Sharda Jain, chairperson of the women doctor’s wing of the Indian Medical Association (IMA), India has one of the highest numbers of anaemia cases in the world, with nearly 90% of women and children anaemic. Narender Saini of IMA explained that the normal haemoglobin level in the blood, according to Indian standards, is 12.5 g/dl and that if the number falls below 10 g/dl, the person is considered anaemic. In Delhi, about 30% of people from affluent families, who have access to good nutritional food, are anaemic. The third in a series of surveys, NFHS-3 is based on a sample of households at the national and state levels, with the basic goal of providing data on health and family welfare.
82 % children anaemic in MP
India has among the highest number of cases of anaemia in the world, according to the National Family Health Survey recently undertaken. The reasons range from high cost of healthcare facilities, poor food quality and the low status of women As many as 79.1% of India’s children between the ages of three and six, and 56.2% of married women in the age-group 15-49 were found to be anaemic in 2006. The figure for the latter was 51.8% in 1999.
Releasing the official figures of the National Family Health Survey-3, Werner Schultink, chief of Unicef India, child health and nutrition, said, on February 21, that there were a number of reasons for India having the largest number of anaemic married women and children in the world. He cited the low social status of women, poor food quality, high cost of healthcare, and genetic problems as being responsible for the problem. NFHS-3 is published jointly by Unicef, the United Nations Population Fund, Britain’s Department for International Development (DFID) and Avahan, an initiative of the Bill and Melinda Gates Foundation. Schultink explained that about 20% of pregnant women in the US and Europe are anaemic. “Even in Indonesia the anaemia rate among women is 30-40%. The NFHS data suggests the rate of anaemia has gone up since 1999 in India.” The survey revealed that among the states, Assam is the worst affected with 72% of married women being anaemic, followed by Haryana (69.7%) and Jharkhand (68.4%). The prevalence of malaria in states like Assam was cited as one of the chief reasons for this sorry state of affairs.
Talking about the condition of children, M Babille, who heads the health division of Unicef India, said that the situation had worsened in 16 Indian states over the last seven years. Among the states worst hit, 79% of children in Andhra Pradesh suffer from anaemia. Rajasthan has a figure of 79.8% and Karnataka and Madhya Pradesh over 82%. Portraying a negative image of India’s growth trajectory in the health sector, Babille added that 33% of women in the 15-49 age-group were underweight. Among the states, 43% of women in Bihar are underweight, followed by Jharkhand (42.6%) and Chhattisgarh (41%). “Nearly 40% of children below the age of three in Maharashtra are underweight too,” he said. This latest National Family Health Survey, conducted in 2005-06, shows that the number of anaemia cases has increased among women, while there has been a slight decline in the case of children. Shockingly, even in the nation’s capital, Delhi, as many as 63.2% of children in the 3-6 age-group, and 43.4% of women between the ages of 15 and 49 years are anaemic, according to the survey. The last survey in 1998-99 showed 69% of children and 40.5% of women were anaemic in Delhi. According to Sharda Jain, chairperson of the women doctor’s wing of the Indian Medical Association (IMA), India has one of the highest numbers of anaemia cases in the world, with nearly 90% of women and children anaemic. Narender Saini of IMA explained that the normal haemoglobin level in the blood, according to Indian standards, is 12.5 g/dl and that if the number falls below 10 g/dl, the person is considered anaemic. In Delhi, about 30% of people from affluent families, who have access to good nutritional food, are anaemic. The third in a series of surveys, NFHS-3 is based on a sample of households at the national and state levels, with the basic goal of providing data on health and family welfare.
Thursday, March 08, 2007
Madhya Pradesh women still have long way to go
By Sanjay Sharma
Bhopal, March 8 (IANS) Women in Madhya Pradesh lag behind their counterparts in most part of the country on almost every front - from health, education, liberty to rights - a sad statement on their condition as the world marks International Women's Day Thursday. With regard to their participation in governance, while the Constitutional 73rd Amendment has reserved one-third of seats for women and enabled their presence in panchayat (village council) bodies, they continue to be under male dominance.
"Women panchayat members continue to suffer from gender bias," says a worker of Mahila Chetna Manch (MCM), an NGO working in the field of women empowerment. Despite the seats reserved for women, it is men, who dominate the proceedings in the panchayat - through the women members, who happen to be wives, mothers or daughters.
In the case of women sarpanchs (heads) of Salkhera and Barbel gram panchayats, in Khargone district, 44 percent women do not go alone to attend meetings, some are accompanied by their husbands or adult male members of the family, while the rest said their husbands actually represent them, said Abha Chauhan, of the Institute of Social Sciences in her observation on women's participation in panchayat in Scheduled Areas with special reference to Madhya Pradesh.
There have been cases when women representatives signed documents while totally ignorant of the contents due to illiteracy. More than 1,300 women sarpanchs have been slapped with false corruption charges. Some 50 of them have been removed from office through forced no-confidence motions. They have also been threatened and humiliated.
Domestic violence against women in the state has increased three times in the last five years, police records say. From 7,283 cases in 2001, the figure went up to 23,215 in 2005. The 2006 figures are yet to be computed. The new National Family Health Survey-III data reveals that 45 percent women in the state have never heard of HIV/AIDS. The state has a Maternal Mortality Ratio of 379 (maternal deaths per 100,000 live births) - one of the six highest in the country. Approximately 27-30 women die every day in the state within 42 days of delivery due to complications and unsafe abortions.
According to the survey, the state contributes 7,000 maternal mortality cases every year to the figure of 70,000 for the country as a whole. The sex ratio is 829 females for every 1,000 males.
Lack of transport and access to proper medical facilities as well as the absence of planning for delivery are major impediments to safe motherhood coupled with shortage of medicines.
"Though the state has launched schemes - like promoting institutional deliveries - to arrest maternal mortality, specially among those below the poverty line and those belonging to scheduled castes and tribes, much still needs to be done," say activists working in the field.
While institutional deliveries have risen from 27 percent in 2004-2005 to 35 percent in 2005-2006, it is faced by impediments like low awareness about various schemes for pregnant women, lack of planning for delivery and shortage of medicines and health facilities, the study points out.
Around 40.11 percent of women have a body-mass weight index below normal or are under nourished, says the survey undertaken by the union government. "About 57.9 percent pregnant women, between 15-49 years of age, are anaemic while only 46.7 percent women participate in household decisions and 45.8 percent have experienced spousal violence," it says.
Bhopal, March 8 (IANS) Women in Madhya Pradesh lag behind their counterparts in most part of the country on almost every front - from health, education, liberty to rights - a sad statement on their condition as the world marks International Women's Day Thursday. With regard to their participation in governance, while the Constitutional 73rd Amendment has reserved one-third of seats for women and enabled their presence in panchayat (village council) bodies, they continue to be under male dominance.
"Women panchayat members continue to suffer from gender bias," says a worker of Mahila Chetna Manch (MCM), an NGO working in the field of women empowerment. Despite the seats reserved for women, it is men, who dominate the proceedings in the panchayat - through the women members, who happen to be wives, mothers or daughters.
In the case of women sarpanchs (heads) of Salkhera and Barbel gram panchayats, in Khargone district, 44 percent women do not go alone to attend meetings, some are accompanied by their husbands or adult male members of the family, while the rest said their husbands actually represent them, said Abha Chauhan, of the Institute of Social Sciences in her observation on women's participation in panchayat in Scheduled Areas with special reference to Madhya Pradesh.
There have been cases when women representatives signed documents while totally ignorant of the contents due to illiteracy. More than 1,300 women sarpanchs have been slapped with false corruption charges. Some 50 of them have been removed from office through forced no-confidence motions. They have also been threatened and humiliated.
Domestic violence against women in the state has increased three times in the last five years, police records say. From 7,283 cases in 2001, the figure went up to 23,215 in 2005. The 2006 figures are yet to be computed. The new National Family Health Survey-III data reveals that 45 percent women in the state have never heard of HIV/AIDS. The state has a Maternal Mortality Ratio of 379 (maternal deaths per 100,000 live births) - one of the six highest in the country. Approximately 27-30 women die every day in the state within 42 days of delivery due to complications and unsafe abortions.
According to the survey, the state contributes 7,000 maternal mortality cases every year to the figure of 70,000 for the country as a whole. The sex ratio is 829 females for every 1,000 males.
Lack of transport and access to proper medical facilities as well as the absence of planning for delivery are major impediments to safe motherhood coupled with shortage of medicines.
"Though the state has launched schemes - like promoting institutional deliveries - to arrest maternal mortality, specially among those below the poverty line and those belonging to scheduled castes and tribes, much still needs to be done," say activists working in the field.
While institutional deliveries have risen from 27 percent in 2004-2005 to 35 percent in 2005-2006, it is faced by impediments like low awareness about various schemes for pregnant women, lack of planning for delivery and shortage of medicines and health facilities, the study points out.
Around 40.11 percent of women have a body-mass weight index below normal or are under nourished, says the survey undertaken by the union government. "About 57.9 percent pregnant women, between 15-49 years of age, are anaemic while only 46.7 percent women participate in household decisions and 45.8 percent have experienced spousal violence," it says.
Wednesday, March 07, 2007
77,000 maternal deaths per year in India
A woman dies every seven minutes in India due to complications related to pregnancy, the Lok Sabha (Lower House of Indian Parliament) was informed today. "There are approximately 77,000 maternal deaths per year, which in other words mean one women dies every seven minutes due to complications related to pregnancy and child birth," said Minister of State for Health and Family Welfare Panabaka Lakshmi in a written reply in Lok Sabha.
She said these findings were based on the official estimates of Registrar General of India (RGI). The Maternal Mortality Ratio (MMR) for India (2001-03) is 301 per 100,000 live births.
Lakshmi informed the House that as per the latest survey reports, the reasons for high Maternal Mortality in the country are--Hemorrhage (38 percent), Sepsis (11 percent), Abortion (eight percent), Obstructed Labor (five percent), Hypertensive Disorders (five percent) and other reasons (34 percent). "To provide basic facilities in rural areas including those at the time of delivery, the government has launched the National Rural Health Mission (NRHM) in the year 2005 with special emphasis on improving the health status of rural population throughout the country," she said.
The mission will operate over a period of seven years from 2005 to 2012 with the goal of achieving reduction of Maternal Mortality Ratio to 100 per 100,000 live births, she added.
She said these findings were based on the official estimates of Registrar General of India (RGI). The Maternal Mortality Ratio (MMR) for India (2001-03) is 301 per 100,000 live births.
Lakshmi informed the House that as per the latest survey reports, the reasons for high Maternal Mortality in the country are--Hemorrhage (38 percent), Sepsis (11 percent), Abortion (eight percent), Obstructed Labor (five percent), Hypertensive Disorders (five percent) and other reasons (34 percent). "To provide basic facilities in rural areas including those at the time of delivery, the government has launched the National Rural Health Mission (NRHM) in the year 2005 with special emphasis on improving the health status of rural population throughout the country," she said.
The mission will operate over a period of seven years from 2005 to 2012 with the goal of achieving reduction of Maternal Mortality Ratio to 100 per 100,000 live births, she added.
Saturday, March 03, 2007
A 10th of Indian maternity deaths in Madhya Pradesh
Bhopal, March 2 Madhya Pradesh accounts for 10 percent of all maternity related deaths in India, says a new study. The reasons for this are many including lack of transport or access to proper medical facilities as well as absence of planning for delivering babies.
So says a UNICEF facilitated study by the state's health department. 'Shortage of medicines at health centres and the disinterested attitude of the medical staff also add to the problem,' adds the study. 'Madhya Pradesh reports 10 percent of maternal deaths in the country while India reports 20 percent of maternal deaths in the world,' said UNICEF state head Hamid El Bashir, speaking to IANS. Though the state has launched many schemes, such as promoting institutional deliveries, to arrest maternal mortality especially among the poor and those belonging to Dalits and tribals, a sustained commitment was required, say experts and activists working in the field.
The study was carried out in August 2006 in seven districts with high institutional child delivery rates and seven with low rates. It covered 1,705 women, of whom 934 had institutional deliveries. The rest had home delivery. The districts covered under the first category were Indore, Ujjain, Bhopal, Japalpur, Panna, Umaria and Gwalior and those under the second included West Nimar, Ratlam, Betul, Chhattarpur, Sidhi and Bhind.
With a maternal mortality rate (MMR) of 379, Madhya Pradesh is among the six worst affected states in the country. Approximately 27 to 30 women die every day in the state within 42 days of delivery. Complications during pregnancy and unsafe abortions are among the main reasons for the rising MMR. While institutional deliveries rose from 27 percent in 2004-05 to 35 percent in 2005-06, low awareness about various schemes for pregnant women, lack of planning for deliveries and unavailability of medicines at health centers were some of the impediments that still needed to be tackled on a priority basis. Only eight percent women interviewed had planned where to go for delivery and over 75 percent women had to buy medicines. 'Fifty percent women cited transport problems and cost of hospital delivery as reasons for preferring home delivery,' the study pointed out.
Bashir told IANS that the civil society needed to engage communities at a high level to push accountability within the system to help women and children get a better deal.
So says a UNICEF facilitated study by the state's health department. 'Shortage of medicines at health centres and the disinterested attitude of the medical staff also add to the problem,' adds the study. 'Madhya Pradesh reports 10 percent of maternal deaths in the country while India reports 20 percent of maternal deaths in the world,' said UNICEF state head Hamid El Bashir, speaking to IANS. Though the state has launched many schemes, such as promoting institutional deliveries, to arrest maternal mortality especially among the poor and those belonging to Dalits and tribals, a sustained commitment was required, say experts and activists working in the field.
The study was carried out in August 2006 in seven districts with high institutional child delivery rates and seven with low rates. It covered 1,705 women, of whom 934 had institutional deliveries. The rest had home delivery. The districts covered under the first category were Indore, Ujjain, Bhopal, Japalpur, Panna, Umaria and Gwalior and those under the second included West Nimar, Ratlam, Betul, Chhattarpur, Sidhi and Bhind.
With a maternal mortality rate (MMR) of 379, Madhya Pradesh is among the six worst affected states in the country. Approximately 27 to 30 women die every day in the state within 42 days of delivery. Complications during pregnancy and unsafe abortions are among the main reasons for the rising MMR. While institutional deliveries rose from 27 percent in 2004-05 to 35 percent in 2005-06, low awareness about various schemes for pregnant women, lack of planning for deliveries and unavailability of medicines at health centers were some of the impediments that still needed to be tackled on a priority basis. Only eight percent women interviewed had planned where to go for delivery and over 75 percent women had to buy medicines. 'Fifty percent women cited transport problems and cost of hospital delivery as reasons for preferring home delivery,' the study pointed out.
Bashir told IANS that the civil society needed to engage communities at a high level to push accountability within the system to help women and children get a better deal.
Saturday, February 24, 2007
More than 4 out of 5 children in State are anaemic
by Vikram Jethwani Bhopal. The Pioneer Bhopal Feb 23, 2007
....between the ages of 6 and 35 monthsEighty two of every 100 children, between the ages of six and 35 months, in Madhya Pradesh suffer from anaemia, a serious ailment related to abnormal deficiency of red blood cells. Not only does the report of National Family Health Survey III (NFHS-3) fly in the face of Government claims but it specifically raises a point of concern revealing that the number of children suffering from anaemia increased substantially during 2005-06 in comparison to the previous years.
The NFH Survey (NFHS-2) of 1998-99 had reported that 75 per cent of the children were anaemic. It is alarming to learn that instead of improving rhe situation has deteriorated in Madhya Pradesh over the last seven years. Compare this with Chhattisgarh's example where there has been a decline in the same period from 87.7 percent marked in 1998-99 to 81 per cent in 2005-06. Maharashtra too has improved from 76 to 71.9 per cent.
Pediatricians explained that anaemia makes children more vulnerable to dangerous infectious diseases like tuberculosis, cholera, jaundice, typhoid and also stunts their mental and physical development..
The Women and Child department of Madhya Pradesh has been running the nation-wide Integrated Child Development Services (ICDS) programme in the State. Under it, a sum of Rs 2 per day , shared equally by the Centre and the State Governments , is sanctioned for supplementary nutrition to a child," Principal Secretary of the department and member of the nationwide sub-group on ICDS and nutrition Prashant Mehta told The Pioneer. The scheme applies to children between the ages of six months and six years, he added.
According to the country head of United Nations Children Fund (UNICEF) health division M Babille, Madhya Pradesh is the worst hit by anaemia and compares poorly even with others like Andhra Pradesh and Rajasthan that suffer anaemia rates as high as 79 and 79.8 percent, respectively. Even Bihar, traditionally considered a laggard in civic and health matters is ahead of Madhya Pradesh. Linked to the high incidence of anaemia among children is the appallingly high rate of malnutrition among the young. The recent claim made by the State that only 49.2 percent of the children suffered from malnutrition is in contrast to the finding of the NFHS-2 which had recorded it at 54 per cent.
It is never too late to implement a comprehensive plan to eradicate both anaemia and malnutrition in children of the State after all they represent out tomorrow.
....between the ages of 6 and 35 monthsEighty two of every 100 children, between the ages of six and 35 months, in Madhya Pradesh suffer from anaemia, a serious ailment related to abnormal deficiency of red blood cells. Not only does the report of National Family Health Survey III (NFHS-3) fly in the face of Government claims but it specifically raises a point of concern revealing that the number of children suffering from anaemia increased substantially during 2005-06 in comparison to the previous years.
The NFH Survey (NFHS-2) of 1998-99 had reported that 75 per cent of the children were anaemic. It is alarming to learn that instead of improving rhe situation has deteriorated in Madhya Pradesh over the last seven years. Compare this with Chhattisgarh's example where there has been a decline in the same period from 87.7 percent marked in 1998-99 to 81 per cent in 2005-06. Maharashtra too has improved from 76 to 71.9 per cent.
Pediatricians explained that anaemia makes children more vulnerable to dangerous infectious diseases like tuberculosis, cholera, jaundice, typhoid and also stunts their mental and physical development..
The Women and Child department of Madhya Pradesh has been running the nation-wide Integrated Child Development Services (ICDS) programme in the State. Under it, a sum of Rs 2 per day , shared equally by the Centre and the State Governments , is sanctioned for supplementary nutrition to a child," Principal Secretary of the department and member of the nationwide sub-group on ICDS and nutrition Prashant Mehta told The Pioneer. The scheme applies to children between the ages of six months and six years, he added.
According to the country head of United Nations Children Fund (UNICEF) health division M Babille, Madhya Pradesh is the worst hit by anaemia and compares poorly even with others like Andhra Pradesh and Rajasthan that suffer anaemia rates as high as 79 and 79.8 percent, respectively. Even Bihar, traditionally considered a laggard in civic and health matters is ahead of Madhya Pradesh. Linked to the high incidence of anaemia among children is the appallingly high rate of malnutrition among the young. The recent claim made by the State that only 49.2 percent of the children suffered from malnutrition is in contrast to the finding of the NFHS-2 which had recorded it at 54 per cent.
It is never too late to implement a comprehensive plan to eradicate both anaemia and malnutrition in children of the State after all they represent out tomorrow.
Sunday, February 18, 2007
10 percent of national maternal deaths in Madhya Pradesh: UNICEF
'Civil society is a duty bearer for the rights of women and children and it should help make the system accountable,' Gulati said, expressing concern over the high maternal mortality rate - in the state.
By IANS, [RxPG] Bhopal, Feb 18 - Madhya Pradesh registers 10 percent of the number of women dying at childbirth in India, according to UNICEF, which has called for a sustained commitment towards bettering the health of women and children in the state and the country.'India contributes 20 percent of the maternal deaths in the world which can be reduced only if there is a sustained commitment to deliver for the benefit of women and children,' UNICEF state head Hamid El Bashir said here Friday while addressing NGOs supporting the promotion of safe motherhood. Bashir said civil society needed to engage communities at a high level to push accountabilities within the administrative system.
The state's maternal mortality ratio -, the number of maternal deaths per 100,000 live births, is 379 and is considered to be one of the six worst performing states of India. Around 27-30 women die every day in the state within 42 days of delivery. Pregnancy complications and unsafe abortions are cited as the main reasons for the rising MMR. Appreciating the role of the media in highlighting the issue, Anil Gulati of the UNICEF said the need now was to take this momentum forward through community empowerment and engagement of the civil society.'Civil society is a duty bearer for the rights of women and children and it should help make the system accountable,' Gulati said, expressing concern over the high maternal mortality rate - in the state. Over 60 NGOs participated in the meet from various
By IANS, [RxPG] Bhopal, Feb 18 - Madhya Pradesh registers 10 percent of the number of women dying at childbirth in India, according to UNICEF, which has called for a sustained commitment towards bettering the health of women and children in the state and the country.'India contributes 20 percent of the maternal deaths in the world which can be reduced only if there is a sustained commitment to deliver for the benefit of women and children,' UNICEF state head Hamid El Bashir said here Friday while addressing NGOs supporting the promotion of safe motherhood. Bashir said civil society needed to engage communities at a high level to push accountabilities within the administrative system.
The state's maternal mortality ratio -, the number of maternal deaths per 100,000 live births, is 379 and is considered to be one of the six worst performing states of India. Around 27-30 women die every day in the state within 42 days of delivery. Pregnancy complications and unsafe abortions are cited as the main reasons for the rising MMR. Appreciating the role of the media in highlighting the issue, Anil Gulati of the UNICEF said the need now was to take this momentum forward through community empowerment and engagement of the civil society.'Civil society is a duty bearer for the rights of women and children and it should help make the system accountable,' Gulati said, expressing concern over the high maternal mortality rate - in the state. Over 60 NGOs participated in the meet from various
Blogs help raise social issues in MP
by IANS
Bhopal, Feb 17: Blogs are fast catching on in Madhya Pradesh where it provides a platform to activists and officials to voice concern on social issues like safe motherhood and children's plight.
Among the blogs - a user-generated website as is commonly known - is www.safemotherhood. blogspot. com. Managed by 'Campaign to Raise Concern on Maternal Deaths' in the state, it has activists working to help mothers.
There are other blogs too like newswhichmatter. blogspot.com, which has news about the state and opinions of people, and mpchildinfo.blogspot.com, which deals with infant mortality and low nutrition levels among children. Another blog is madhyapradesh.blogspot.com, which provides news and views on matters concerning the state. The safemotherhood. blogspot. com brings together media reports on maternal mortality in the state.
Maternal mortality at 498 per every 1,000 women is one of state's biggest blights. Most of the deaths occur due to pregnancy-related complications within a fortnight of delivery. 'To raise concern about and bring visibility to the issue of maternal deaths and factors impacting it, the safe motherhood Blog helps to bring out issues at the district level that rarely find a place in the state level media,' said Anil Gulati, a blogger.
The blog, he said, translates the Hindi news into English or adapts it from Hindi and reproduces it on its weblog along with its source. Many a time these news stories from district editions can form a story for the state editions or alternatively can be a pitch for the big story, which also adds to the purpose of the blog, he said.
Blogs also help to give expression to one's creative challenge, added Gulati, who has come to be regarded as blogman of Bhopal. He is a regular contributor to some of the blogs. 'Some blogs have been able to raise concern on issues like maternal and child deaths in Madhya Pradesh,' said Sachin Jain, who heads a media advocacy group, Vikas Samvad, in Bhopal.
For him it is a good advocacy tool. 'Blogs also take up issues which would have remained invisible otherwise. They help to bring the plight of people of the 'other India' into focus,' he claimed.
Blogs and citizen journalists are part of newer trends in engaging people and making their voices heard. But do they make any difference? 'They may not be too effective today but they have the potential to complement other forms of journalism one day,' said PP Singh of Makhanlal Chaturvedi National University of Journalism.
'These new technology tools can play a major role in reaching out to people with more transparency as they are not bound by present day media constraints, and thus serve the purpose more effectively,' he added. Other blogs that have become popular in a short time are bhopal.blogspot.com and bhopal. wordpress.com. There is also a Persecution Blog, which shares news and information about the Christian community.
Bhopal, Feb 17: Blogs are fast catching on in Madhya Pradesh where it provides a platform to activists and officials to voice concern on social issues like safe motherhood and children's plight.
Among the blogs - a user-generated website as is commonly known - is www.safemotherhood. blogspot. com. Managed by 'Campaign to Raise Concern on Maternal Deaths' in the state, it has activists working to help mothers.
There are other blogs too like newswhichmatter. blogspot.com, which has news about the state and opinions of people, and mpchildinfo.blogspot.com, which deals with infant mortality and low nutrition levels among children. Another blog is madhyapradesh.blogspot.com, which provides news and views on matters concerning the state. The safemotherhood. blogspot. com brings together media reports on maternal mortality in the state.
Maternal mortality at 498 per every 1,000 women is one of state's biggest blights. Most of the deaths occur due to pregnancy-related complications within a fortnight of delivery. 'To raise concern about and bring visibility to the issue of maternal deaths and factors impacting it, the safe motherhood Blog helps to bring out issues at the district level that rarely find a place in the state level media,' said Anil Gulati, a blogger.
The blog, he said, translates the Hindi news into English or adapts it from Hindi and reproduces it on its weblog along with its source. Many a time these news stories from district editions can form a story for the state editions or alternatively can be a pitch for the big story, which also adds to the purpose of the blog, he said.
Blogs also help to give expression to one's creative challenge, added Gulati, who has come to be regarded as blogman of Bhopal. He is a regular contributor to some of the blogs. 'Some blogs have been able to raise concern on issues like maternal and child deaths in Madhya Pradesh,' said Sachin Jain, who heads a media advocacy group, Vikas Samvad, in Bhopal.
For him it is a good advocacy tool. 'Blogs also take up issues which would have remained invisible otherwise. They help to bring the plight of people of the 'other India' into focus,' he claimed.
Blogs and citizen journalists are part of newer trends in engaging people and making their voices heard. But do they make any difference? 'They may not be too effective today but they have the potential to complement other forms of journalism one day,' said PP Singh of Makhanlal Chaturvedi National University of Journalism.
'These new technology tools can play a major role in reaching out to people with more transparency as they are not bound by present day media constraints, and thus serve the purpose more effectively,' he added. Other blogs that have become popular in a short time are bhopal.blogspot.com and bhopal. wordpress.com. There is also a Persecution Blog, which shares news and information about the Christian community.
Friday, February 16, 2007
Health system needs to deliver: A call by civil society
Central Chronicle, Feb 16, 2007
Bhopal, Feb 16: A state level meeting of campaign partners supporting the promotion of safe
motherhood and raising concern on maternal mortality in the state of Madhya Pradesh was held in Bhopal today. More than 60 non governmental organizations from various districts of the state including Panna, Dhar, Jabalpur, Indore, Mandsaur, Sehore, Bhopal, Sagar, Ujjain, Sheopur, Gwalior, Bhind, Barwani, Dewas, Satna, Shivpuri, Rewa, Neemuch, Datia, Ashok Nagar, Tikamgarh, Chhattarpur, Khargone participated in the meeting.
Non governmental organizations representing network organizations like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha, Madhya Pradesh Jan Adhikar Manch, Bharat Gyan Vigyan Samiti, Central Regional Board of Health Services, Mahila Chetna Manch, Vikas Samvad, Department of Journalism, Makhan Lal Chaturvedi National University of Journalism shared their concern and outcomes of their efforts with communities and elected representatives.
Inaugurating the meeting Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh said that civil society needs to engage communities at high level to push accountabilities within the system to better deliver for women and children. Civil society is a duty bearer for the rights of women and children and it is they who should help make the system accountable. He also raised the issue of violation of rights of women and children and said that there are gaps in the system. He added that state of Madhya Pradesh contributes 10 % of maternal deaths in the country while India contributes 20 % of maternal deaths in the world. It is possible to reduce them but the need is of sustained commitment to deliver for benefit of women and children in the state.
Anil Gulati Communication officer UNICEF spoke on the need of the community empowerment and with civil society their engagement on the issue of women health. Media has helped to bring the issue to forefront but the need is to take this momentum forward.
Manoj Joshi of Madhya Pradesh Voluntary Health Association, P.P. Singh, Department of Journalism Makhan Lal Chaturvedi University of Journalism, Sandesh Bansal State Coordinator Jan Adhikar Manch, Dr Sheela Bhambal of Central Board of Regional Health Services, Sachin Jain of Vikas Samvad, Deep Damani of Mahila Chetna Manch, Fr Mathew and sister Joicy of Madhya Pradesh Samaj Sewa Sanstha made presentation of their efforts in the various parts of the state to help bring the much needed momentum on the issue of maternal deaths and promoting safe motherhood state wide. Their partner organizations were present during the same presentations. A concern was expressed that still a lot needs to be done especially in promoting infrastructure increasing manpower and budget allocations for promoting safe motherhood. Promoting institution delivery alone will not help.
Dr Narayan Goankar Health Officer UNICEF presented the findings of maternal deaths audit in the districts of Guna and Shivpuri. Participations also focused on issue of rights. A need for third party monitoring was expressed in the meeting and for having an Observatory for the rights of women and children. This could be an Observatory which can report on the status of women and children in the state. Veena Bandyopadhyay, Planning officer, UNICEF presented a possible option of setting up of 'Child Rights Observatory' in the state of Madhya Pradesh, which could act as third party for monitoring rights of children and women. Himanshu Sikka of Infrastructure Professional Enterprise also participated in the meeting.
Bhopal, Feb 16: A state level meeting of campaign partners supporting the promotion of safe
motherhood and raising concern on maternal mortality in the state of Madhya Pradesh was held in Bhopal today. More than 60 non governmental organizations from various districts of the state including Panna, Dhar, Jabalpur, Indore, Mandsaur, Sehore, Bhopal, Sagar, Ujjain, Sheopur, Gwalior, Bhind, Barwani, Dewas, Satna, Shivpuri, Rewa, Neemuch, Datia, Ashok Nagar, Tikamgarh, Chhattarpur, Khargone participated in the meeting.
Non governmental organizations representing network organizations like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha, Madhya Pradesh Jan Adhikar Manch, Bharat Gyan Vigyan Samiti, Central Regional Board of Health Services, Mahila Chetna Manch, Vikas Samvad, Department of Journalism, Makhan Lal Chaturvedi National University of Journalism shared their concern and outcomes of their efforts with communities and elected representatives.
Inaugurating the meeting Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh said that civil society needs to engage communities at high level to push accountabilities within the system to better deliver for women and children. Civil society is a duty bearer for the rights of women and children and it is they who should help make the system accountable. He also raised the issue of violation of rights of women and children and said that there are gaps in the system. He added that state of Madhya Pradesh contributes 10 % of maternal deaths in the country while India contributes 20 % of maternal deaths in the world. It is possible to reduce them but the need is of sustained commitment to deliver for benefit of women and children in the state.
Anil Gulati Communication officer UNICEF spoke on the need of the community empowerment and with civil society their engagement on the issue of women health. Media has helped to bring the issue to forefront but the need is to take this momentum forward.
Manoj Joshi of Madhya Pradesh Voluntary Health Association, P.P. Singh, Department of Journalism Makhan Lal Chaturvedi University of Journalism, Sandesh Bansal State Coordinator Jan Adhikar Manch, Dr Sheela Bhambal of Central Board of Regional Health Services, Sachin Jain of Vikas Samvad, Deep Damani of Mahila Chetna Manch, Fr Mathew and sister Joicy of Madhya Pradesh Samaj Sewa Sanstha made presentation of their efforts in the various parts of the state to help bring the much needed momentum on the issue of maternal deaths and promoting safe motherhood state wide. Their partner organizations were present during the same presentations. A concern was expressed that still a lot needs to be done especially in promoting infrastructure increasing manpower and budget allocations for promoting safe motherhood. Promoting institution delivery alone will not help.
Dr Narayan Goankar Health Officer UNICEF presented the findings of maternal deaths audit in the districts of Guna and Shivpuri. Participations also focused on issue of rights. A need for third party monitoring was expressed in the meeting and for having an Observatory for the rights of women and children. This could be an Observatory which can report on the status of women and children in the state. Veena Bandyopadhyay, Planning officer, UNICEF presented a possible option of setting up of 'Child Rights Observatory' in the state of Madhya Pradesh, which could act as third party for monitoring rights of children and women. Himanshu Sikka of Infrastructure Professional Enterprise also participated in the meeting.
Madhya Pradesh contributes 10 pc MMR: Bashir
Bhopal, Feb 16: Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh said that Madhya Pradesh contributes 10 percent of maternal deaths in the country while India contributes 20 percent of maternal deaths in the world. It is possible to reduce them but the need is of sustained commitment to deliver for benefit of women and children in the state. He claimed that there are gaps in the system. He was speaking after inaugurating the state level meeting of campaign partners supporting the promotion of safe motherhood and raising concern on maternal mortality in the state of Madhya Pradesh, here on Friday.
He further said that the civil society needs to engage communities at high level to push accountabilities within the system to better deliver for women and children. Civil society is a duty bearer for the rights of women and children and it should help make the system accountable. More than 60 non governmental organizations from various districts of the state including Panna, Dhar, Jabalpur, Indore, Mandsaur, Sehore, Bhopal, Sagar, Ujjain, Sheopur, Gwalior, Bhind, Barwani, Dewas, Satna, Shivpuri, Rewa, Neemuch, Datia, Ashok Nagar, Tikamgarh, Chhattarpur, Khargone participated in the meeting.
NGOs representing network organizations like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha, Madhya Pradesh Jan Adhikar Manch, Bharat Gyan Vigyan Samiti, Mahila Chetna Manch, Vikas Samvad, Department of Journalism, Makhanlal Chaturvedi National University (MCNU) of Journalism shared their concern. Anil Gulati Communication officer UNICEF spoke on the need of the community empowerment and with civil society their engagement on the issue of women health. Media has helped to bring the issue to forefront but the need is to take this momentum forward.
Manoj Joshi of Madhya Pradesh Voluntary Health Association, P.P. Singh, Department of Journalism MCNU, Sandesh Bansal State Coordinator Jan Adhikar Manch, Dr Sheela Bhambal of Central Board of Regional Health Services, Sachin Jain of Vikas Samvad, Deep Damani of Mahila Chetna Manch, Fr Mathew and sister Joicy of Madhya Pradesh Samaj Sewa Sanstha gave presentation in the various parts of the state to help bring the much needed momentum on the issue. Dr Narayan Goankar Health Officer UNICEF presented the findings of maternal deaths audit in the districts of Guna and Shivpuri. Participations also focused on issue of rights.
Published at www.mpnewsonline.com
He further said that the civil society needs to engage communities at high level to push accountabilities within the system to better deliver for women and children. Civil society is a duty bearer for the rights of women and children and it should help make the system accountable. More than 60 non governmental organizations from various districts of the state including Panna, Dhar, Jabalpur, Indore, Mandsaur, Sehore, Bhopal, Sagar, Ujjain, Sheopur, Gwalior, Bhind, Barwani, Dewas, Satna, Shivpuri, Rewa, Neemuch, Datia, Ashok Nagar, Tikamgarh, Chhattarpur, Khargone participated in the meeting.
NGOs representing network organizations like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha, Madhya Pradesh Jan Adhikar Manch, Bharat Gyan Vigyan Samiti, Mahila Chetna Manch, Vikas Samvad, Department of Journalism, Makhanlal Chaturvedi National University (MCNU) of Journalism shared their concern. Anil Gulati Communication officer UNICEF spoke on the need of the community empowerment and with civil society their engagement on the issue of women health. Media has helped to bring the issue to forefront but the need is to take this momentum forward.
Manoj Joshi of Madhya Pradesh Voluntary Health Association, P.P. Singh, Department of Journalism MCNU, Sandesh Bansal State Coordinator Jan Adhikar Manch, Dr Sheela Bhambal of Central Board of Regional Health Services, Sachin Jain of Vikas Samvad, Deep Damani of Mahila Chetna Manch, Fr Mathew and sister Joicy of Madhya Pradesh Samaj Sewa Sanstha gave presentation in the various parts of the state to help bring the much needed momentum on the issue. Dr Narayan Goankar Health Officer UNICEF presented the findings of maternal deaths audit in the districts of Guna and Shivpuri. Participations also focused on issue of rights.
Published at www.mpnewsonline.com
Thursday, February 15, 2007
A woman dies every 7 minutes
New Delhi/Gwalior, One woman dies every seven minutes in India due to pregnancy-related complications and these are conservative estimates since more than 30 per cent of maternal mortality cases go unreported, according to estimates. India has one of the worst statistics in the world as far as maternal mortality goes. Even Bangladesh and Sri Lanka have lower maternal mortality ratios than India, according to Unicef.
One of the prime worries in India has been its inability to reduce maternal mortality despite efforts for decades and increased funding and schemes introduced by the government. This has been attributed by Unicef MMR project officer Karuna Bishnoi to a lack of medical facilities in rural areas, lack of trained birth attendants and almost 65 percent of births taking place at homes without assistance from trained attendants.
India at present has an MMR of around 301, which means 301 mothers die during delivery, or within 42 days after delivery, for one lakh live births. At this rate, India will be unable to reach the millennium development goals (MDGs) on MMR where it needs to reach an MMR of 106. But estimates project that India will be only able to achieve an MMR of 240 by 2015, which is by when the MDGs have to be achieved.
Statistics show that MMR is significantly higher amongst SC/ST women as compared to other women in India, whether in urban areas or rural areas. This is also an area of concern for the government of India. In Shivpuri village in Madhya Pradesh, Ram Swarup Batham sits outside his mud hut surrounded by his three young children, all below the age of five.
His wife Veeja died recently in a hospital in Gwalior while giving birth to her ninth child, becoming one more statistic in the long list of maternal mortality deaths in this country. Over the last six years, there has been no significant reduction in maternal mortality deaths.
Describing how he tried to save her, Batham says, “I rushed her to the district hospital in Shivpuri. The doctor there informed me she needed to be taken to Gwalior. I took her to Gwalior Medical College but she died soon after being admitted there.” He passes his fingers through his greying hair. It is obvious he is trying to figure out how to feed, clothe and educate his six young children. His elder three daughters have been married though none of them had crossed 18 when their marriages were negotiated. Batham, a tribal, is fortunate to own 25 bighas of land. “I borrowed Rs 15,000 for her treatment. I’ll sell my land if I cannot repay the loan,” he adds.
The stark reality of his changed circumstances stares him in his face. The death of his wife has plunged their family into chaos. For one, the entire responsibility of feeding six young children has fallen on his aged mother, who admits she simply cannot cope. Sitting on the mud-caked floor in their front courtyard, the old woman mutters, “The doctors were completely callous. Veeja died within five minutes of being given an injection. Now I am supposed to do everything for these children. How much responsibility can I shoulder?” Internal bleeding, eclampsia and obstructed labour are just some of the factors that are responsible for the high number of maternal mortality deaths in Madhya Pradesh. The number of women who die due to pregnancy, childbirth and abortion-related deaths are estimated at 136,000. The maternal mortality ratio (MMR) in Madhya Pradesh at present is 540 deaths per 100,000 live births. Uttar Pradesh alone accounts for close to 40,000 maternal deaths per year. The tragedy of Veeja’s death is that it could have been easily prevented. Mr Hamid al-Bashir, Unicef’s state representative in Bhopal, believes, “Most maternal deaths could be prevented if women had access to appropriate health care during pregnancy, childbirth and immediately after her delivery. When a mother dies during pregnancy, the family suffers a further increase in poverty.” “One of the key methods to improve maternal survival would be to review all maternal deaths at the community level ‘ he added. Dr Aparajita Gogoi, national coordinator for the White Ribbon Alliance, India, described these MMR deaths as a “silent tsunami”. “Over 200,000 families have been devastated by these deaths, which have left 350,000 kids orphaned. Another 600,000 women have been left disabled because of pregnancy-related disorders,” Dr Gogoi said, adding, “We have not been able to stem this tide of maternal deaths despite having 20,000 obstetricians, five lakh trained doctors and 25 lakh nurses and midwives.” Even poor countries like Bangladesh, Bolivia and the Honduras have reduced MMR in similar resource settings. Countries like China, Indonesia and Sri Lanka have built up teams of skilled birth attendants and well-connected frontline providers.
Though India has a large number of medical personnel, 80 per cent of them are concentrated in urban areas, where 25 per cent of the population lives, compared to 20 percent medical personnel in rural areas, where 75 per cent of the population lives, according to estimates given by Dr Hamid al-Bashir. The statistics in Madhya Pradesh are even more alarming because in rural areas, local NGOs point out, for every 5.6 villages (average population of 2,000 in one village) only one hospital bed is available. Over 82 per cent of the children suffer from anaemia while 58 per cent of pregnant women are also found to be anaemic. According to Indian government statistics, 58 percent of pregnant woman are anaemic in India, which compounds all the problems of pregnancies. This is due to poverty amongst many rural women, which makes it impossible for them to eat sufficient amounts of the right kinds of foods, said Dr Aparajita Gogoi.
Unicef believes one of the ways to strengthen community initiatives is by holding maternal death audits. One such audit was recently held in Purulia, West Bengal, between May 2005 and June 2006. It was found that from 55,000 deliveries there were 106 maternal deaths. This figure was arrived at after interviewing family members of the deceased. It was believed that the number of deaths was actually around 140 since most families continue to under-report maternal deaths. The audit brought to light that the average age of marriage for girls in Purulia was 17. None of the girls interviewed had been to school while the average number of years their husbands had spent in school averaged four years. While 61 per cent of deaths occurred in a health facility, 24 per cent died at home and another 13 per cent died en route to a facility. The majority of deaths occurred during labour and in the post-partum period.
India’s inability to reach the millennium development goals are primarily due to its inability to increase institutional births, which Sri Lanka has achieved at above 90 percent; skilled attendants at birth, which has been achieved for a majority of cases by Indonesia; and training of local midwives, which is the way Bangladesh has improved its MMR.
One of the prime worries in India has been its inability to reduce maternal mortality despite efforts for decades and increased funding and schemes introduced by the government. This has been attributed by Unicef MMR project officer Karuna Bishnoi to a lack of medical facilities in rural areas, lack of trained birth attendants and almost 65 percent of births taking place at homes without assistance from trained attendants.
India at present has an MMR of around 301, which means 301 mothers die during delivery, or within 42 days after delivery, for one lakh live births. At this rate, India will be unable to reach the millennium development goals (MDGs) on MMR where it needs to reach an MMR of 106. But estimates project that India will be only able to achieve an MMR of 240 by 2015, which is by when the MDGs have to be achieved.
Statistics show that MMR is significantly higher amongst SC/ST women as compared to other women in India, whether in urban areas or rural areas. This is also an area of concern for the government of India. In Shivpuri village in Madhya Pradesh, Ram Swarup Batham sits outside his mud hut surrounded by his three young children, all below the age of five.
His wife Veeja died recently in a hospital in Gwalior while giving birth to her ninth child, becoming one more statistic in the long list of maternal mortality deaths in this country. Over the last six years, there has been no significant reduction in maternal mortality deaths.
Describing how he tried to save her, Batham says, “I rushed her to the district hospital in Shivpuri. The doctor there informed me she needed to be taken to Gwalior. I took her to Gwalior Medical College but she died soon after being admitted there.” He passes his fingers through his greying hair. It is obvious he is trying to figure out how to feed, clothe and educate his six young children. His elder three daughters have been married though none of them had crossed 18 when their marriages were negotiated. Batham, a tribal, is fortunate to own 25 bighas of land. “I borrowed Rs 15,000 for her treatment. I’ll sell my land if I cannot repay the loan,” he adds.
The stark reality of his changed circumstances stares him in his face. The death of his wife has plunged their family into chaos. For one, the entire responsibility of feeding six young children has fallen on his aged mother, who admits she simply cannot cope. Sitting on the mud-caked floor in their front courtyard, the old woman mutters, “The doctors were completely callous. Veeja died within five minutes of being given an injection. Now I am supposed to do everything for these children. How much responsibility can I shoulder?” Internal bleeding, eclampsia and obstructed labour are just some of the factors that are responsible for the high number of maternal mortality deaths in Madhya Pradesh. The number of women who die due to pregnancy, childbirth and abortion-related deaths are estimated at 136,000. The maternal mortality ratio (MMR) in Madhya Pradesh at present is 540 deaths per 100,000 live births. Uttar Pradesh alone accounts for close to 40,000 maternal deaths per year. The tragedy of Veeja’s death is that it could have been easily prevented. Mr Hamid al-Bashir, Unicef’s state representative in Bhopal, believes, “Most maternal deaths could be prevented if women had access to appropriate health care during pregnancy, childbirth and immediately after her delivery. When a mother dies during pregnancy, the family suffers a further increase in poverty.” “One of the key methods to improve maternal survival would be to review all maternal deaths at the community level ‘ he added. Dr Aparajita Gogoi, national coordinator for the White Ribbon Alliance, India, described these MMR deaths as a “silent tsunami”. “Over 200,000 families have been devastated by these deaths, which have left 350,000 kids orphaned. Another 600,000 women have been left disabled because of pregnancy-related disorders,” Dr Gogoi said, adding, “We have not been able to stem this tide of maternal deaths despite having 20,000 obstetricians, five lakh trained doctors and 25 lakh nurses and midwives.” Even poor countries like Bangladesh, Bolivia and the Honduras have reduced MMR in similar resource settings. Countries like China, Indonesia and Sri Lanka have built up teams of skilled birth attendants and well-connected frontline providers.
Though India has a large number of medical personnel, 80 per cent of them are concentrated in urban areas, where 25 per cent of the population lives, compared to 20 percent medical personnel in rural areas, where 75 per cent of the population lives, according to estimates given by Dr Hamid al-Bashir. The statistics in Madhya Pradesh are even more alarming because in rural areas, local NGOs point out, for every 5.6 villages (average population of 2,000 in one village) only one hospital bed is available. Over 82 per cent of the children suffer from anaemia while 58 per cent of pregnant women are also found to be anaemic. According to Indian government statistics, 58 percent of pregnant woman are anaemic in India, which compounds all the problems of pregnancies. This is due to poverty amongst many rural women, which makes it impossible for them to eat sufficient amounts of the right kinds of foods, said Dr Aparajita Gogoi.
Unicef believes one of the ways to strengthen community initiatives is by holding maternal death audits. One such audit was recently held in Purulia, West Bengal, between May 2005 and June 2006. It was found that from 55,000 deliveries there were 106 maternal deaths. This figure was arrived at after interviewing family members of the deceased. It was believed that the number of deaths was actually around 140 since most families continue to under-report maternal deaths. The audit brought to light that the average age of marriage for girls in Purulia was 17. None of the girls interviewed had been to school while the average number of years their husbands had spent in school averaged four years. While 61 per cent of deaths occurred in a health facility, 24 per cent died at home and another 13 per cent died en route to a facility. The majority of deaths occurred during labour and in the post-partum period.
India’s inability to reach the millennium development goals are primarily due to its inability to increase institutional births, which Sri Lanka has achieved at above 90 percent; skilled attendants at birth, which has been achieved for a majority of cases by Indonesia; and training of local midwives, which is the way Bangladesh has improved its MMR.
Tuesday, February 13, 2007
India lags far behind in protecting mothers
Azera Rahman (IANS)Gwalior (Madhya Pradesh), February 13, 2007
There has been no appreciable decline in the number of women dying at childbirth in India since 1990, quite unlike other nations like Bangladesh, Gautemala and Morocco that have managed to arrest this trend. India's Maternal Mortality Ratio (MMR), the number of maternal deaths per 100,000 live births, was 301 in 2002 and 2003. According to the Sample Registration Survey (SRS), 70,000 women die every year in India but UNICEF says the number crosses 100,000.
"The real concern for the high MMR in India is not lack of resources but failure in the system," said Aparajita Gogoi, national coordinator of the White Ribbon Alliance (WRA) that works on issues concerning safe motherhood.
Gogoi was speaking at a workshop on maternal mortality organised by UNICEF in Gwalior last week. Talking about the successes in reducing MMR in other countries, Gogoi said there are various facets that have been worked upon in those countries, which if looked into here would bring down the number of maternal deaths to a great extent.
Increasing availability of emergency obstetric care (EmOC) facilities, skilled birth attendants, maternity waiting homes and financial accessibility, which have been adopted in countries like Zimbabwe, Indonesia, Bolivia and Honduras have greatly helped. These nations have been able to reduce their MMR by 52 per cent.
In India, only 40 per cent women have access to skilled birth attendance. And according to the National Family Health Survey (NFHS), only one in six women receive post-natal care when 60 per cent of the maternal deaths occur after the delivery of the child. Promoting accountability is another factor that, when looked into seriously, brought down the number of maternal deaths in China from 1,500 per 100,000 live births to less than 200 in the year 2000. "Accountability is very important. No one is held responsible when a mother dies ... most of the times it's not even registered. It's very important to keep a tab of the health of a pregnant woman". "Only then can the matter be looked into if any complication arises and a similar situation can be prevented in the future," Gogoi said.
Bangladesh has brought down its MMR by 22 per cent, Egypt by 52 per cent, Honduras by 41 per cent, Morocco by eight per cent and Guatemala by 30 per cent. One of the reasons for the high MMR in India country is the ratio of the population to the number of skilled medical staff available. Although 70 per cent of the population resides in rural areas, only 20-30 per cent medical aid is available to them while the ratio is the opposite in urban areas.
Non-functional health centres, scarcity of blood banks, inadequate number of specialists like gynaecologists and anaesthetists in rural areas and the poor condition of the transport system are some of the bottlenecks of the problem. "Seventy per cent of the national budget allocated for health support goes back unutilised. The system is not delivering end results and that's where the problem lies," stated Hamid El-Bashir, Madhya Pradesh state representative of UNICEF. "These deaths are completely preventable and that is the greatest tragedy. It is a silent tsunami," remarked Gogoi.
There has been no appreciable decline in the number of women dying at childbirth in India since 1990, quite unlike other nations like Bangladesh, Gautemala and Morocco that have managed to arrest this trend. India's Maternal Mortality Ratio (MMR), the number of maternal deaths per 100,000 live births, was 301 in 2002 and 2003. According to the Sample Registration Survey (SRS), 70,000 women die every year in India but UNICEF says the number crosses 100,000.
"The real concern for the high MMR in India is not lack of resources but failure in the system," said Aparajita Gogoi, national coordinator of the White Ribbon Alliance (WRA) that works on issues concerning safe motherhood.
Gogoi was speaking at a workshop on maternal mortality organised by UNICEF in Gwalior last week. Talking about the successes in reducing MMR in other countries, Gogoi said there are various facets that have been worked upon in those countries, which if looked into here would bring down the number of maternal deaths to a great extent.
Increasing availability of emergency obstetric care (EmOC) facilities, skilled birth attendants, maternity waiting homes and financial accessibility, which have been adopted in countries like Zimbabwe, Indonesia, Bolivia and Honduras have greatly helped. These nations have been able to reduce their MMR by 52 per cent.
In India, only 40 per cent women have access to skilled birth attendance. And according to the National Family Health Survey (NFHS), only one in six women receive post-natal care when 60 per cent of the maternal deaths occur after the delivery of the child. Promoting accountability is another factor that, when looked into seriously, brought down the number of maternal deaths in China from 1,500 per 100,000 live births to less than 200 in the year 2000. "Accountability is very important. No one is held responsible when a mother dies ... most of the times it's not even registered. It's very important to keep a tab of the health of a pregnant woman". "Only then can the matter be looked into if any complication arises and a similar situation can be prevented in the future," Gogoi said.
Bangladesh has brought down its MMR by 22 per cent, Egypt by 52 per cent, Honduras by 41 per cent, Morocco by eight per cent and Guatemala by 30 per cent. One of the reasons for the high MMR in India country is the ratio of the population to the number of skilled medical staff available. Although 70 per cent of the population resides in rural areas, only 20-30 per cent medical aid is available to them while the ratio is the opposite in urban areas.
Non-functional health centres, scarcity of blood banks, inadequate number of specialists like gynaecologists and anaesthetists in rural areas and the poor condition of the transport system are some of the bottlenecks of the problem. "Seventy per cent of the national budget allocated for health support goes back unutilised. The system is not delivering end results and that's where the problem lies," stated Hamid El-Bashir, Madhya Pradesh state representative of UNICEF. "These deaths are completely preventable and that is the greatest tragedy. It is a silent tsunami," remarked Gogoi.
Monday, February 12, 2007
UNICEF launches new scheme to conduct enquiry on maternal deaths
Aarti Dhar
- Social audit to identify ways to prevent avoidable deaths
- Women have little or no role in decision to seek healthcare
- UNICEF for sustained political commitment for safe motherhood
GWALIOR (M.P.): Concerned over the high maternal mortality ratio (MMR) in the country — 301 per 100,000 live births — the United Nations Children's Fund (UNICEF) has launched a new scheme to conduct maternal death inquiry. The Maternal and Perinatal Death Inquiry (MAPEDI) or the social audit — also known as verbal autopsy — is aimed at providing an understanding of the contributing factors that can be used by decision-makers and stakeholders to address obstacles to quality obstetric care and to identify ways to prevent avoidable deaths.
Survey of healthcare facilities
One such survey was conducted in Purulia district of West Bengal between July 2005 and June 2006 and its findings made the State Government order a review of every maternal death and initiate a survey of the health care facilities. All maternity beds in public sector facilities in the State have now been made non-paying for all and the Government is now working on a cashless referral transport system.
Of the 106 maternal mortalities reported, 62 per cent died during labour or delivery, 26 per cent during pregnancy and 12 per cent during abortion. As many as 61 per cent died at the health facility, 24 per cent died at home, 13 per cent en route to health facility and three per cent due to related causes. Fifty one per cent deaths were due to direct obstetric causes like bleeding, infection, eclampsia, and obstructed labour, 27 per cent due to indirect causes like anaemia, malaria, hepatitis, tuberculosis and cardiac, while 22 per cent died due to other causes.
The women were illiterate, most of them belonged to the Scheduled Castes, followed by the Scheduled Tribes and 42 per cent were below poverty line (BPL) cardholders.
According to Sudha Balakrishnan of UNICEF, husbands played a major role in deciding to seek healthcare and the women themselves had little or no role in this decision. The survey also revealed that 46 per cent sought formal health care after complications arose, 80 per cent sought formal care at some point of time and 20 per cent did not seek any.
Sadly, 16 per cent did not think the woman was sick enough, 8 per cent thought the problem required traditional care, for 23 per cent the cost and transportation was unaffordable. For another 11 per cent transport was not available at all. A similar audit conducted on 104 maternal mortality deaths in Shivpuri and Guna districts of Madhya Pradesh indicated that 83 per cent died after delivery, 5 per cent during delivery, 11 per cent during pregnancy and one per cent after abortion.
The UNICEF has been advocating sustained political commitment and strengthening policies for safe motherhood, ensuring availability of skilled maternal heath care provider and increasing awareness of communities and families for timely recognition of danger signs and deciding for referral besides improving availability of round-the-clock emergency obstetric care services.
- Social audit to identify ways to prevent avoidable deaths
- Women have little or no role in decision to seek healthcare
- UNICEF for sustained political commitment for safe motherhood
GWALIOR (M.P.): Concerned over the high maternal mortality ratio (MMR) in the country — 301 per 100,000 live births — the United Nations Children's Fund (UNICEF) has launched a new scheme to conduct maternal death inquiry. The Maternal and Perinatal Death Inquiry (MAPEDI) or the social audit — also known as verbal autopsy — is aimed at providing an understanding of the contributing factors that can be used by decision-makers and stakeholders to address obstacles to quality obstetric care and to identify ways to prevent avoidable deaths.
Survey of healthcare facilities
One such survey was conducted in Purulia district of West Bengal between July 2005 and June 2006 and its findings made the State Government order a review of every maternal death and initiate a survey of the health care facilities. All maternity beds in public sector facilities in the State have now been made non-paying for all and the Government is now working on a cashless referral transport system.
Of the 106 maternal mortalities reported, 62 per cent died during labour or delivery, 26 per cent during pregnancy and 12 per cent during abortion. As many as 61 per cent died at the health facility, 24 per cent died at home, 13 per cent en route to health facility and three per cent due to related causes. Fifty one per cent deaths were due to direct obstetric causes like bleeding, infection, eclampsia, and obstructed labour, 27 per cent due to indirect causes like anaemia, malaria, hepatitis, tuberculosis and cardiac, while 22 per cent died due to other causes.
The women were illiterate, most of them belonged to the Scheduled Castes, followed by the Scheduled Tribes and 42 per cent were below poverty line (BPL) cardholders.
According to Sudha Balakrishnan of UNICEF, husbands played a major role in deciding to seek healthcare and the women themselves had little or no role in this decision. The survey also revealed that 46 per cent sought formal health care after complications arose, 80 per cent sought formal care at some point of time and 20 per cent did not seek any.
Sadly, 16 per cent did not think the woman was sick enough, 8 per cent thought the problem required traditional care, for 23 per cent the cost and transportation was unaffordable. For another 11 per cent transport was not available at all. A similar audit conducted on 104 maternal mortality deaths in Shivpuri and Guna districts of Madhya Pradesh indicated that 83 per cent died after delivery, 5 per cent during delivery, 11 per cent during pregnancy and one per cent after abortion.
The UNICEF has been advocating sustained political commitment and strengthening policies for safe motherhood, ensuring availability of skilled maternal heath care provider and increasing awareness of communities and families for timely recognition of danger signs and deciding for referral besides improving availability of round-the-clock emergency obstetric care services.
Sunday, February 11, 2007
Patients suffer due to lack of drinking water in health centre’s of Madhya Pradesh
Sandhya Prakash, Bhopal (Hindi) Feb 11, 2007
As per reproductive and child health district level household survey (2004) out of the 386 primary health centre where this survey was carried out only 224 had drinking water facility. This means that only 58.3 percent primary health centre’s have drinking water other have no such facility. In case of community health centre’s out of the 46 surveyed only 10 had facility of drinking water.
Similarly out of the 386 primary health centre surveyed only 35 had vehicles which were in running condition. In case of 46 community health centre’s surveyed 31 had vehicles in running condition. (Blog comments - This also means that problem is more acute where it is most needed in the interiors of Madhya Pradesh where accessibility is an issue)
NGOs working in the state question the state policies and say that at one place state is announcing schemes while on other hand state lacks adequate infrastructure to provide health services to its people.
Adapted from the media report published in hindi in Sandhya Prakash.
As per reproductive and child health district level household survey (2004) out of the 386 primary health centre where this survey was carried out only 224 had drinking water facility. This means that only 58.3 percent primary health centre’s have drinking water other have no such facility. In case of community health centre’s out of the 46 surveyed only 10 had facility of drinking water.
Similarly out of the 386 primary health centre surveyed only 35 had vehicles which were in running condition. In case of 46 community health centre’s surveyed 31 had vehicles in running condition. (Blog comments - This also means that problem is more acute where it is most needed in the interiors of Madhya Pradesh where accessibility is an issue)
NGOs working in the state question the state policies and say that at one place state is announcing schemes while on other hand state lacks adequate infrastructure to provide health services to its people.
Adapted from the media report published in hindi in Sandhya Prakash.
Saturday, February 10, 2007
Maternal mortality rate high in Madhya Pradesh
Aarti Dhar
The Hindu, Feb 11, 2007
Especially in rural areas where healthcare system is virtually non-existent
Gwalior (M.P.): When Khiloni delivered her second child in her hutment at Duhiya village of Gwalior district in December 2005, the family celebrated.
It was only after a while they realised that her placenta had not come out and she needed immediate medical attention. Her husband, Ashok, a daily wage earner, arranged for a tractor in the middle of the night to take Khiloni (25) to the Civil Hospital at Morar, about 35 km away.
However, little did Ashok realise that the worse was to come at the hospital as the doctors refused to admit Khiloni saying that the hospital was not equipped to handle such a complicated case and asked him to take his wife to a private nursing home reportedly owned by a doctor employed at the Civil Hospital.
Khiloni died a few hours later but the child survived. Ashok took a loan of Rs. 10,000 for the entire exercise and the family is yet to re-pay it.
Tragic tale
Khiloni's two children are being looked after by their maternal and paternal grandmothers.
A few kilometres away in Banjaron ka Dera, a tribal village, young Leela was being treated at the Hastinapur Public Health Centre for complications during her third pregnancy.
During her regular visits to the centre, she was examined by the doctor only once and the rest of the times, it was the health worker who treated her.
A disillusioned Leela was taken to a private doctor when she had a miscarriage in the fifth month of her pregnancy. As there was no sign of improvement even after spending a huge sum, Leela was shifted to the Civil Hospital at Murar on a bullock cart one night when her condition deteriorated, but died the following day.
The family paid Rs. 800 to take back the body. Her husband Mahesh, who took a loan of Rs. 35,000 for this, now works as a bonded labourer while his two children are being looked after by their grandmothers.
Madhya Pradesh figures among the list of States where maternal mortality is high, particularly in rural areas, where the healthcare system is virtually non-existent and awareness on the subject among the people extremely low.
According to UNICEF, Madhya Pradesh along with Assam and Uttar Pradesh has a high Maternal Mortality Rate (MMR) of 700 or more per 100,000 live birth as against the national figure of 407 per 100,000 live births as per the 2001 Census figure. However, regional disparities in maternal mortality are wide with the death ratio being low in Kerala, Tamil Nadu and Punjab and extremely high in most northern States.
The Hindu, Feb 11, 2007
Especially in rural areas where healthcare system is virtually non-existent
Gwalior (M.P.): When Khiloni delivered her second child in her hutment at Duhiya village of Gwalior district in December 2005, the family celebrated.
It was only after a while they realised that her placenta had not come out and she needed immediate medical attention. Her husband, Ashok, a daily wage earner, arranged for a tractor in the middle of the night to take Khiloni (25) to the Civil Hospital at Morar, about 35 km away.
However, little did Ashok realise that the worse was to come at the hospital as the doctors refused to admit Khiloni saying that the hospital was not equipped to handle such a complicated case and asked him to take his wife to a private nursing home reportedly owned by a doctor employed at the Civil Hospital.
Khiloni died a few hours later but the child survived. Ashok took a loan of Rs. 10,000 for the entire exercise and the family is yet to re-pay it.
Tragic tale
Khiloni's two children are being looked after by their maternal and paternal grandmothers.
A few kilometres away in Banjaron ka Dera, a tribal village, young Leela was being treated at the Hastinapur Public Health Centre for complications during her third pregnancy.
During her regular visits to the centre, she was examined by the doctor only once and the rest of the times, it was the health worker who treated her.
A disillusioned Leela was taken to a private doctor when she had a miscarriage in the fifth month of her pregnancy. As there was no sign of improvement even after spending a huge sum, Leela was shifted to the Civil Hospital at Murar on a bullock cart one night when her condition deteriorated, but died the following day.
The family paid Rs. 800 to take back the body. Her husband Mahesh, who took a loan of Rs. 35,000 for this, now works as a bonded labourer while his two children are being looked after by their grandmothers.
Madhya Pradesh figures among the list of States where maternal mortality is high, particularly in rural areas, where the healthcare system is virtually non-existent and awareness on the subject among the people extremely low.
According to UNICEF, Madhya Pradesh along with Assam and Uttar Pradesh has a high Maternal Mortality Rate (MMR) of 700 or more per 100,000 live birth as against the national figure of 407 per 100,000 live births as per the 2001 Census figure. However, regional disparities in maternal mortality are wide with the death ratio being low in Kerala, Tamil Nadu and Punjab and extremely high in most northern States.
Hospitals turning into tombs in rural India
Surpura (Madhya Pradesh), Feb 11 (IANS)
The paint-peeling single-storey building wears a ghostly look. Cobwebs hang from the walls, used syringes and cotton swabs lie on the blood stained floor and the rooms are in darkness. And the doctor is nowhere to be seen.
Welcome to the block level hospital in rural Madhya Pradesh, one of the country's largest states.Catering to emergency situations of a population of nearly 30,000 people, this scene, shocking to a visitor used to tales of booming medical tourism in five-star city hospitals, is an eye opener to the kind of medical aid the villagers in many areas of rural India receive. It's of no surprise then that, among others, the maternal mortality rate here is very high.The delivery room of the hospital couldn't have been worse with a broken sink, no bed and a dirty toilet. "The midwife gets water from outside since there is no running water," says Sumhira Badhoria, an attendant present. "We hardly get electricity for two hours," she adds.But the most surprising fact is that the doctor who is supposed to be on duty for 24 hours was nowhere in sight at 2 o'clock in the afternoon. "The doctor hardly comes here. He comes about twice a week. We have no choice but to go to the private practitioners and pay a hefty sum," lamented one of the villagers.Although the hospital is supposed to have a staff strength of 10, only two attendants were seen. But if this sight is any bad, then the condition of another village about five kilometres away is worse.Kishupura village has a sub health centre, but broken and abandoned. "No one comes here. The nurse comes twice a month and goes around the village," says Sanjay Singh Badhoria, a farmer of the village.The consequences of such negligence in medical facility?
Heart wrenching stories.
Rekha, 22, was pregnant with her third child when she suddenly started bleeding heavily. Alarmed, her husband and a few relatives hired a car and rushed her to the Surpura block level hospital but after getting no medical assistance there, they had to take her to a private practitioner who gave her some medication.Although the bleeding stopped for some time, it resumed soon after at night. With no other option in hand, they rushed her to the district hospital in Bhind, about 35 km from the village.But by the time the hapless husband could stand in the queue to admit her in spite of saying that it was an emergency, she died."It took us more than half an hour to get her admitted. Then we had to look for the doctor. By that time it was too late," lamented her husband, Anil Singh Badhoria, to the visiting IANS correspondent.Survived by two kids, a boy aged four and a girl aged three, Rekha's story is one of the many that remain hidden behind silent cries of the innocent, motherless children.More than 7,000 women die of pregnancy-related issues in Madhya Pradesh every year contributing to 10 percent of the maternal mortality rate in the country. Globally, India accounts for 20 percent of the maternal mortality rate.
By Azera Rahman
The paint-peeling single-storey building wears a ghostly look. Cobwebs hang from the walls, used syringes and cotton swabs lie on the blood stained floor and the rooms are in darkness. And the doctor is nowhere to be seen.
Welcome to the block level hospital in rural Madhya Pradesh, one of the country's largest states.Catering to emergency situations of a population of nearly 30,000 people, this scene, shocking to a visitor used to tales of booming medical tourism in five-star city hospitals, is an eye opener to the kind of medical aid the villagers in many areas of rural India receive. It's of no surprise then that, among others, the maternal mortality rate here is very high.The delivery room of the hospital couldn't have been worse with a broken sink, no bed and a dirty toilet. "The midwife gets water from outside since there is no running water," says Sumhira Badhoria, an attendant present. "We hardly get electricity for two hours," she adds.But the most surprising fact is that the doctor who is supposed to be on duty for 24 hours was nowhere in sight at 2 o'clock in the afternoon. "The doctor hardly comes here. He comes about twice a week. We have no choice but to go to the private practitioners and pay a hefty sum," lamented one of the villagers.Although the hospital is supposed to have a staff strength of 10, only two attendants were seen. But if this sight is any bad, then the condition of another village about five kilometres away is worse.Kishupura village has a sub health centre, but broken and abandoned. "No one comes here. The nurse comes twice a month and goes around the village," says Sanjay Singh Badhoria, a farmer of the village.The consequences of such negligence in medical facility?
Heart wrenching stories.
Rekha, 22, was pregnant with her third child when she suddenly started bleeding heavily. Alarmed, her husband and a few relatives hired a car and rushed her to the Surpura block level hospital but after getting no medical assistance there, they had to take her to a private practitioner who gave her some medication.Although the bleeding stopped for some time, it resumed soon after at night. With no other option in hand, they rushed her to the district hospital in Bhind, about 35 km from the village.But by the time the hapless husband could stand in the queue to admit her in spite of saying that it was an emergency, she died."It took us more than half an hour to get her admitted. Then we had to look for the doctor. By that time it was too late," lamented her husband, Anil Singh Badhoria, to the visiting IANS correspondent.Survived by two kids, a boy aged four and a girl aged three, Rekha's story is one of the many that remain hidden behind silent cries of the innocent, motherless children.More than 7,000 women die of pregnancy-related issues in Madhya Pradesh every year contributing to 10 percent of the maternal mortality rate in the country. Globally, India accounts for 20 percent of the maternal mortality rate.
By Azera Rahman
Dying to have a baby
Sanchita Sharma
Bhind, Madhya Pradesh, February 10, 2007
Guns have a higher place in society than women in Madhya Pradesh's Bhind district, perhaps best known as the former haunt of bandit queen Phoolan Devi."If a person's gun gets stolen, he loses all respect in society. They say that a man who cannot protect his gun is good for nothing," says Pahalwan Singh Badoria of Hamirapura village in the Ater block of Bhind.This warped logic perhaps explains why men look after their gun more than their wives, who are among the most underweight and anaemic women in India. At 380 deaths per 100,000 live births, Madhya Pradesh has a very high maternal mortality rate (MMR). "Of the 70,000 women who die at childbirth, Madhya Pradesh accounts for 7,000 deaths," says Hamid al-Bashir, state representative, UNICEF.According to the Sample Registration Survey, India's MMR dropped to 301 in 2002-03 from 398 in 1997-98. The Union health ministry widely credits the drop to a rise in the number of hospital deliveries of babies, a fact that is not borne on the ground.
Though the Primary Health Centre (PHC) in Shivpura village in Ater block has medical staff of seven – including two doctors and three Auxiliary Nurse Midwives (ANM) – only one ANM was present on Friday. The PHC, which is the nodal health centre for a population of 30,000, treated only one patient that day. "This PHC faces a cremation ground and the burning corpses scare people away. No one stays overnight because they fear ghosts," says ANM Sumeera Badauri.The cremation ground is the least of the problems. The PHC gets electricity for two hours a day, and has no running water, not even in the delivery room. "The water from the hand-pump is brackish water and unfit for use, so we send the sweeper or the patients' attendants to fetch buckets of water from the village a kilometre away," she says.Villagers claim it is not ghosts but the poor quality of service that keeps them away. "You were lucky you found the PHC open today, they must have known you were coming. It is always locked, so we don't waste time going there. We go to private doctors or the District Hospital in Bhind town 30 kms away," says Sanjay Singh Badauri of the neighbouring Sheopura village.
In Sheopura, the health subcentre functions as the community urinal. "A nurse comes twice a month but now the roof has collapsed, so perhaps she will stop coming," he shrugs.Pregnant women usually walk, bus or pillion-ride on a bicycle on kutcha roads to reach the District Hospital. At times even that does not help. Anil Singh's wife Rekha died of bleeding when pregnant with their third child. "We rushed her in a hired car but she died while we spent half-an-hour getting the paperwork done for hospital admission," says Singh, also of Sheopura village.It is debatable whether Rekha would have lived if she had reached the District Hospital in time. The hospital has no blood bank and there is none in all of Bhind. "We acquired all blood-banking equipment two years but did not get a licence because we do not have the 1,000 sq foot area needed to run a blood bank," says the district chief medical officer SM Ojha.If you are wondering how the hospital functions without blood, here's the answer. "We ask critical patients to go to Gwalior. The city has many hospitals," he says. And those who die trying to reach care become another statistic.
Bhind, Madhya Pradesh, February 10, 2007
Guns have a higher place in society than women in Madhya Pradesh's Bhind district, perhaps best known as the former haunt of bandit queen Phoolan Devi."If a person's gun gets stolen, he loses all respect in society. They say that a man who cannot protect his gun is good for nothing," says Pahalwan Singh Badoria of Hamirapura village in the Ater block of Bhind.This warped logic perhaps explains why men look after their gun more than their wives, who are among the most underweight and anaemic women in India. At 380 deaths per 100,000 live births, Madhya Pradesh has a very high maternal mortality rate (MMR). "Of the 70,000 women who die at childbirth, Madhya Pradesh accounts for 7,000 deaths," says Hamid al-Bashir, state representative, UNICEF.According to the Sample Registration Survey, India's MMR dropped to 301 in 2002-03 from 398 in 1997-98. The Union health ministry widely credits the drop to a rise in the number of hospital deliveries of babies, a fact that is not borne on the ground.
Though the Primary Health Centre (PHC) in Shivpura village in Ater block has medical staff of seven – including two doctors and three Auxiliary Nurse Midwives (ANM) – only one ANM was present on Friday. The PHC, which is the nodal health centre for a population of 30,000, treated only one patient that day. "This PHC faces a cremation ground and the burning corpses scare people away. No one stays overnight because they fear ghosts," says ANM Sumeera Badauri.The cremation ground is the least of the problems. The PHC gets electricity for two hours a day, and has no running water, not even in the delivery room. "The water from the hand-pump is brackish water and unfit for use, so we send the sweeper or the patients' attendants to fetch buckets of water from the village a kilometre away," she says.Villagers claim it is not ghosts but the poor quality of service that keeps them away. "You were lucky you found the PHC open today, they must have known you were coming. It is always locked, so we don't waste time going there. We go to private doctors or the District Hospital in Bhind town 30 kms away," says Sanjay Singh Badauri of the neighbouring Sheopura village.
In Sheopura, the health subcentre functions as the community urinal. "A nurse comes twice a month but now the roof has collapsed, so perhaps she will stop coming," he shrugs.Pregnant women usually walk, bus or pillion-ride on a bicycle on kutcha roads to reach the District Hospital. At times even that does not help. Anil Singh's wife Rekha died of bleeding when pregnant with their third child. "We rushed her in a hired car but she died while we spent half-an-hour getting the paperwork done for hospital admission," says Singh, also of Sheopura village.It is debatable whether Rekha would have lived if she had reached the District Hospital in time. The hospital has no blood bank and there is none in all of Bhind. "We acquired all blood-banking equipment two years but did not get a licence because we do not have the 1,000 sq foot area needed to run a blood bank," says the district chief medical officer SM Ojha.If you are wondering how the hospital functions without blood, here's the answer. "We ask critical patients to go to Gwalior. The city has many hospitals," he says. And those who die trying to reach care become another statistic.
Sunday, February 04, 2007
State rapped on Janani Yojana
Hindustan Times, Bhopal, Feb 3, 2007
Sravani Sarkar
MADHYA PRADESH is among 11 states that were served notice by the Supreme Court for ‘dismal inaction’ in implementation of the Janani Suraksha Yojana – the Centre- sponsored health scheme meant for nutritional assistance to pregnant women.
In order dated February 1, the double bench of Justice Arijit Pasayat and Justice S N Kapoor of the apex court served notice to 11 states and the Union Government to file replies within four weeks and three weeks respectively as to why there was inaction in the scheme’s implementation. The Union Government has also been asked to indicate as to how it proposes to monitor the implementation of the schemes by the state government and in what way there can be more coordinated effort for implementing the schemes.
The other states to get the notice from Supreme Court are Uttar Pradesh, Uttaranchal, Bihar, Delhi, Jharkhand, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu and Kashmir.
The notices have been served in response to a petition filed by civil society organisation, the People’s Union for Civil Liberties (PUCL) and based on an analytical report on the matter compiled and presented to the SC by its permanent commissioners N C Saxena and Harsh Mander.
The State Health Department, however, has outright rejected failure of implementation. Health Commissioner Dr Rajesh Rajora told the Hindustan Times that Madhya Pradesh, at present, is the topmost state in the implementation of the JSY. He said that only recently the state health department made a presentation regarding the scheme before the Union Government’s Joint Review Mission. He added the scenario could be well gauged from fact that as against 68,000 beneficiaries in 2005-06, 1.95 lakh women were benefited by the scheme in 2006-07 (till date).
The Supreme Court, however, has taken a very serious view of the analytical report by its commissioners that incorporates a number of complaints regarding implementation of scheme.
The apex court has asked the Centre to also indicate whether it would be in the interest of the beneficiaries if the funds were directly placed at the disposal of Gram Panchayats.
The funds under the JSY is available with the Chief Medical and Health Officer of the district concerned and the centralised disbursal system makes it difficult for the funds to reach beneficiaries in time. In its order, the Supreme Court also quotes the Commissioners’ report that the non-performance in rural areas is more acute.
“It would be appropriate if the Union of India and the state governments take steps to make the beneficiaries aware of the benefits of the schemes and the entitlements flowing there from’’ observes the Supreme Court order. The senior counsel for the PUCL Colin Gonsalves has been asked to compile the responses (of the union and state governments) and to give his (Gonsalves’s) suggestion as regards the modes to the adopted for better results. The matter would be taken up for hearing again in third week of March.
Sravani Sarkar
MADHYA PRADESH is among 11 states that were served notice by the Supreme Court for ‘dismal inaction’ in implementation of the Janani Suraksha Yojana – the Centre- sponsored health scheme meant for nutritional assistance to pregnant women.
In order dated February 1, the double bench of Justice Arijit Pasayat and Justice S N Kapoor of the apex court served notice to 11 states and the Union Government to file replies within four weeks and three weeks respectively as to why there was inaction in the scheme’s implementation. The Union Government has also been asked to indicate as to how it proposes to monitor the implementation of the schemes by the state government and in what way there can be more coordinated effort for implementing the schemes.
The other states to get the notice from Supreme Court are Uttar Pradesh, Uttaranchal, Bihar, Delhi, Jharkhand, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu and Kashmir.
The notices have been served in response to a petition filed by civil society organisation, the People’s Union for Civil Liberties (PUCL) and based on an analytical report on the matter compiled and presented to the SC by its permanent commissioners N C Saxena and Harsh Mander.
The State Health Department, however, has outright rejected failure of implementation. Health Commissioner Dr Rajesh Rajora told the Hindustan Times that Madhya Pradesh, at present, is the topmost state in the implementation of the JSY. He said that only recently the state health department made a presentation regarding the scheme before the Union Government’s Joint Review Mission. He added the scenario could be well gauged from fact that as against 68,000 beneficiaries in 2005-06, 1.95 lakh women were benefited by the scheme in 2006-07 (till date).
The Supreme Court, however, has taken a very serious view of the analytical report by its commissioners that incorporates a number of complaints regarding implementation of scheme.
The apex court has asked the Centre to also indicate whether it would be in the interest of the beneficiaries if the funds were directly placed at the disposal of Gram Panchayats.
The funds under the JSY is available with the Chief Medical and Health Officer of the district concerned and the centralised disbursal system makes it difficult for the funds to reach beneficiaries in time. In its order, the Supreme Court also quotes the Commissioners’ report that the non-performance in rural areas is more acute.
“It would be appropriate if the Union of India and the state governments take steps to make the beneficiaries aware of the benefits of the schemes and the entitlements flowing there from’’ observes the Supreme Court order. The senior counsel for the PUCL Colin Gonsalves has been asked to compile the responses (of the union and state governments) and to give his (Gonsalves’s) suggestion as regards the modes to the adopted for better results. The matter would be taken up for hearing again in third week of March.
Friday, February 02, 2007
Paying a steep price for motherhood
Indiatogether.org
Sachin Jain
Even as New Delhi says maternal mortality numbers are falling, tribal women Madhya Pradesh are facing a negligent, cruel and corrupt healthcare system and dying during childbirth. When the conduct of hospital staff is questioned, they face retaliation instead of accountability. Sachin Jain reports.
On 19 November 2006, Newa Bai, a seven month pregnant poor tribal women of Nidanpur village, Ashoknager district, M.P., died at the local government hospital. Her husband Kpoora Adivasi had taken her to the nearest Chanderi government hospital after she complained about nausea and severe abdominal pain. After a primary check-up, the doctor in charge, R P Sharma (the position of gynaecologist, usually a lady doctor, is lying vacant and there is no timeline till when she would be recruited) put Newa on a blood infusion. It was about 1.00 pm which is lunch time for the staff and they left the hospital for extended lunch break, which normally lasts few hours. But only the nurse returned that too after 5 hours. Meanwhile Newa's condition deteriorated and she became critical. Some people who accompanied her alleged that there was even reverse blood flow after the transfusion was over. Newa died.
Sainath, a civil society organization working in the area took up the issue and a concern was raised by them with the district administration. They urged the district to undertake an enquiry. The moment concern was raised and accountability questioned, the district hospital stopped providing any treatment to villagers of Nidanpur. Even if one dares to go to hospital from the village the staff yells at them and even uses bad words.
On 27 December, another pregnant woman Phool Kunwar from the same village in labour pains was taken to Chanderi Hospital. She delivered a girl child on the way. By the time she reached hospital her position got serious. The medical doctor in-charge, that knowing that she is from Nidanpur village, denied any treatment to her. Her husband Uday took her to the Ashoknager district hospital and then to the Guna government hospital. But she could not be saved and died the same day. Her new born baby died on 30 December. The Sarpanch of Nidanpur, Sendra Pal Singh, is in despair. He asks, "where we will go, it seems now that the entire state is against our village. Have we done anything wrong by asking women rights for safe motherhood?"
The deaths come at a time when the state government of Madhya Pradesh is strongly advocating institutional deliveries as the mantra to combat high rates of maternal deaths in the state. Unfortunately in the state the campaign exists in the advertisement hoardings, newspaper advertisements and in media, thanks to efforts of public relation department of the state. Very little effort is being put to strengthen quality of services and hardly any on improving human – human interaction of the health delivery staff.
Village Sarari Khurd, Sheopur has a primary health centre but no doctor. Since when it does not have doctor, even villagers can't remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipment and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometres of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily). And there is nothing to take care of a pregnant women and children. Even in case of unavailability of medicines, village level health staff is sailing the various kind of medicines to the Villagers.
Janani Suraksha Yojana. On paper, the central government feels that maternal relief and safe delivery does not end with better nutrition, but it involves comprehensive care during pregnancy, child birth and after-delivery support by through quality care in essential and emergency obstetric services.
Ostensibly, the aim seems to be make deliveries safe thereby reducing maternal/infant mortality by providing policy emphasis on institutional deliveries and financial assistance to the pregnant women under the Janani Suraksha Yojana. Previously this scheme used to be known as National Maternity Benefit Scheme.
There are 533 villages in the Saheriya primitive tribe dominated Sheopur district with a population of 5.60 lakhs. The total number of bed available at the one district hospital and other hospitals is only 166, of which 148 beds have not been changed during the last 13 years. During the last two years, several big claims have been made about promoting safe motherhood but just like last six years, three out of four posts of doctors in the Karahal block are still vacant. There was no improvement in the medical facilities during this period and even a single gynaecologist and obstetrician could not be posted.
Bilasi Devi, an anganwadi worker from Gothra Kapura village of the district, speaks from experience and asks as to why should one go to hospital? No one even speaks properly there and everyone right from doctors to nurses to sanitary workers asks for money to take any action. The state government claims that anyone going for institutional childbirth would get Rs.1700 worth financial aid, transport fare and free medicines. The central government sponsored Janani Suraksha Yojana provides Rs.700 and the state government sponsored Vijayaraje Janani Bima Kalyan Yojana provides Rs.1000 for safe deliveries. Despite this, when Babhuti, a Sahariya tribal woman of Gothra Kapura was taken for childbirth to a hospital, her family had to pawn their land for completing her delivery.
In recent years the Sahariya Primitive Tribal Group (PTG) has become a new synonym of acute poverty, chronic hunger and marginalisation but Sahariya women face the double burden of gendered poverty.
In the meantime, the Government of India, on 31 October 2006, released maternal mortality figures for the first time since 1998, which claims that the Maternal Mortality Rate (MMR) has gone down from 498 (per lakh or 100,000 childbirths) to 379 during the period. But the report Maternal Mortality in India: Trends, causes and risk factors - 1997-2003 is itself facing some basic technical questions. The key question is whether the government is trying to veil the adverse ground reality by putting out statistics.
One important point is that this study of MMR has been conducted by considering only a limited number of cases of a particular situation. The survey was conducted over a period of six years and reported low MMR in M.P. and Chhattisgarh (365). But during this period about 103,000 cases of maternal mortality were reported in the two states. The second point is that all these cases (365) are those that have been registered in official records while analyses indicate that only one out of three maternal deaths get officially recorded. The problem is that in the district hospitals, community health centres and the lower level of health set up, the deaths during childbirth are recorded as general mortality. This is to shield hospital staff from being held responsible for negligence and unaccountability.
The next question is that the Madhya Pradesh Government (GoMP) had itself in 2003 pointed out through the State Family Health Evaluation that in the rural areas of the state, the MMR was as high as 763. This study was done on 25 percent populace of each district. Yet the union government is releasing contradictory figures for the same period.
The health facilities in M.P. are in an ugly situation. The analysis of recent efforts of state government does not bring any good news. Only one hospital bed is available per two villages in M.P. A total of 17 lakh childbirths occur in the state every year and 40 percent of state populace is below poverty line, yet the government provides only Rs.150 per person per year as health budget of which Rs.126 is spend on salary-allowances and other infrastructure costs.
Key posts continue to remain vacant. Only 137 posts of gynaecologists and obstetricians are approved in entire state and of these 38 are vacant since several years, according to information unearthed by the Right to Food Campaign in M.P., from Department of Health and Family Welfare, using the national Right to Information law. After a long battle, in early 2005, the state government started the process for filling up 78 posts of gynaecologists and obstetricians but only 31 applications were received. A total 112 posts of anaesthetists were to be filled up but only 12 took up the job. No doctors are willing to take up government jobs owing to lack of facilities including diagnostic implements, medicines and general sanitary facilities. In such situation, doctors often have to face the wrath of the family members of the patient in case of death.
Furthermore, corruption at all levels is making conditions far more dangerous for the pregnant women. Corruption has already seeped in the medicine purchases under the new medicine policy, and the Rs.700 of financial support for mothers under the Janani Suraksha Yojana is spent in giving bribes to the local health staff. Despite unreliable data, statistics say that out of 1.47 lakh maternal deaths in the country every year, 97,000 are contributed by the five BIMARU states and the three newly carved states. The World Health Organisation also accepts this. In fact, half of the maternal deaths in South Asia are contributed by the states of Rajasthan, M.P., Bihar, U.P. and Orissa in India. It is in this light the Government of India's recent attempt to portray low MMR numbers for M.P. must be seen.
MMR is directly related to social disparity, exploitation and poverty. The governments (centre and state) have limited the scope of poverty to hunger and this has limited the rights of the women for safe motherhood. On the one hand, private health services are expanding, and due to poverty, more than 40 percent below poverty line families in M.P, are not able to access them. And on the other hand, the government's accountability to the poorer communities for their access to public health has only fallen.
Sachin Kumar Jain is a development journalist and is associated with the Right to Food Campaign in Madhya Pradesh.
Sachin Jain
Even as New Delhi says maternal mortality numbers are falling, tribal women Madhya Pradesh are facing a negligent, cruel and corrupt healthcare system and dying during childbirth. When the conduct of hospital staff is questioned, they face retaliation instead of accountability. Sachin Jain reports.
On 19 November 2006, Newa Bai, a seven month pregnant poor tribal women of Nidanpur village, Ashoknager district, M.P., died at the local government hospital. Her husband Kpoora Adivasi had taken her to the nearest Chanderi government hospital after she complained about nausea and severe abdominal pain. After a primary check-up, the doctor in charge, R P Sharma (the position of gynaecologist, usually a lady doctor, is lying vacant and there is no timeline till when she would be recruited) put Newa on a blood infusion. It was about 1.00 pm which is lunch time for the staff and they left the hospital for extended lunch break, which normally lasts few hours. But only the nurse returned that too after 5 hours. Meanwhile Newa's condition deteriorated and she became critical. Some people who accompanied her alleged that there was even reverse blood flow after the transfusion was over. Newa died.
Sainath, a civil society organization working in the area took up the issue and a concern was raised by them with the district administration. They urged the district to undertake an enquiry. The moment concern was raised and accountability questioned, the district hospital stopped providing any treatment to villagers of Nidanpur. Even if one dares to go to hospital from the village the staff yells at them and even uses bad words.
On 27 December, another pregnant woman Phool Kunwar from the same village in labour pains was taken to Chanderi Hospital. She delivered a girl child on the way. By the time she reached hospital her position got serious. The medical doctor in-charge, that knowing that she is from Nidanpur village, denied any treatment to her. Her husband Uday took her to the Ashoknager district hospital and then to the Guna government hospital. But she could not be saved and died the same day. Her new born baby died on 30 December. The Sarpanch of Nidanpur, Sendra Pal Singh, is in despair. He asks, "where we will go, it seems now that the entire state is against our village. Have we done anything wrong by asking women rights for safe motherhood?"
The deaths come at a time when the state government of Madhya Pradesh is strongly advocating institutional deliveries as the mantra to combat high rates of maternal deaths in the state. Unfortunately in the state the campaign exists in the advertisement hoardings, newspaper advertisements and in media, thanks to efforts of public relation department of the state. Very little effort is being put to strengthen quality of services and hardly any on improving human – human interaction of the health delivery staff.
Village Sarari Khurd, Sheopur has a primary health centre but no doctor. Since when it does not have doctor, even villagers can't remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipment and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometres of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily). And there is nothing to take care of a pregnant women and children. Even in case of unavailability of medicines, village level health staff is sailing the various kind of medicines to the Villagers.
Janani Suraksha Yojana. On paper, the central government feels that maternal relief and safe delivery does not end with better nutrition, but it involves comprehensive care during pregnancy, child birth and after-delivery support by through quality care in essential and emergency obstetric services.
Ostensibly, the aim seems to be make deliveries safe thereby reducing maternal/infant mortality by providing policy emphasis on institutional deliveries and financial assistance to the pregnant women under the Janani Suraksha Yojana. Previously this scheme used to be known as National Maternity Benefit Scheme.
There are 533 villages in the Saheriya primitive tribe dominated Sheopur district with a population of 5.60 lakhs. The total number of bed available at the one district hospital and other hospitals is only 166, of which 148 beds have not been changed during the last 13 years. During the last two years, several big claims have been made about promoting safe motherhood but just like last six years, three out of four posts of doctors in the Karahal block are still vacant. There was no improvement in the medical facilities during this period and even a single gynaecologist and obstetrician could not be posted.
Bilasi Devi, an anganwadi worker from Gothra Kapura village of the district, speaks from experience and asks as to why should one go to hospital? No one even speaks properly there and everyone right from doctors to nurses to sanitary workers asks for money to take any action. The state government claims that anyone going for institutional childbirth would get Rs.1700 worth financial aid, transport fare and free medicines. The central government sponsored Janani Suraksha Yojana provides Rs.700 and the state government sponsored Vijayaraje Janani Bima Kalyan Yojana provides Rs.1000 for safe deliveries. Despite this, when Babhuti, a Sahariya tribal woman of Gothra Kapura was taken for childbirth to a hospital, her family had to pawn their land for completing her delivery.
In recent years the Sahariya Primitive Tribal Group (PTG) has become a new synonym of acute poverty, chronic hunger and marginalisation but Sahariya women face the double burden of gendered poverty.
In the meantime, the Government of India, on 31 October 2006, released maternal mortality figures for the first time since 1998, which claims that the Maternal Mortality Rate (MMR) has gone down from 498 (per lakh or 100,000 childbirths) to 379 during the period. But the report Maternal Mortality in India: Trends, causes and risk factors - 1997-2003 is itself facing some basic technical questions. The key question is whether the government is trying to veil the adverse ground reality by putting out statistics.
One important point is that this study of MMR has been conducted by considering only a limited number of cases of a particular situation. The survey was conducted over a period of six years and reported low MMR in M.P. and Chhattisgarh (365). But during this period about 103,000 cases of maternal mortality were reported in the two states. The second point is that all these cases (365) are those that have been registered in official records while analyses indicate that only one out of three maternal deaths get officially recorded. The problem is that in the district hospitals, community health centres and the lower level of health set up, the deaths during childbirth are recorded as general mortality. This is to shield hospital staff from being held responsible for negligence and unaccountability.
The next question is that the Madhya Pradesh Government (GoMP) had itself in 2003 pointed out through the State Family Health Evaluation that in the rural areas of the state, the MMR was as high as 763. This study was done on 25 percent populace of each district. Yet the union government is releasing contradictory figures for the same period.
The health facilities in M.P. are in an ugly situation. The analysis of recent efforts of state government does not bring any good news. Only one hospital bed is available per two villages in M.P. A total of 17 lakh childbirths occur in the state every year and 40 percent of state populace is below poverty line, yet the government provides only Rs.150 per person per year as health budget of which Rs.126 is spend on salary-allowances and other infrastructure costs.
Key posts continue to remain vacant. Only 137 posts of gynaecologists and obstetricians are approved in entire state and of these 38 are vacant since several years, according to information unearthed by the Right to Food Campaign in M.P., from Department of Health and Family Welfare, using the national Right to Information law. After a long battle, in early 2005, the state government started the process for filling up 78 posts of gynaecologists and obstetricians but only 31 applications were received. A total 112 posts of anaesthetists were to be filled up but only 12 took up the job. No doctors are willing to take up government jobs owing to lack of facilities including diagnostic implements, medicines and general sanitary facilities. In such situation, doctors often have to face the wrath of the family members of the patient in case of death.
Furthermore, corruption at all levels is making conditions far more dangerous for the pregnant women. Corruption has already seeped in the medicine purchases under the new medicine policy, and the Rs.700 of financial support for mothers under the Janani Suraksha Yojana is spent in giving bribes to the local health staff. Despite unreliable data, statistics say that out of 1.47 lakh maternal deaths in the country every year, 97,000 are contributed by the five BIMARU states and the three newly carved states. The World Health Organisation also accepts this. In fact, half of the maternal deaths in South Asia are contributed by the states of Rajasthan, M.P., Bihar, U.P. and Orissa in India. It is in this light the Government of India's recent attempt to portray low MMR numbers for M.P. must be seen.
MMR is directly related to social disparity, exploitation and poverty. The governments (centre and state) have limited the scope of poverty to hunger and this has limited the rights of the women for safe motherhood. On the one hand, private health services are expanding, and due to poverty, more than 40 percent below poverty line families in M.P, are not able to access them. And on the other hand, the government's accountability to the poorer communities for their access to public health has only fallen.
Sachin Kumar Jain is a development journalist and is associated with the Right to Food Campaign in Madhya Pradesh.
Thursday, February 01, 2007
Reproductive health services: Govt in a dilemma
EDITORIAL by Central Chronicle, MP Edition, Feb 2, 2007
a call of concern by the Chronicle Reproductive health services in Madhya Pradesh
There has not been desired improvement in the condition of pregnant women in Madhya Pradesh. The state is also not left aloof from the revolutionary developments in health services. However, the news of deaths of 13,000 pregnant women, as per a survey, is really shocking. It is a direct slap on the face of our system which proclaims a lot about the progress being achieved in the health sector. This is a bitter truth which needs to be admitted. In Madhya Pradesh, the urban areas are developing well but the condition of people in the rural areas is deteriorating. Even though the government may have made efforts at its level to improve the situation in rural regions but the lacking of facilities is due to laxity and awareness in the implementation of various health schemes. The data of 13,000 deaths of pregnant women pertain mostly to rural areas.
There is shortage of hospitals in villages even today and where hospitals are present, the doctors are not available. There are many hospitals which have not even seen the faces of the doctors who were appointed for them. When the hospitals are sans general physicians then what to talk of specialist gynaecologists. In this context it may be pointed out that even government hospitals in the urban areas are facing shortage of specialist doctors. The government too is in a fix as to how to improve the standard of its hospitals but till today no permanent solution seems to be in sight. The government launched schemes of anganwadis, trained nurses and `trained dais'. Even then it is only a dilemma that the rural hospitals are not getting the services of these trained nurses. There are allegations of women from urban areas reaping the benefit of `dais'. As a result the trained nurses are not available at the time of deliveries of children and in absence of proper care deaths take place. The deaths are not only due to this factor but a host of diseases during pregnancy.
a call of concern by the Chronicle Reproductive health services in Madhya Pradesh
There has not been desired improvement in the condition of pregnant women in Madhya Pradesh. The state is also not left aloof from the revolutionary developments in health services. However, the news of deaths of 13,000 pregnant women, as per a survey, is really shocking. It is a direct slap on the face of our system which proclaims a lot about the progress being achieved in the health sector. This is a bitter truth which needs to be admitted. In Madhya Pradesh, the urban areas are developing well but the condition of people in the rural areas is deteriorating. Even though the government may have made efforts at its level to improve the situation in rural regions but the lacking of facilities is due to laxity and awareness in the implementation of various health schemes. The data of 13,000 deaths of pregnant women pertain mostly to rural areas.
There is shortage of hospitals in villages even today and where hospitals are present, the doctors are not available. There are many hospitals which have not even seen the faces of the doctors who were appointed for them. When the hospitals are sans general physicians then what to talk of specialist gynaecologists. In this context it may be pointed out that even government hospitals in the urban areas are facing shortage of specialist doctors. The government too is in a fix as to how to improve the standard of its hospitals but till today no permanent solution seems to be in sight. The government launched schemes of anganwadis, trained nurses and `trained dais'. Even then it is only a dilemma that the rural hospitals are not getting the services of these trained nurses. There are allegations of women from urban areas reaping the benefit of `dais'. As a result the trained nurses are not available at the time of deliveries of children and in absence of proper care deaths take place. The deaths are not only due to this factor but a host of diseases during pregnancy.
MP needs more medical colleges
View point - Central Chronicle, Bhopal, Feb 2, 2007
The government of Madhya Pradesh has launched many health schemes with a view to check maternal mortality but without much success. Vijay Raje Bima Yojna, taken up by the state government is unable to reach out to each and every woman of the state. The women who live near by towns and districts get medical benefits while women in far-flung areas are still deprived of the same. On the one hand, the government is promoting women for the institutional deliveries while hospitals at districts and tehsils are facing lack of infrastructure and medical staff on the other. There are only five medical colleges, which bring out a limited doctors against six crore people in Madhya Pradesh. Besides, the medical colleges also suffer from lack of medical teachers. The state government recently extended retiring age from 62 to 65 years for the medical teachers. But it cannot be deemed as permanent solution for the government and people. Students who go in for medical degrees opted-some of them-teaching profession while others become medical practitioners. The state needs more medical colleges to meet the health requirement of the people. However, the government has laid a foundation stone for the construction of a medical college at Sagar that will fulfill the medical need to some extent.
Although the state government has come up with a new idea yet it does not get 100% result, due to many impediments; they can be political, social and geographical. Death rate of women who die during prenatal and postnatal is partly because of poverty. Expectant mothers suffer from anemia and partly due to no hospitals in the vicinity.
However, child and women welfare department of state government has announced nutritious meals schemes to the rural expectant and nursing mothers as well as children of 3 to 6 years. They will be given puri, and mix veg, nutritious mathari, wheat soya barfi, laddus of suji and besan, upama of dal and vegetables, laddus of rice and besan, murmura and chana laddu. Besides, poha khamad, rice and dal chila, soya and rice chakki, chawal ka pura, chana chura and mungphali pati, nutritious poha, bajara-besan laddu, bajara mathrai, khasta vegetable curries and so on would be distributed as nutritious food on the basis of local food model to the beneficiaries on the pattern of mid-day meal in schools. It is moot question as to why women in European countries do not die, due to prenatal and postnatal complications? But India, the maternal mortality rate is so high that cannot be controlled only by agency of medical institutions. From the childhood, girls suffer from malnutrition and while reaching on threshold of adolescence and puberty, they become patients of anemia and at the same time they are married off. The pregnancy period becomes a battle field for them to fight between life and death.
The scheme launched by the government can prove as a short in the arm in health improvement movement if it is implemented by the ground level officials and workers.
The government has entrusted collectors to select the items as per protein and calorie quantity and the food grain would be supplied through self-help groups at local level. It is a drawback for the state government that it launches schemes but do not meet to the target, due to apathetic attitude by the field workers and officials.
Sunil Kumar
The government of Madhya Pradesh has launched many health schemes with a view to check maternal mortality but without much success. Vijay Raje Bima Yojna, taken up by the state government is unable to reach out to each and every woman of the state. The women who live near by towns and districts get medical benefits while women in far-flung areas are still deprived of the same. On the one hand, the government is promoting women for the institutional deliveries while hospitals at districts and tehsils are facing lack of infrastructure and medical staff on the other. There are only five medical colleges, which bring out a limited doctors against six crore people in Madhya Pradesh. Besides, the medical colleges also suffer from lack of medical teachers. The state government recently extended retiring age from 62 to 65 years for the medical teachers. But it cannot be deemed as permanent solution for the government and people. Students who go in for medical degrees opted-some of them-teaching profession while others become medical practitioners. The state needs more medical colleges to meet the health requirement of the people. However, the government has laid a foundation stone for the construction of a medical college at Sagar that will fulfill the medical need to some extent.
Although the state government has come up with a new idea yet it does not get 100% result, due to many impediments; they can be political, social and geographical. Death rate of women who die during prenatal and postnatal is partly because of poverty. Expectant mothers suffer from anemia and partly due to no hospitals in the vicinity.
However, child and women welfare department of state government has announced nutritious meals schemes to the rural expectant and nursing mothers as well as children of 3 to 6 years. They will be given puri, and mix veg, nutritious mathari, wheat soya barfi, laddus of suji and besan, upama of dal and vegetables, laddus of rice and besan, murmura and chana laddu. Besides, poha khamad, rice and dal chila, soya and rice chakki, chawal ka pura, chana chura and mungphali pati, nutritious poha, bajara-besan laddu, bajara mathrai, khasta vegetable curries and so on would be distributed as nutritious food on the basis of local food model to the beneficiaries on the pattern of mid-day meal in schools. It is moot question as to why women in European countries do not die, due to prenatal and postnatal complications? But India, the maternal mortality rate is so high that cannot be controlled only by agency of medical institutions. From the childhood, girls suffer from malnutrition and while reaching on threshold of adolescence and puberty, they become patients of anemia and at the same time they are married off. The pregnancy period becomes a battle field for them to fight between life and death.
The scheme launched by the government can prove as a short in the arm in health improvement movement if it is implemented by the ground level officials and workers.
The government has entrusted collectors to select the items as per protein and calorie quantity and the food grain would be supplied through self-help groups at local level. It is a drawback for the state government that it launches schemes but do not meet to the target, due to apathetic attitude by the field workers and officials.
Sunil Kumar
Govt Schemes : It is same old story
Sonia Khandelwal Indore, January 23, 2007
THE LOFTY schemes of Madhya Pradesh government for promoting institutional deliveries — for bringing down Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) — need a reality check at ground level as was highlighted by an incident in a village in Barwani district raising several questions about awareness and implementation of these schemes.s.
Twentyone-year-old Santoshi Raju from Rajpur was referred to the District Hospital at Barwani for delivery, from where she was referred to M Y Hospital here as her blood pressure had increased to a dangerous level. Then started her traumatic journey of running from pillar to post.
“At Barwani, they (the doctors) asked us either to fill a consent form for taking responsibility of complicated delivery (which could mean threat to the lives of either the mother or the child or both) at Barwani or take her to Indore,” Santoshi’s husband Raju, a labourer, told Hindustan Times at the post natal ward.
Not ready to take risk at Barwani, Raju asked Barwani Civil Surgeon Dr B K Sawner to provide him ambulance to take Santoshi to Indore. “But as we did not have Deendayal Antyoday Yojana card, the doctor did not agree for the ambulance,” Raju added.
However, Deendayal Yojana card is not required for ambulance service. Despite repeated requests when the hospital authorities did not agree, an Accredited Social Health Activist (ASHA) from Rajpur Sarika Gopal Mukesh, who had accompanied them to Barwani, suggested taking Santoshi back to Rajpur. By this time, Raju, whose family comes under BPL, was penniless and collected funds from donors to take Santoshi back to Rajpur.
Fortunately, the PHC there provided an ambulance and Santoshi was brought to MY Hospital here on time, where she delivered a girl late Thursday night.The incident has exposed the cracks in the system and brings out the true picture painted by the actual implementation of the various welfare schemes of the state government.
To start with, Sarika, an ASHA, did not have proper information about Janani Suraksha Yojana, wherein she is supposed to get Rs 600 for bringing any expectant mother to a health facility. Not just this one scheme, she was not aware of many other schemes.“I have not heard about Janani Suraksha Yojana but during our training, we were told only about our incentives and basic work. They (trainers) never told us about how to tackle serious situations and also about facilities available like ambulance service for taking expecting women to a health facility,” Sarika told Hindustan Times at MY Hospital here.
When asked why the family had no Deendayal Antyodaya Yojana card, Sarika further said, “Almost 50 per cent of the people in our village (Rajpur) do not have this card as on today. The cards are being prepared for a long time and hence not distributed.”
Higher medical officials do not want to take any responsibility and have been passing the buck when it came to pinning down the person responsible for such an incident. Barwani Chief Medical and Health Officer (CMHO) Dr Lakshmi Baghel, when contacted on telephone about the incident, said, “As far as I am concerned, we had organised fairs and programmes to create awareness about Janani Suraksha Yojana at all the villages under our jurisdiction. If the volunteers are still unaware about it, we will try to create more awareness about it.”
Dr Sawner when contacted over telephone first said “I had given permission for providing ambulance to Santoshi”, only to retract later saying “Santoshi was referred to Indore by Barwani District Hospital gynaecologist Dr Sushila Kumrawat. Santoshi’s relatives did not approach me for ambulance.”
The above incident raises several questions. Like inadequate training of ASHAs, no proper publicity about various schemes of the government amid the target group; officials not bothered about proper implementation of schemes and last but not the least lack of awareness on part of the individual (here both Santoshi and Raju are illiterate) about their rights and the facilities available for them.
Published in HT, Indore Jan 23, 2007
THE LOFTY schemes of Madhya Pradesh government for promoting institutional deliveries — for bringing down Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) — need a reality check at ground level as was highlighted by an incident in a village in Barwani district raising several questions about awareness and implementation of these schemes.s.
Twentyone-year-old Santoshi Raju from Rajpur was referred to the District Hospital at Barwani for delivery, from where she was referred to M Y Hospital here as her blood pressure had increased to a dangerous level. Then started her traumatic journey of running from pillar to post.
“At Barwani, they (the doctors) asked us either to fill a consent form for taking responsibility of complicated delivery (which could mean threat to the lives of either the mother or the child or both) at Barwani or take her to Indore,” Santoshi’s husband Raju, a labourer, told Hindustan Times at the post natal ward.
Not ready to take risk at Barwani, Raju asked Barwani Civil Surgeon Dr B K Sawner to provide him ambulance to take Santoshi to Indore. “But as we did not have Deendayal Antyoday Yojana card, the doctor did not agree for the ambulance,” Raju added.
However, Deendayal Yojana card is not required for ambulance service. Despite repeated requests when the hospital authorities did not agree, an Accredited Social Health Activist (ASHA) from Rajpur Sarika Gopal Mukesh, who had accompanied them to Barwani, suggested taking Santoshi back to Rajpur. By this time, Raju, whose family comes under BPL, was penniless and collected funds from donors to take Santoshi back to Rajpur.
Fortunately, the PHC there provided an ambulance and Santoshi was brought to MY Hospital here on time, where she delivered a girl late Thursday night.The incident has exposed the cracks in the system and brings out the true picture painted by the actual implementation of the various welfare schemes of the state government.
To start with, Sarika, an ASHA, did not have proper information about Janani Suraksha Yojana, wherein she is supposed to get Rs 600 for bringing any expectant mother to a health facility. Not just this one scheme, she was not aware of many other schemes.“I have not heard about Janani Suraksha Yojana but during our training, we were told only about our incentives and basic work. They (trainers) never told us about how to tackle serious situations and also about facilities available like ambulance service for taking expecting women to a health facility,” Sarika told Hindustan Times at MY Hospital here.
When asked why the family had no Deendayal Antyodaya Yojana card, Sarika further said, “Almost 50 per cent of the people in our village (Rajpur) do not have this card as on today. The cards are being prepared for a long time and hence not distributed.”
Higher medical officials do not want to take any responsibility and have been passing the buck when it came to pinning down the person responsible for such an incident. Barwani Chief Medical and Health Officer (CMHO) Dr Lakshmi Baghel, when contacted on telephone about the incident, said, “As far as I am concerned, we had organised fairs and programmes to create awareness about Janani Suraksha Yojana at all the villages under our jurisdiction. If the volunteers are still unaware about it, we will try to create more awareness about it.”
Dr Sawner when contacted over telephone first said “I had given permission for providing ambulance to Santoshi”, only to retract later saying “Santoshi was referred to Indore by Barwani District Hospital gynaecologist Dr Sushila Kumrawat. Santoshi’s relatives did not approach me for ambulance.”
The above incident raises several questions. Like inadequate training of ASHAs, no proper publicity about various schemes of the government amid the target group; officials not bothered about proper implementation of schemes and last but not the least lack of awareness on part of the individual (here both Santoshi and Raju are illiterate) about their rights and the facilities available for them.
Published in HT, Indore Jan 23, 2007
Saturday, January 27, 2007
Status of Women in India
Chronic Hunger and the Status of Women in India
Females receive less health care than males. Many women die in childbirth of easily prevented complications. Working conditions and environmental pollution further impairs women's health...This article is listed on blog
www.womenidentity.blogspot.com, do visit the same for further reading..
Females receive less health care than males. Many women die in childbirth of easily prevented complications. Working conditions and environmental pollution further impairs women's health...This article is listed on blog
www.womenidentity.blogspot.com, do visit the same for further reading..
Friday, January 26, 2007
Letter to the Chief Minister
Column in newspaper
by Anil Gulati
'Our family is not listed in below the poverty line list, they say we will have to pay, please help' wrote a needy person from Satna in the state of Madhya Pradesh, in central part of India to the Chief Minister of the state. 'My village has a health centre but it remains closed and we have to suffer' wrote another women from a village in the state. These are letters written directly by individuals or some times by groups of individuals and addressed to the Chief Minister, the highest political head of the state. It is like exercising their democratic right to approach the higher authorities with demand and appeal for justice.
Though they are written directly to the Chief Minister of the Madhya Pradesh but are not routed through his offices and normal channels of bureaucracy rather are written to the 'Editors' of the newspapers. The reason is simple.
In the state of Madhya Pradesh two Hindi newspapers namely Dainik Jagran and Raj Express offer a unique opportunity to their readers or people of the state. They have an additional column on their edit page which is titled as Letter to The Chief Minister. They call it by different names: one calls it 'Letter to Mr. Chief Minister or lately they have named it as 'Yes Chief Minister' and other one says 'Paati Mukhayamantri ke naam'. One used photograph of the Chief Minister at the head of the column while another uses his caricature or sometimes these go without photograph.
Both offer an opportunity for people voice to be heard. You can write directly to the Chief Minister about your problem or an issue. Rather than coming to state capital and trying to meet him, this is an alternative way to approach him - by writing to these newspapers for covering an issue in their column.
If one looks at kind of the letters which appear in print, they are diverse in nature. I am not sure how many are received by them and how many are published? But if one analyzes them a few inferences can be drawn. The issues they raise are diverse, letters are normally written by individuals or sometimes by groups of individuals, and they come from various parts of the state, including interiors villages of the state. At present this is a feature which appears twice or thrice a week or whenever they receive a letter.
If one does a dip stick assessment of the content it reveals that issues of education, problems of state government employees, salaries, unavailability of water, electricity, roads, non accessibility of schemes initiated by the state, maternal deaths, the failure and weaknesses of the health system, and the issue of eve teasing appear more frequently and now transfers, corruption cases are also being received and published. Perhaps these are issues which impact people directly. Regarding education, issues such as lack of building, teacher absenteeism, and vacant positions do come up quite often in these letters. One does not know many of them are being responded to.
One of the roles of media is to provide an opportunity for voices of the communities to be heard, and giving vent to the opinions and views of people. Many possible options are available; letters to editor is one of them. One can use it to raise an issue which was in media or express your opinion on the story, or even to highlight issues which may have got missed in regular reporting.
But when you feel strongly about an issue or have an unresolved problem, you may feel the need to draw the attention of the Chief Minister, who is supposed to be the highest in the rank of the elected representatives. This is one such opportunity to do so. There is some indication that people find this way as an easier way to reach eyes of the Chief Minster. The Department of Public Relations which does media tracking for the state does track many of them and the same is evident from their website, wherein they scan and display the press cuttings tracked by them, indicating that at least some people get a bit of say in the system, with the help of media. May be this needs to increase and others need to catch on...
IANS News of Jan 22, 2007
by Anil Gulati
'Our family is not listed in below the poverty line list, they say we will have to pay, please help' wrote a needy person from Satna in the state of Madhya Pradesh, in central part of India to the Chief Minister of the state. 'My village has a health centre but it remains closed and we have to suffer' wrote another women from a village in the state. These are letters written directly by individuals or some times by groups of individuals and addressed to the Chief Minister, the highest political head of the state. It is like exercising their democratic right to approach the higher authorities with demand and appeal for justice.
Though they are written directly to the Chief Minister of the Madhya Pradesh but are not routed through his offices and normal channels of bureaucracy rather are written to the 'Editors' of the newspapers. The reason is simple.
In the state of Madhya Pradesh two Hindi newspapers namely Dainik Jagran and Raj Express offer a unique opportunity to their readers or people of the state. They have an additional column on their edit page which is titled as Letter to The Chief Minister. They call it by different names: one calls it 'Letter to Mr. Chief Minister or lately they have named it as 'Yes Chief Minister' and other one says 'Paati Mukhayamantri ke naam'. One used photograph of the Chief Minister at the head of the column while another uses his caricature or sometimes these go without photograph.
Both offer an opportunity for people voice to be heard. You can write directly to the Chief Minister about your problem or an issue. Rather than coming to state capital and trying to meet him, this is an alternative way to approach him - by writing to these newspapers for covering an issue in their column.
If one looks at kind of the letters which appear in print, they are diverse in nature. I am not sure how many are received by them and how many are published? But if one analyzes them a few inferences can be drawn. The issues they raise are diverse, letters are normally written by individuals or sometimes by groups of individuals, and they come from various parts of the state, including interiors villages of the state. At present this is a feature which appears twice or thrice a week or whenever they receive a letter.
If one does a dip stick assessment of the content it reveals that issues of education, problems of state government employees, salaries, unavailability of water, electricity, roads, non accessibility of schemes initiated by the state, maternal deaths, the failure and weaknesses of the health system, and the issue of eve teasing appear more frequently and now transfers, corruption cases are also being received and published. Perhaps these are issues which impact people directly. Regarding education, issues such as lack of building, teacher absenteeism, and vacant positions do come up quite often in these letters. One does not know many of them are being responded to.
One of the roles of media is to provide an opportunity for voices of the communities to be heard, and giving vent to the opinions and views of people. Many possible options are available; letters to editor is one of them. One can use it to raise an issue which was in media or express your opinion on the story, or even to highlight issues which may have got missed in regular reporting.
But when you feel strongly about an issue or have an unresolved problem, you may feel the need to draw the attention of the Chief Minister, who is supposed to be the highest in the rank of the elected representatives. This is one such opportunity to do so. There is some indication that people find this way as an easier way to reach eyes of the Chief Minster. The Department of Public Relations which does media tracking for the state does track many of them and the same is evident from their website, wherein they scan and display the press cuttings tracked by them, indicating that at least some people get a bit of say in the system, with the help of media. May be this needs to increase and others need to catch on...
IANS News of Jan 22, 2007
Thursday, January 25, 2007
No barat for last twenty years !
Agencies
Katrol, (Bhind), Jan 25: It is a scene more heart-rending than the Nithari visuals when a mother is compelled to murder her female infant by placing a charpoy's leg on the child's neck.
This is the brutal method adopted for several decades in hundreds of villages in Madhya Pradesh's Bhind, Morena and a few neighbouring districts where the desire for male offspring is simply overwhelming.
Nithari has only two known accused, but the hundreds of offenders in these districts are parents themselves even as the sonography machine has assumed a satanic role and female foeticide is a thriving business.
During a just-concluded tour organised by the Press Information Bureau, a team of journalists learnt that such crime--that beats even medieval-era cruelty--has assumed the dimensions of a social evil and as a direct consequence the gender balance in Morena and Bhind has taken a body blow.
In some villages of Morena, there are as few as 400 to 700 females for every 1,000 males. No 'barat' (bridegroom's procession) has entered a few villages for 20 years.
The political system and administrative machinery have their own perception of this burning problem. Careful about their votebanks, political leaders fight shy of saying or doing anything against the menace while the officialdom hesitates to take any open initiative as it considers the mass slaughter a ''social'' issue.
While admitting the grave nature of the killings, Morena's District Collector Akash Tripathi says, ''an April-December 2006 survey conducted in the district painted a startling picture about the gender balance in some blocks. If conditions do not improve, girls will be on the brink of extinction in a few villages.''
The bureaucrat quotes the 2001 Census figures that clearly reveal a population increase but the district's gender balance is declining. It is 822:1,000 as compared to the state's 920:1,000 and the national ratio 933:1,000.
''At the initiative of Chambal's Divisional Commissioner Ajit Kesri, a meeting recently worked out a multipronged strategy to stamp out the evil in Morena, Bhind, Sheopur and Shivpuri districts.
Besides a key role by voluntary organisations, assistance will be sought from religious leaders as 'Bhagwat Katha' and other religious events are conducted round the year in Morena,'' Mr Tripathi adds.
At these events, men of religion would raise their voices against female foeticide and infanticide. Ms Rajkumari Sharma, who is associated with the voluntary organisation 'Sambhav' that is toiling in Bhind's Gurikha village panchayat and surrounding villages, laments that--despite all the effort--the picture has not brightened.
''I know of a family where six female infants were murdered one after the other,'' she reveals while her eyes reveal sorrow.
In Chambal region's rural areas, such infanticide is openly admitted. ''At a village in Bhind district, a fearful mother braved post-delivery weakness and other complications to hide in a hayloft, without food and water, for two days along with her infant daughter,'' reveals Ms Sharma.
The woman's father and brother reached the place and assured her in-laws that they would bear the expense of the daughter's upbringing and marriage. The mother-daughter duo emerged from the hayloft but the infant was slain just a few hours later. Chambal region's Morena and Bhind districts are famed for mustard cultivation and Morena is known as the ''mustard capital'' of Madhya Pradesh but ironically, the prosperity ensured by such cultivation has further fuelled gender imbalance and the craving for male offspring.
Sociologists believe that it has become the region's undeclared tradition to have more boys for maintaining social standing in the face of the dowry evil.
''Sonography kits, doctors and technicians access remote villages in vehicles. If a male foetus is detected, they say 'gulab ka phool' (a rose is blooming) or 'thali bajao' (celebrate). The number of sonography centres in Morena is one-and-a-half times the number of nursing homes,'' says Mr Devendra of the voluntary organisation Dharti that is battling female foeticide in Morena for decades. In Bhind district's Katrol village, this correspondent was stunned when a nine-year-old boy divulged that, soon after his sister was born, his father stuffed tobacco into her mouth and then strangled her.
After a girl is killed, the chant of ''Lali ladki tu ja aur lala ladka ko le aa (go away girl and let a boy come instead) seems to tell a brutal story in a nutshell.
Katrol, (Bhind), Jan 25: It is a scene more heart-rending than the Nithari visuals when a mother is compelled to murder her female infant by placing a charpoy's leg on the child's neck.
This is the brutal method adopted for several decades in hundreds of villages in Madhya Pradesh's Bhind, Morena and a few neighbouring districts where the desire for male offspring is simply overwhelming.
Nithari has only two known accused, but the hundreds of offenders in these districts are parents themselves even as the sonography machine has assumed a satanic role and female foeticide is a thriving business.
During a just-concluded tour organised by the Press Information Bureau, a team of journalists learnt that such crime--that beats even medieval-era cruelty--has assumed the dimensions of a social evil and as a direct consequence the gender balance in Morena and Bhind has taken a body blow.
In some villages of Morena, there are as few as 400 to 700 females for every 1,000 males. No 'barat' (bridegroom's procession) has entered a few villages for 20 years.
The political system and administrative machinery have their own perception of this burning problem. Careful about their votebanks, political leaders fight shy of saying or doing anything against the menace while the officialdom hesitates to take any open initiative as it considers the mass slaughter a ''social'' issue.
While admitting the grave nature of the killings, Morena's District Collector Akash Tripathi says, ''an April-December 2006 survey conducted in the district painted a startling picture about the gender balance in some blocks. If conditions do not improve, girls will be on the brink of extinction in a few villages.''
The bureaucrat quotes the 2001 Census figures that clearly reveal a population increase but the district's gender balance is declining. It is 822:1,000 as compared to the state's 920:1,000 and the national ratio 933:1,000.
''At the initiative of Chambal's Divisional Commissioner Ajit Kesri, a meeting recently worked out a multipronged strategy to stamp out the evil in Morena, Bhind, Sheopur and Shivpuri districts.
Besides a key role by voluntary organisations, assistance will be sought from religious leaders as 'Bhagwat Katha' and other religious events are conducted round the year in Morena,'' Mr Tripathi adds.
At these events, men of religion would raise their voices against female foeticide and infanticide. Ms Rajkumari Sharma, who is associated with the voluntary organisation 'Sambhav' that is toiling in Bhind's Gurikha village panchayat and surrounding villages, laments that--despite all the effort--the picture has not brightened.
''I know of a family where six female infants were murdered one after the other,'' she reveals while her eyes reveal sorrow.
In Chambal region's rural areas, such infanticide is openly admitted. ''At a village in Bhind district, a fearful mother braved post-delivery weakness and other complications to hide in a hayloft, without food and water, for two days along with her infant daughter,'' reveals Ms Sharma.
The woman's father and brother reached the place and assured her in-laws that they would bear the expense of the daughter's upbringing and marriage. The mother-daughter duo emerged from the hayloft but the infant was slain just a few hours later. Chambal region's Morena and Bhind districts are famed for mustard cultivation and Morena is known as the ''mustard capital'' of Madhya Pradesh but ironically, the prosperity ensured by such cultivation has further fuelled gender imbalance and the craving for male offspring.
Sociologists believe that it has become the region's undeclared tradition to have more boys for maintaining social standing in the face of the dowry evil.
''Sonography kits, doctors and technicians access remote villages in vehicles. If a male foetus is detected, they say 'gulab ka phool' (a rose is blooming) or 'thali bajao' (celebrate). The number of sonography centres in Morena is one-and-a-half times the number of nursing homes,'' says Mr Devendra of the voluntary organisation Dharti that is battling female foeticide in Morena for decades. In Bhind district's Katrol village, this correspondent was stunned when a nine-year-old boy divulged that, soon after his sister was born, his father stuffed tobacco into her mouth and then strangled her.
After a girl is killed, the chant of ''Lali ladki tu ja aur lala ladka ko le aa (go away girl and let a boy come instead) seems to tell a brutal story in a nutshell.
Friday, January 19, 2007
Child dies due to lack of medical treatment in district hospital Sheopur
Sunita Bai, a Harjan woman of Banikhera village in Sheopur district in State of Madhya Pradesh lost her child immediately after birth. Her husband and other community members say that hospital has inadequate facilities and treatment was not given to the child and the mother after delivery. Both Sunita Bai and her child had developed some complications but were denied adequate medical facilities at the district hospital. She lost her child. Her husband has given a written complaint to the Collector. Media reports challenge the state institutional delivery mantra of the state if state does not have the available infrastructure to save lives of women and children.
Adapted from media report published in Nai Dunia dated January 16, 2007
Adapted from media report published in Nai Dunia dated January 16, 2007
All expectant mothers in Govt hospitals to get Janani Suraksha Yojna benefits
The Pioneer, January 20, Bhopal
All expectant mothers getting admission for deliveries in State Government hospitals general wards would get the benefit of the Janani Suraksha Yojna. The provision was made as per the directives of the Union Government. Also, increase has been made in the amount given to the beneficiaries in order to encourage institutional deliveries. The expectant mothers of the rural areas will now get Rs 1,400 in place of Rs 700. Similarly Rs 1,000 will be paid to the expectant mothers in the urban areas. Moreover, an amount of Rs 600 and Rs 200 is being paid to the person encouraging institutional deliveries of rural and urban area respectively.
The Janani suraksha yojna was implemented in the State on August 15, 2005. A total of 2,64,656 women has been benefited under the scheme so far. It has been noticed that after the amendment in the scheme to encourage institutional deliveries, the number of the women getting benefited is increasing day by day. It may be mentioned that in order to extend benefit of the scheme to the maximum women, many rules have been relaxed including exemption from the age limit as well as children limit.
All expectant mothers getting admission for deliveries in State Government hospitals general wards would get the benefit of the Janani Suraksha Yojna. The provision was made as per the directives of the Union Government. Also, increase has been made in the amount given to the beneficiaries in order to encourage institutional deliveries. The expectant mothers of the rural areas will now get Rs 1,400 in place of Rs 700. Similarly Rs 1,000 will be paid to the expectant mothers in the urban areas. Moreover, an amount of Rs 600 and Rs 200 is being paid to the person encouraging institutional deliveries of rural and urban area respectively.
The Janani suraksha yojna was implemented in the State on August 15, 2005. A total of 2,64,656 women has been benefited under the scheme so far. It has been noticed that after the amendment in the scheme to encourage institutional deliveries, the number of the women getting benefited is increasing day by day. It may be mentioned that in order to extend benefit of the scheme to the maximum women, many rules have been relaxed including exemption from the age limit as well as children limit.
False claims under JSY coming in the state capital
Janani Suraksha Yojana was started in the state to promote institutional delivery wherein the pregnant women from rural areas gets Rs 1400.00 as an incentive while motivators get Rs 600.00 as an incentive. State Capital Jai Prakash Hospital had noticed cases of fals claims by motivators, who actually are not even living in the same area. These are WCD/ health workers. They normally come for claim after the women has been discharged with the certificate. Dr D.K. Verma Medical Superintendent while speaking to media accepted that such cases had come in but he added they are now getting lesser and we normally send them back.
Hindi story in Raj Express, January 19, 2007
Hindi story in Raj Express, January 19, 2007
Thursday, January 18, 2007
Promoting safemotherhood
Rally by Church of North India volunteers to create awareness on the issue of maternal mortality and promote safe motherhood in villages of Mandleswar, Madhya Pradesh
Wednesday, January 17, 2007
Mobile health scheme to cover another 80 blocks
Staff Reporter Bhopal
Mobile health clinics launched this year to provide medical facilities in far flung tribal areas in Madhya Pradesh have so far treated 2.53 lakh patients. After considering the success of the clinics, the State Government is extending the mobile health clinic scheme in another 80 blocks of the State. The Health Department has invited tenders for mobile health clinics.
Besides medical checkup, treatment facilities, medicines free of cost were provided to the beneficiaries. As many 150 patients are undergoing medical check up daily under the Deendayal Mobile Health Clinic Scheme.
At present, Mobile Health Clinics facility is being provided in eleven tribal blocks of the State. These blocks include Bhimpur (Betul), Karahal (Sheopur), Mawai (Mandla), Sondwa (Jhabua), Bajag (Dindori), Budhar (Shahdol), Pushprajgarh (Anuppur), Virsa (Balaghat), Pali (Umariya), Kundam (Jabalpur) and Kusumi (Sidhi). Sofar, 8 thousand 500 expectent mothers have been benefited under the scheme in these blocks.
Mobile health clinics launched this year to provide medical facilities in far flung tribal areas in Madhya Pradesh have so far treated 2.53 lakh patients. After considering the success of the clinics, the State Government is extending the mobile health clinic scheme in another 80 blocks of the State. The Health Department has invited tenders for mobile health clinics.
Besides medical checkup, treatment facilities, medicines free of cost were provided to the beneficiaries. As many 150 patients are undergoing medical check up daily under the Deendayal Mobile Health Clinic Scheme.
At present, Mobile Health Clinics facility is being provided in eleven tribal blocks of the State. These blocks include Bhimpur (Betul), Karahal (Sheopur), Mawai (Mandla), Sondwa (Jhabua), Bajag (Dindori), Budhar (Shahdol), Pushprajgarh (Anuppur), Virsa (Balaghat), Pali (Umariya), Kundam (Jabalpur) and Kusumi (Sidhi). Sofar, 8 thousand 500 expectent mothers have been benefited under the scheme in these blocks.
Rusted equipments in labour room
Photograph of rusted equipments in district hospital of Betul (Madhya Pradesh) in a room where deliveries are done....Saturday, January 13, 2007
Shortage of equipments in labour room in Sultania hospital in state capital
By Rani Sharma. Dainik Bhaskar, Bhopal, January 13, 2007
Sultania ladies hospital was provided with funds to the tune of Rupees fifty lakhs to provide for new fully equipped labour room. Though the new room has been constructed but lacks basic equipments and is non functional. Under RCH II scheme new model labour rooms was sanctioned in Aug 2005 for the five medical colleges and funds had been allocated to the tune of crores (app 2.5 crores). But still labour room at the hospital in the state capital is not functioning.
The new labour room needs to have 2 ventilators, 5 cardiac monitor, 2 ECG machines, 1 defibrillator, pulse oxymeter and delivery table. Sulatnia hospital does not have neo –natalogy care unit. The children in case of need are referred to Kamla Nehru Hospital. M.M. Upadhyaya Principal Secretary Health & Family Welfare of Government of Madhya Pradesh, when contacted said that he was not aware of the situation said he will try and see to to that it could be started immediately.
(Adpated from hindi news in Dainik Bhaskar, Bhopal, January 13, 2007)
Sultania ladies hospital was provided with funds to the tune of Rupees fifty lakhs to provide for new fully equipped labour room. Though the new room has been constructed but lacks basic equipments and is non functional. Under RCH II scheme new model labour rooms was sanctioned in Aug 2005 for the five medical colleges and funds had been allocated to the tune of crores (app 2.5 crores). But still labour room at the hospital in the state capital is not functioning.
The new labour room needs to have 2 ventilators, 5 cardiac monitor, 2 ECG machines, 1 defibrillator, pulse oxymeter and delivery table. Sulatnia hospital does not have neo –natalogy care unit. The children in case of need are referred to Kamla Nehru Hospital. M.M. Upadhyaya Principal Secretary Health & Family Welfare of Government of Madhya Pradesh, when contacted said that he was not aware of the situation said he will try and see to to that it could be started immediately.
(Adpated from hindi news in Dainik Bhaskar, Bhopal, January 13, 2007)
Thursday, January 11, 2007
where are the doctors to implement state schemes
Dainik Jagran, Bhopal, January 12, 2007
State has various schemes to promote safe motherhood but to implement thoose, state suffers with shortage of medical doctors. In order to compensate the same state's health department had announced a scheme of ‘contract doctors’ wherein they are paid Rupees eighteen thousand as monthly salary and Rupees ten thousand as an incentive. But still health department is unable to recruit many.
Condition at the primary health centres and community health centres near the state capital is pathetic, what does one say about health centers, in far flung areas of the state which is widely spread. Media report in Dainik Jagran quotes example of community health centre Berasia wherein medical doctor was recruited more than a year back but with hardly any facility medical doctor could not do much and was on leave for most of the period, finally was removed. Issues like no operation centre, poor infrastructure, impacts heavily on the state run schemes.
adapted from hindi news in dainik jagran, bhopal edition, page 2
State has various schemes to promote safe motherhood but to implement thoose, state suffers with shortage of medical doctors. In order to compensate the same state's health department had announced a scheme of ‘contract doctors’ wherein they are paid Rupees eighteen thousand as monthly salary and Rupees ten thousand as an incentive. But still health department is unable to recruit many.
Condition at the primary health centres and community health centres near the state capital is pathetic, what does one say about health centers, in far flung areas of the state which is widely spread. Media report in Dainik Jagran quotes example of community health centre Berasia wherein medical doctor was recruited more than a year back but with hardly any facility medical doctor could not do much and was on leave for most of the period, finally was removed. Issues like no operation centre, poor infrastructure, impacts heavily on the state run schemes.
adapted from hindi news in dainik jagran, bhopal edition, page 2
90% health centres have no labour room
Vikram Jethwani Bhopal
It may sound shocking but the residents of Madhya Pradesh have to stomach the hard fact that 90 per cent community health centres (CHCs) of the State are not equipped with basic infrastructure to deliver a child.
And thus, the State maintains its dubious distinction of having the highest Maternal Mortality Rates (MMR) in the country, with death of a pregnant woman every 40 minutes.
The fact is supported by a study undertaken by Reproductive and Child Healthcare (RCH) programme between 1997 and 2004. As per the study, meagrely 31 primary health centres (PHC) have labour rooms while the State has a total of 285 CHCs across 48 districts.
The gravity of the situation could be gauged by the fact that there does not exists the basic need of a labour room, while according to the norms laid down for institutional delivery there should be a well-equipped 5-bed labour room with availability of oxygen cylinder, OT table, operation kit and a power generator. The condition in the rural areas is worse. Governmental healthcare facilities are not available in most of the areas, health department sources said. President of Madhya Pradesh State Health Workers Association LN Sharma, who supervises health facilities in the rural areas, said, "The ground realities are pathetic and we need a holistic approach to address this issue directly." Ironically, the condition at Primary Health Centres (PHCs) could be perceived a bit better as about 196 PHCs from the total of 1,152 such centres have labour rooms. State Health Minister Ajay Vishnoi and Health Commissioner Rajesh Rajora could not be contacted.
However, chief medical and health officer of Bhopal BS Ohri told The Pioneer, "Conditions at Bhopal district have improved and both CHCs of Bhopal at Berasia and Gandhi Nagar are well-equipped. The concept of Comprehensive Emergency Obstetric and Neonatal care unit (CMOCs) also has been doing well and Bhopal recorded a rise of 3,497 institutional delivery to the total number of 17,086 in year 2006, from 13,589 of year 2005.
Earlier, The Pioneer on January 10 had published a report, on eight pregnant women namely Newabai (28), Padwawati (22) of Lakhanwara, Radhabai (25) of Kuthla, Rinki Kewat (22) of Badari, Guddibai, Raddhobai, Meena and Shashi of Badwara of Ashok Nagar and Katni districts respectively, who had to lost their lives in absence of healthcare facilities.
It may sound shocking but the residents of Madhya Pradesh have to stomach the hard fact that 90 per cent community health centres (CHCs) of the State are not equipped with basic infrastructure to deliver a child.
And thus, the State maintains its dubious distinction of having the highest Maternal Mortality Rates (MMR) in the country, with death of a pregnant woman every 40 minutes.
The fact is supported by a study undertaken by Reproductive and Child Healthcare (RCH) programme between 1997 and 2004. As per the study, meagrely 31 primary health centres (PHC) have labour rooms while the State has a total of 285 CHCs across 48 districts.
The gravity of the situation could be gauged by the fact that there does not exists the basic need of a labour room, while according to the norms laid down for institutional delivery there should be a well-equipped 5-bed labour room with availability of oxygen cylinder, OT table, operation kit and a power generator. The condition in the rural areas is worse. Governmental healthcare facilities are not available in most of the areas, health department sources said. President of Madhya Pradesh State Health Workers Association LN Sharma, who supervises health facilities in the rural areas, said, "The ground realities are pathetic and we need a holistic approach to address this issue directly." Ironically, the condition at Primary Health Centres (PHCs) could be perceived a bit better as about 196 PHCs from the total of 1,152 such centres have labour rooms. State Health Minister Ajay Vishnoi and Health Commissioner Rajesh Rajora could not be contacted.
However, chief medical and health officer of Bhopal BS Ohri told The Pioneer, "Conditions at Bhopal district have improved and both CHCs of Bhopal at Berasia and Gandhi Nagar are well-equipped. The concept of Comprehensive Emergency Obstetric and Neonatal care unit (CMOCs) also has been doing well and Bhopal recorded a rise of 3,497 institutional delivery to the total number of 17,086 in year 2006, from 13,589 of year 2005.
Earlier, The Pioneer on January 10 had published a report, on eight pregnant women namely Newabai (28), Padwawati (22) of Lakhanwara, Radhabai (25) of Kuthla, Rinki Kewat (22) of Badari, Guddibai, Raddhobai, Meena and Shashi of Badwara of Ashok Nagar and Katni districts respectively, who had to lost their lives in absence of healthcare facilities.
Health Centre slams doors on Saharias
HT CorrespondentGwalior, January 10, 2007
THE DOORS of Chanderi Community Health Centre (CHC) in Ashok Nagar district have been allegedly closed on the Saharia tribals of Nidanpur village. Reason? The tribals had dared to complain against the block medical officer.
The Saharias of Nidanpur, 20 km from Chanderi block, had, on December 2 last, alleged that the death of a woman Neba Bai was caused by the negligence of BMO Dr R P Sharma and other staff.
However, Dr Sharma has denied the allegation and said it was his professional duty to treat patients. About charges regarding negligence, he said the police were investigating the case and the truth would come out soon. According to Neba Bai’s husband Kapoora, she was admitted to Chanderi CHC on November 17 in an advanced stage of pregnancy. She was administered glucose intravenous. However, after sometime, when the bottle emptied, blood started entering the bottle from Neba Bai and no hospital staff was on hand to attend to her. The attendant of another patient removed the needle from the woman’s wrist to stop the bleeding. But she died the next day. Later, Kapoora, with the help of village Sarpanch and local non-governmental organisations, lodged a complaint with Police.
The postmortem report termed the death as due to ‘natural’ causes. The villagers allege that after their complaint, the doctors have been refusing to treat Saharia patients of Nidanpur on one pretext or the other, which resulted in the death of another woman Phool Kunwar, wife of Udham Singh, on December 27. Phool Kunwar was also pregnant and was taken to Chanderi CHC on December 26 from where she was referred to Ashok Nagar hospital.
Village Sarpanch Saindpal Singh Bundela said that Saharia patients of village were not treated in the health centre. Social workers Rajesh Kumar and Asma Parveen said that auxiliary nurse midwife (ANM) did not attend to Phool Kunwar during pregnancy. They also accused Dr Sharma of refusing to take in patients of Nidanpur village and misbehaving with social workers. The villagers have complained in this connection to the district Collector besides sending a complaint to the Chief Minister by fax.
THE DOORS of Chanderi Community Health Centre (CHC) in Ashok Nagar district have been allegedly closed on the Saharia tribals of Nidanpur village. Reason? The tribals had dared to complain against the block medical officer.
The Saharias of Nidanpur, 20 km from Chanderi block, had, on December 2 last, alleged that the death of a woman Neba Bai was caused by the negligence of BMO Dr R P Sharma and other staff.
However, Dr Sharma has denied the allegation and said it was his professional duty to treat patients. About charges regarding negligence, he said the police were investigating the case and the truth would come out soon. According to Neba Bai’s husband Kapoora, she was admitted to Chanderi CHC on November 17 in an advanced stage of pregnancy. She was administered glucose intravenous. However, after sometime, when the bottle emptied, blood started entering the bottle from Neba Bai and no hospital staff was on hand to attend to her. The attendant of another patient removed the needle from the woman’s wrist to stop the bleeding. But she died the next day. Later, Kapoora, with the help of village Sarpanch and local non-governmental organisations, lodged a complaint with Police.
The postmortem report termed the death as due to ‘natural’ causes. The villagers allege that after their complaint, the doctors have been refusing to treat Saharia patients of Nidanpur on one pretext or the other, which resulted in the death of another woman Phool Kunwar, wife of Udham Singh, on December 27. Phool Kunwar was also pregnant and was taken to Chanderi CHC on December 26 from where she was referred to Ashok Nagar hospital.
Village Sarpanch Saindpal Singh Bundela said that Saharia patients of village were not treated in the health centre. Social workers Rajesh Kumar and Asma Parveen said that auxiliary nurse midwife (ANM) did not attend to Phool Kunwar during pregnancy. They also accused Dr Sharma of refusing to take in patients of Nidanpur village and misbehaving with social workers. The villagers have complained in this connection to the district Collector besides sending a complaint to the Chief Minister by fax.
Wednesday, January 10, 2007
Pregnant woman dies due to negligence
Pioneer, Jan 11, 2007
In a shivering incident, a pregnant woman lost her life in a Government hospital of Ashoknagar district due to absence of healthcare staff during emergency. Nevabai, a tribal resident of Chanderi block of the district, was admitted to the hospital under the Institutional Delivery Scheme of the State Government.
The doctor on duty after examining Nevabai directed the nurse to transfuse a bottle of blood to the lady. After a few minutes, Nevabai's condition worsened as the bottle passed air in her vein. The perturbed woman, in absence of any caretaker went unconscious and continued loosing blood till the nurse saw her at 5 pm, her husband Kapura told.
After severely loosing blood, Nevabai succumbed the next day at 6 pm. Non-Governmental sources informed they have witnessed as many as seven pregnant women lose their lives in the past 30 days at Katni district hospital due to the negligence of doctors and nurses.
Padwawati (22) of Lakhanwara, Radhabai (25) of Kuthla, Rinki Kewat (22) of Badari, Guddibai, Raddhobai, Meena and Shashi of Badwara of the district are few of the victims who instead of receiving benefits of institutional delivery had to lost their lives.
In a shivering incident, a pregnant woman lost her life in a Government hospital of Ashoknagar district due to absence of healthcare staff during emergency. Nevabai, a tribal resident of Chanderi block of the district, was admitted to the hospital under the Institutional Delivery Scheme of the State Government.
The doctor on duty after examining Nevabai directed the nurse to transfuse a bottle of blood to the lady. After a few minutes, Nevabai's condition worsened as the bottle passed air in her vein. The perturbed woman, in absence of any caretaker went unconscious and continued loosing blood till the nurse saw her at 5 pm, her husband Kapura told.
After severely loosing blood, Nevabai succumbed the next day at 6 pm. Non-Governmental sources informed they have witnessed as many as seven pregnant women lose their lives in the past 30 days at Katni district hospital due to the negligence of doctors and nurses.
Padwawati (22) of Lakhanwara, Radhabai (25) of Kuthla, Rinki Kewat (22) of Badari, Guddibai, Raddhobai, Meena and Shashi of Badwara of the district are few of the victims who instead of receiving benefits of institutional delivery had to lost their lives.
Monday, January 08, 2007
Madhya Pradesh lacks medical staff
Central Chronicle, Bhopal, January 9, 2007
The state government has launched number of health schemes on the trot with a view to reduce the high mortalities rates of women and child in Madhya Pradesh. But it did not get desired results due to many reasons.
The schemes are depend upon the ground level people who are entrusted to implement the same. Feedback of Vijay Raje Bima Yojna-in which Rs upto 2,400 are given to the beneficiaries of below poverty line for undergoing institutional deliveries-has been satisfactory to some extent but women of the remotest and those who have no BPL cards are being deprived of the schemes. Before going to start any health schemes, the state government should mull over infrastructure whether it is available or not at last unit of democracy set up.
The rural people depend on district hospitals but the unruly behaviors of staff members of the hospital add more to the misery of the patients. However, state government says that it is committed to improving health sector but seems to be failed, due to lack of adequate medical staff at tehsil and district level hospital. The women, who live to the adjacent of the town and district, have access to get hospital treatments while others perform their deliveries at home at high risk.
Sunil Kumar, Bhopal
The state government has launched number of health schemes on the trot with a view to reduce the high mortalities rates of women and child in Madhya Pradesh. But it did not get desired results due to many reasons.
The schemes are depend upon the ground level people who are entrusted to implement the same. Feedback of Vijay Raje Bima Yojna-in which Rs upto 2,400 are given to the beneficiaries of below poverty line for undergoing institutional deliveries-has been satisfactory to some extent but women of the remotest and those who have no BPL cards are being deprived of the schemes. Before going to start any health schemes, the state government should mull over infrastructure whether it is available or not at last unit of democracy set up.
The rural people depend on district hospitals but the unruly behaviors of staff members of the hospital add more to the misery of the patients. However, state government says that it is committed to improving health sector but seems to be failed, due to lack of adequate medical staff at tehsil and district level hospital. The women, who live to the adjacent of the town and district, have access to get hospital treatments while others perform their deliveries at home at high risk.
Sunil Kumar, Bhopal
Tribal still survive on food cooked from grass
Nai Dunia, Bhopal, jan 8, 2007
by Aarti Pandey
An op-ed in hindi vernacular Nai Dunai in Bhopal challenges political leadership and state’s claim of implementation of various schemes in the state of Madhya Pradesh for benefit of women and children. This op-ed speaks about village Taka in the district Tikamgarh of the state wherein tribal’s till today have to survive on chapattis cooked after grinding seeds of samai (grass seeds). It speaks of pathetic situation of tribal’s in the state. Though state has had many schemes for benefit of people but this op-ed challenges them .This includes state’s bal sanjvini scheme for combating malnutrition among children, national rural health management, national employment rural guarantee schemes. It relates the situation of women and children when hundreds of years ago Maharana Pratap went into hiding and had to eat chapattis cooked of grass and this is true in this century too.
Aarti is the media fellow of Makhanlal National University of Journalism, Bhopal.
(This is adapted shorter version in english of the full article in hindi.)
by Aarti Pandey
An op-ed in hindi vernacular Nai Dunai in Bhopal challenges political leadership and state’s claim of implementation of various schemes in the state of Madhya Pradesh for benefit of women and children. This op-ed speaks about village Taka in the district Tikamgarh of the state wherein tribal’s till today have to survive on chapattis cooked after grinding seeds of samai (grass seeds). It speaks of pathetic situation of tribal’s in the state. Though state has had many schemes for benefit of people but this op-ed challenges them .This includes state’s bal sanjvini scheme for combating malnutrition among children, national rural health management, national employment rural guarantee schemes. It relates the situation of women and children when hundreds of years ago Maharana Pratap went into hiding and had to eat chapattis cooked of grass and this is true in this century too.
Aarti is the media fellow of Makhanlal National University of Journalism, Bhopal.
(This is adapted shorter version in english of the full article in hindi.)
Saturday, January 06, 2007
55 % of women have never heard about HIV/AIDS in MP
Published at www.mpnewsonline.com
Bhopal, Jan 06: Only 45 percent of women are in the category of ‘ever married adults between 15- 49 years who had ever heard of HIV/AIDS in Madhya Pradesh. This fact came to light in the latest 2005-2006 National Family Health Survey (NFHS-3), released recently by Government of India. This is the third survey in the NFHS series of surveys and provides information on population, health and nutrition in India and each of its 29 states. This survey is based on a sample of households, which is representative at the national and state levels.
In further analysis of the data tells us that in urban and rural divide- 74 percent of women in urban areas of MP had heard about HIV/AIDS while the figures is juts 35 percent in rural areas. This means that in rural areas in Madhya Pradesh (which is almost 75 percent of the total population of MP) women have never heard of HIV/AIDS. In case of men the figure is 95 percent in urban areas while in rural areas it is 59 percent and the total awareness is just 68 percent.
Experts believe that women are more vulnerable to HIV /AIDS as compared to men which means the efforts need to be targeted to reach them more then men. They add that range of factors like poverty, lack of information and decision power and factors, which impact gender discrimination, make her more vulnerable. NFHS data reveals that young girls and women in reproductive age group are at high risk in the state.
An important point to be noted in these data is- this only talks of whether they have heard or not. The data does not tell us about habits. The key to prevention in HIV/AUDS as given by the communication experts is to transform the information into knowledge then into action, whereas here level of information is very low, not to mention of other aspects.
Madhya Pradesh AIDS Control Society Deputy Director Savita Thakur accepted that there is no discrimination between males and females while creating awareness among the people towards AIDS. “Generally, all the training programmes are common for males and females. Particularly for females, we are trying to seek help from self-help groups to educate women and a module for imparting training to Anganwadi workers are is also being planned,” he added.
Bhopal, Jan 06: Only 45 percent of women are in the category of ‘ever married adults between 15- 49 years who had ever heard of HIV/AIDS in Madhya Pradesh. This fact came to light in the latest 2005-2006 National Family Health Survey (NFHS-3), released recently by Government of India. This is the third survey in the NFHS series of surveys and provides information on population, health and nutrition in India and each of its 29 states. This survey is based on a sample of households, which is representative at the national and state levels.
In further analysis of the data tells us that in urban and rural divide- 74 percent of women in urban areas of MP had heard about HIV/AIDS while the figures is juts 35 percent in rural areas. This means that in rural areas in Madhya Pradesh (which is almost 75 percent of the total population of MP) women have never heard of HIV/AIDS. In case of men the figure is 95 percent in urban areas while in rural areas it is 59 percent and the total awareness is just 68 percent.
Experts believe that women are more vulnerable to HIV /AIDS as compared to men which means the efforts need to be targeted to reach them more then men. They add that range of factors like poverty, lack of information and decision power and factors, which impact gender discrimination, make her more vulnerable. NFHS data reveals that young girls and women in reproductive age group are at high risk in the state.
An important point to be noted in these data is- this only talks of whether they have heard or not. The data does not tell us about habits. The key to prevention in HIV/AUDS as given by the communication experts is to transform the information into knowledge then into action, whereas here level of information is very low, not to mention of other aspects.
Madhya Pradesh AIDS Control Society Deputy Director Savita Thakur accepted that there is no discrimination between males and females while creating awareness among the people towards AIDS. “Generally, all the training programmes are common for males and females. Particularly for females, we are trying to seek help from self-help groups to educate women and a module for imparting training to Anganwadi workers are is also being planned,” he added.
Friday, January 05, 2007
National health assembly begins from March 23
HT CorrespondentBhopal, January 5, 2007
THE JAN Swasthya Abhiyan will organise the second National Health Assembly in Bhopal from March 23-25, to discuss the impact of increasing privatisation in the health sector on the health scenario in the country. Informing this at a press conference here on Friday, Jan Swasthya Abhiyan’s Dr Amit Sen Gupta condemned the Union and State Governments of falling into traps of the private sector. “In the name of privatisation of health services, Governments are just shirking away from their basic responsibilities even as the health indicators in the country remain to be as bad as ever,’’ Dr Sen Gupta alleged.
He said the three-day assembly in March would mainly discuss the impact of globalisation in dismantling of the public health system in India. It would also discuss globalisation’s impact on people’s lives.
The assembly will also try to brainstorm on key concerns like the strengthening and reformation of the public health system, regulation of private sector, ensuring access to essential medicines and the need for women’s health for their rights, Dr Sen Gupta stated. Participants from all over India will be taking part in the assembly while foreign delegations – from Bangladesh, Pakistan, Nepal, Latin American Countries and Africa – were also expected to arrive at the assembly, Dr Sen Gupta stated.
Assembly’s organising chairman Sharad Chandra Behar pointed out that the right to health was still not being considered as a fundamental right in India. “Even the right to education has been added as a fundamental right but no one is concerned to do the same about the right to health,’’ Behar lamented. Abhiyan’s Dr Vandana Prasad criticised the poor implementation of health services in the country and the State. She said National Rural Health Mission, Janani Suraksha Yojana and similar schemes were not being carried out effectively. “The child mortality rate in India still remains to be of great concern, as pointed out by the Third National Family Health Survey,’’ she stated.
MP Jan Swasthya Abhiyan coordinator Dr Ajay Khare, MP Bharat Gyan Vigyan Samiti executive president Asha Mishra and other office-bearers were also present.
THE JAN Swasthya Abhiyan will organise the second National Health Assembly in Bhopal from March 23-25, to discuss the impact of increasing privatisation in the health sector on the health scenario in the country. Informing this at a press conference here on Friday, Jan Swasthya Abhiyan’s Dr Amit Sen Gupta condemned the Union and State Governments of falling into traps of the private sector. “In the name of privatisation of health services, Governments are just shirking away from their basic responsibilities even as the health indicators in the country remain to be as bad as ever,’’ Dr Sen Gupta alleged.
He said the three-day assembly in March would mainly discuss the impact of globalisation in dismantling of the public health system in India. It would also discuss globalisation’s impact on people’s lives.
The assembly will also try to brainstorm on key concerns like the strengthening and reformation of the public health system, regulation of private sector, ensuring access to essential medicines and the need for women’s health for their rights, Dr Sen Gupta stated. Participants from all over India will be taking part in the assembly while foreign delegations – from Bangladesh, Pakistan, Nepal, Latin American Countries and Africa – were also expected to arrive at the assembly, Dr Sen Gupta stated.
Assembly’s organising chairman Sharad Chandra Behar pointed out that the right to health was still not being considered as a fundamental right in India. “Even the right to education has been added as a fundamental right but no one is concerned to do the same about the right to health,’’ Behar lamented. Abhiyan’s Dr Vandana Prasad criticised the poor implementation of health services in the country and the State. She said National Rural Health Mission, Janani Suraksha Yojana and similar schemes were not being carried out effectively. “The child mortality rate in India still remains to be of great concern, as pointed out by the Third National Family Health Survey,’’ she stated.
MP Jan Swasthya Abhiyan coordinator Dr Ajay Khare, MP Bharat Gyan Vigyan Samiti executive president Asha Mishra and other office-bearers were also present.
Wednesday, January 03, 2007
No end to Rajgarh residents' health problems
Published in The Pioneer , Bhopal, Jan 4, 2006
Thirty-five-year-old Kali Bai has to walk through six kms to get nearest primary healthcentre for every health problem she or her family faces. The situation of other residents of Ataikheda village is no better.
Though the Madhya Pradesh Government has claimed that efforts are being made to provide better health facilities in rural areas, the villagers find no end to their problems.
There are over 50 villages in Rajgarh district, which are deprived of medical facilities. The Health department in view of providing facility of institutionalised delivery restricted the in-house deliveries and midwifery system was abolished in the State.
There are 229 community healthcentres (CHCs), 1,194 primary healthcentres (PHCs) and 8,835 secondary healthcentres (SHCs) in the State. Particularly in Rajgarh district, there are only four CHCs, 31 CHCs and 166 SHCs.
Shivlal of Ataikheda village said that on an average in every four-five months, only one delivery takes place in the village. Instead of taking the pregnant woman to six-km away healthcentre, services of experienced old women are sought. "Taking pregnant woman on the kachcha road is quite difficult and there have been instances of miscarriage in the past," he added. He informed that only one non-medical assistant (NMA) is scheduled to visit the village once in a week.
Similar are the woes of Rasulpura village residents. This village is nine kms from the main road and 24 kms from Pachore tehsil. There have been instances of snake and scorpio bites in the villages, but the victims never received any medical facility. JP Sharma, a project assistant with the District Poverty Initiative Programme (DPIP) in the villages of Rajgarh district, felt that the project officials are considering to providing medical training to the common interest groups (CIGs) of the villages so that they could take care of their health problems.
The inferences of National Family Health Survey (NFHS-3) are revealing. A total of 60 per cent of children under three are malnourished, 27 women die everyday due to complication within pregnancy or 42 days after pregnancy and 79 children die out of 1,000 born before their first birthday. Similarly, 60 per cent of children are not fully immunised and 40 per cent women are malnourished.
Health Minister Ajay Vishnoi while talking to The Pioneer accepted that there is shortage of medical experts in far-flung villages, but medical experts would soon be deployed in the villages. The State Government has recently recruited MBBS doctors on contract basis for posting in rural areas, he added.
Thirty-five-year-old Kali Bai has to walk through six kms to get nearest primary healthcentre for every health problem she or her family faces. The situation of other residents of Ataikheda village is no better.
Though the Madhya Pradesh Government has claimed that efforts are being made to provide better health facilities in rural areas, the villagers find no end to their problems.
There are over 50 villages in Rajgarh district, which are deprived of medical facilities. The Health department in view of providing facility of institutionalised delivery restricted the in-house deliveries and midwifery system was abolished in the State.
There are 229 community healthcentres (CHCs), 1,194 primary healthcentres (PHCs) and 8,835 secondary healthcentres (SHCs) in the State. Particularly in Rajgarh district, there are only four CHCs, 31 CHCs and 166 SHCs.
Shivlal of Ataikheda village said that on an average in every four-five months, only one delivery takes place in the village. Instead of taking the pregnant woman to six-km away healthcentre, services of experienced old women are sought. "Taking pregnant woman on the kachcha road is quite difficult and there have been instances of miscarriage in the past," he added. He informed that only one non-medical assistant (NMA) is scheduled to visit the village once in a week.
Similar are the woes of Rasulpura village residents. This village is nine kms from the main road and 24 kms from Pachore tehsil. There have been instances of snake and scorpio bites in the villages, but the victims never received any medical facility. JP Sharma, a project assistant with the District Poverty Initiative Programme (DPIP) in the villages of Rajgarh district, felt that the project officials are considering to providing medical training to the common interest groups (CIGs) of the villages so that they could take care of their health problems.
The inferences of National Family Health Survey (NFHS-3) are revealing. A total of 60 per cent of children under three are malnourished, 27 women die everyday due to complication within pregnancy or 42 days after pregnancy and 79 children die out of 1,000 born before their first birthday. Similarly, 60 per cent of children are not fully immunised and 40 per cent women are malnourished.
Health Minister Ajay Vishnoi while talking to The Pioneer accepted that there is shortage of medical experts in far-flung villages, but medical experts would soon be deployed in the villages. The State Government has recently recruited MBBS doctors on contract basis for posting in rural areas, he added.
Women of Satna district ask for their rights
Women ask for their rights
Thousands of women participated in the recent Jan Sunwai held at District Satna by Samiratan Society, a partner of Madhya Pradesh Samaj Sewa Sanstha - a network of civil society organisations in the state working on the issue of maternal mortality. 397 cases were registered in the Sunwai. The issues which were taken up by the women ranged from maternal health, to violence against women and old age pension.
Tuesday, January 02, 2007
Connecting to Reproductive Rights Blog
News Round Up (Jan. 1) Happy New Year!
Our blog was mentioned on the Reporductive Rights blog and here is the article where it gets linked
In the past few days I've found a whole lot of stories that I don't want clogging my bookmarks. Plus, my mac sucks. Just thought I would throw that out there.Excerpts from Reproductive Rights blog News Round Up (Jan. 1)- Happy New Year! In the past few days I've found a whole lot of stories that I don't want clogging my bookmarks. Plus, my mac sucks. Just thought I would throw that out there.
The American College of OBGYNs (great website, btw) is now recommending that ALL women be offered a screening test for Down's Syndrome. This less invasive test (less invasive than an amniocentises) is called a nuchal translucency test, which measures the fetus' neck width. The test can be done earlier in the pregnancy, which gives women options to terminate, or to prepare for the baby earlier.
I got an email giving me a heads up about a campaign to reduce maternal mortality in India. One of the things that struck me when I was in India was how little autonomy women had regarding their own health care. We had 300 reported cases of bride burnings the summer I worked in Delhi (that's 300 in Delhi alone), and likely hundreds more that weren't reported. The most interesting thing to me was that women had to ask permission to seek health services (often denied by their husbands, in-laws, or parents) and that women didn't have any expectation of privacy regarding their medical services if they were married. As readers know, issues regarding safe motherhood are not at all limited to India.RHRealityCheck.org wrote about a human rights challenge to Nicaragua's abortion ban.
For full article please refer to the link above..
Our blog was mentioned on the Reporductive Rights blog and here is the article where it gets linked
In the past few days I've found a whole lot of stories that I don't want clogging my bookmarks. Plus, my mac sucks. Just thought I would throw that out there.Excerpts from Reproductive Rights blog News Round Up (Jan. 1)- Happy New Year! In the past few days I've found a whole lot of stories that I don't want clogging my bookmarks. Plus, my mac sucks. Just thought I would throw that out there.
The American College of OBGYNs (great website, btw) is now recommending that ALL women be offered a screening test for Down's Syndrome. This less invasive test (less invasive than an amniocentises) is called a nuchal translucency test, which measures the fetus' neck width. The test can be done earlier in the pregnancy, which gives women options to terminate, or to prepare for the baby earlier.
I got an email giving me a heads up about a campaign to reduce maternal mortality in India. One of the things that struck me when I was in India was how little autonomy women had regarding their own health care. We had 300 reported cases of bride burnings the summer I worked in Delhi (that's 300 in Delhi alone), and likely hundreds more that weren't reported. The most interesting thing to me was that women had to ask permission to seek health services (often denied by their husbands, in-laws, or parents) and that women didn't have any expectation of privacy regarding their medical services if they were married. As readers know, issues regarding safe motherhood are not at all limited to India.RHRealityCheck.org wrote about a human rights challenge to Nicaragua's abortion ban.
For full article please refer to the link above..
Saturday, December 30, 2006
As we continue, needs of women and children remain unfulfilled
Published in Central Chronicle, Bhopal
Adhir Kumar Saxena
Bhopal, Dec 30 : In the year gone by discussions on women and children of the state were dominated with the issues of maternal & infant mortality and malnutrition which was very right too. Madhya Pradesh has highest rates of malnutrition among children and infant mortality in India. Media, media advocacy groups, social activists and civil society networks did aggressively advocate on these issues in the state this year, probably which was right and had brought a positive turn within the civil society networks in the state. Well, as we end the year the latest National Family Health Survey III data reveals that 60 % of children in the state are malnourished. There has been an increase in the malnourishment rates in the state. Last survey held in the year 1998 - 99 pointed out that state had about 54 % children who were malnourished. There has been an increase of six percent in the years rather than a decrease. Just few days back Joint Commission of Enquiry set up by Supreme court commissioners pointed out one of the districts in Madhya Pradesh namely Sheopur as World's hotspot of malnutrition, which means that situation demand immediate action.
State did announce many new schemes and policies but somehow still has not made any mark on the situation. State still reports hunger deaths. Not only Sheopur but recently Badwani district reported hunger deaths too. Children die every day in the state. Women are dying - earlier it was at homes unnoticed now in hospitals and outside the hospital. Recent examples are Shivpuri, Gwalior, Bhind, Bhopal and at many other places.
Many districts of the state have low sex ratio. Bhind and Morena are the worst performing in this regard in the state. This year more than 60,000 thousands people got affected with Chikunguniya in the state while state shelved it as a fashion statement and ignored the pain people went through. Similarly were cases of dengue which came up and many deaths were reported due to dengue. State had floods this year, many died due to floods and others suffered after floods due to the infections, which came after.
State reported cases of polio after being polio free for some time now state reported three case of polio, an example of our low level of immunisation and how we are missing children not only during polio rounds but even during regular vaccination rounds. When we refer to health one cannot forget about the use of veterinary medicine on the humans being right in the hospital in the State capital!
Also to mention about state's website of health department which was underreporting the data on maternal and infant death? Though state has announced setting up of medical and Health University in the state, hope this happens... may help to serve as lifeline to people of the state in the coming year.
* 60% of children under three are malnourished.
* 27 women die every day due to complication within pregnancy or 42 days after pregnancy.
* 79 children die out of 1000 born before their first birthday.
* 60 % of children are not fully immunised.
* 40 % women are malnourished.
Adhir Kumar Saxena
Bhopal, Dec 30 : In the year gone by discussions on women and children of the state were dominated with the issues of maternal & infant mortality and malnutrition which was very right too. Madhya Pradesh has highest rates of malnutrition among children and infant mortality in India. Media, media advocacy groups, social activists and civil society networks did aggressively advocate on these issues in the state this year, probably which was right and had brought a positive turn within the civil society networks in the state. Well, as we end the year the latest National Family Health Survey III data reveals that 60 % of children in the state are malnourished. There has been an increase in the malnourishment rates in the state. Last survey held in the year 1998 - 99 pointed out that state had about 54 % children who were malnourished. There has been an increase of six percent in the years rather than a decrease. Just few days back Joint Commission of Enquiry set up by Supreme court commissioners pointed out one of the districts in Madhya Pradesh namely Sheopur as World's hotspot of malnutrition, which means that situation demand immediate action.
State did announce many new schemes and policies but somehow still has not made any mark on the situation. State still reports hunger deaths. Not only Sheopur but recently Badwani district reported hunger deaths too. Children die every day in the state. Women are dying - earlier it was at homes unnoticed now in hospitals and outside the hospital. Recent examples are Shivpuri, Gwalior, Bhind, Bhopal and at many other places.
Many districts of the state have low sex ratio. Bhind and Morena are the worst performing in this regard in the state. This year more than 60,000 thousands people got affected with Chikunguniya in the state while state shelved it as a fashion statement and ignored the pain people went through. Similarly were cases of dengue which came up and many deaths were reported due to dengue. State had floods this year, many died due to floods and others suffered after floods due to the infections, which came after.
State reported cases of polio after being polio free for some time now state reported three case of polio, an example of our low level of immunisation and how we are missing children not only during polio rounds but even during regular vaccination rounds. When we refer to health one cannot forget about the use of veterinary medicine on the humans being right in the hospital in the State capital!
Also to mention about state's website of health department which was underreporting the data on maternal and infant death? Though state has announced setting up of medical and Health University in the state, hope this happens... may help to serve as lifeline to people of the state in the coming year.
* 60% of children under three are malnourished.
* 27 women die every day due to complication within pregnancy or 42 days after pregnancy.
* 79 children die out of 1000 born before their first birthday.
* 60 % of children are not fully immunised.
* 40 % women are malnourished.
Tuesday, December 26, 2006
Discourage child marriage: Strict implementation of law must
Editorial, Central Chronicle, December 27, 2006
Madhya Pradesh stands at number two spot as far as marriage of minor girls are concerned whereas Rajasthan ranks first. Looking from global perspective, average age of marriage of an Indian girl is 20 years. However, in the rural areas, 55 per cent girls are married off when they are quite young. In Rajasthan the minimum age in which the girl is married off is 16 years; it is 17 in Madhya Pradesh and in Goa the average age of a girl for marriage is 22 years. In Bihar the average age for girls to be married off is 17.2, in Chhattisgarh 17.6, in New Delhi and Gujarat it is 19.2, haryana 18 years, Punjab 20.5 and Uttar Pradesh 17.5 years. India leads in child marriages as compared to nations including Pakistan and Nigeria (21 years), China, Brazil and Indonesia (23 years) and America (26). The state of the children report of UNICEF for the year 2007 states that the average age for marriage of girls has been increasing during the last 20 years, but 46 percent girls are married off before they attain 18 years of age. This is a cause for concern as the girls have to suffer many ill-effects. The condition of girls in Rajasthan is pitiable and in Madhya Pradesh too the situation is no better. There is clear violation of rule in marrying girls before age for which the girls have to pass from many dangers. The children born from such minor girls also face dangers. The girls are deprive of education too. Mostly the reason for early marriage of girls is financial. People are also of the belief that by getting their daughters married off early, the girls could be saved from sexual harassment and getting pregnant prior to marriage. In MP, efforts are being made to stop child marriage at many levels. Police and the administration are specially involved in this exercise. However, it's a matter for concern that in spite of all out efforts, early marriage of girls is continuing. Hence the need is for strict implementation of the rule against child marriage. People need to be made aware regarding dangers of early marriage as also the role of social, cultural and non-governmental organisations need to be established for this cause.
Comments - As per UNICEF's The State of the World's Children 2007 girls marrying before fifteen years have five times more chances of dying while giving birth to new life. MP and Rajasthan states already has high maternal mortality and both have high incidences of child marriage !. Lot of efforts need to go in changing people's mindsets in combating this..
Madhya Pradesh stands at number two spot as far as marriage of minor girls are concerned whereas Rajasthan ranks first. Looking from global perspective, average age of marriage of an Indian girl is 20 years. However, in the rural areas, 55 per cent girls are married off when they are quite young. In Rajasthan the minimum age in which the girl is married off is 16 years; it is 17 in Madhya Pradesh and in Goa the average age of a girl for marriage is 22 years. In Bihar the average age for girls to be married off is 17.2, in Chhattisgarh 17.6, in New Delhi and Gujarat it is 19.2, haryana 18 years, Punjab 20.5 and Uttar Pradesh 17.5 years. India leads in child marriages as compared to nations including Pakistan and Nigeria (21 years), China, Brazil and Indonesia (23 years) and America (26). The state of the children report of UNICEF for the year 2007 states that the average age for marriage of girls has been increasing during the last 20 years, but 46 percent girls are married off before they attain 18 years of age. This is a cause for concern as the girls have to suffer many ill-effects. The condition of girls in Rajasthan is pitiable and in Madhya Pradesh too the situation is no better. There is clear violation of rule in marrying girls before age for which the girls have to pass from many dangers. The children born from such minor girls also face dangers. The girls are deprive of education too. Mostly the reason for early marriage of girls is financial. People are also of the belief that by getting their daughters married off early, the girls could be saved from sexual harassment and getting pregnant prior to marriage. In MP, efforts are being made to stop child marriage at many levels. Police and the administration are specially involved in this exercise. However, it's a matter for concern that in spite of all out efforts, early marriage of girls is continuing. Hence the need is for strict implementation of the rule against child marriage. People need to be made aware regarding dangers of early marriage as also the role of social, cultural and non-governmental organisations need to be established for this cause.
Comments - As per UNICEF's The State of the World's Children 2007 girls marrying before fifteen years have five times more chances of dying while giving birth to new life. MP and Rajasthan states already has high maternal mortality and both have high incidences of child marriage !. Lot of efforts need to go in changing people's mindsets in combating this..
Monday, December 25, 2006
VIKAS SAMVAD ANNOUNCES FOUR MEDIA FELLOWSHIPS
Vikas Samvad, a media advocacy group in Madhya Pradesh has called for application for third media fellowships for the mainstream hindi journalists from Madhya Pradesh. These fellowships will be provided to those four journalists who are willing to work on any of these following issues on a full time basis for one year in Madhya Pradesh-
1.Women in Panchayati Raj and their political leadership for social change
2.Women and Child rights (with special reference to Health Rights)
3. Social Exclusion and Discrimination
4. Universalisation of Education with quality
These fellows will be selected by an independent jury. This selection committee includes senior and eminent journalists/editors from Madhya Pradesh and social workers. Interested Journalists may obtain application formats from below mentioned address -
Vikas Samvad, E-7/226, First Floor, Opp. Dhanvantri ComplexArera Colony, Shahpura, Bhopal, Madhya PradeshPh-0755-4252789Mob.- 09827361019
Email- vikassamvad@gmail.com
The last date for the submission of application is 10th January 2007. For forms please contact at above mobile and email.
1.Women in Panchayati Raj and their political leadership for social change
2.Women and Child rights (with special reference to Health Rights)
3. Social Exclusion and Discrimination
4. Universalisation of Education with quality
These fellows will be selected by an independent jury. This selection committee includes senior and eminent journalists/editors from Madhya Pradesh and social workers. Interested Journalists may obtain application formats from below mentioned address -
Vikas Samvad, E-7/226, First Floor, Opp. Dhanvantri ComplexArera Colony, Shahpura, Bhopal, Madhya PradeshPh-0755-4252789Mob.- 09827361019
Email- vikassamvad@gmail.com
The last date for the submission of application is 10th January 2007. For forms please contact at above mobile and email.
FIGHTING MALNUTRITION : BETTER WORKPLAN NEEDED
Editorial by Central Chronicle on Malnutrition
December 25, 2006 Bhopal
There has been a 6.3pc rise in malnourished children in Madhya Pradesh. The deduction has been arrived from a report of the National Family Health Survey. In comparison to other states, the state of children is MP is a cause for concern. Percentagewise malnutrition has gone up from 54 to 60.3 whereas the State government has been claiming it to be at 49pc. One reason is also said to be improper use of funds allotted for eradicating the illness. Even the Supreme Court had raised questions over the distribution system of nutritious food to children in the State. The MP government has implemented anganwadi scheme for eradicating malnutrition. However, the number of anganwadis are too little compared to the population. The Supreme Court had, on October 7, given directives for opening an anganwadi centre in every locality, wherein children up to six years of age should be given nutritious diet. It also said that the work of distribution of the food items should not be given to contractors but to women's bodies of localities, self-help groups or other groups of the village people. However, this is not so. A healthy child needs 1700 calories whereas a child is given 80 gm `dalia' in Anganwadi which provides only 300 calories. The state government has achieved notable success in implementation of schemes/ projects but its success in supplying nutritious food to children has not met with desired success. Lack of budget is said to be one of the reasons; other is improper distribution. It is also important to pay attention towards the quality of food being given to the children. The need is for framing a large work plan so that not even one child becomes victim of malnutrition.
December 25, 2006 Bhopal
There has been a 6.3pc rise in malnourished children in Madhya Pradesh. The deduction has been arrived from a report of the National Family Health Survey. In comparison to other states, the state of children is MP is a cause for concern. Percentagewise malnutrition has gone up from 54 to 60.3 whereas the State government has been claiming it to be at 49pc. One reason is also said to be improper use of funds allotted for eradicating the illness. Even the Supreme Court had raised questions over the distribution system of nutritious food to children in the State. The MP government has implemented anganwadi scheme for eradicating malnutrition. However, the number of anganwadis are too little compared to the population. The Supreme Court had, on October 7, given directives for opening an anganwadi centre in every locality, wherein children up to six years of age should be given nutritious diet. It also said that the work of distribution of the food items should not be given to contractors but to women's bodies of localities, self-help groups or other groups of the village people. However, this is not so. A healthy child needs 1700 calories whereas a child is given 80 gm `dalia' in Anganwadi which provides only 300 calories. The state government has achieved notable success in implementation of schemes/ projects but its success in supplying nutritious food to children has not met with desired success. Lack of budget is said to be one of the reasons; other is improper distribution. It is also important to pay attention towards the quality of food being given to the children. The need is for framing a large work plan so that not even one child becomes victim of malnutrition.
Maternal Mortality: Civil Societies Call for Action
by Anil Gulati
Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.........
For full article please click the link on the title....
Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.........
For full article please click the link on the title....
Saturday, December 23, 2006
Starvation on rise in MP
82 percent state children are anaemic : Survey
Published in The Pioneer, Bhopal Edition December 24, 2006
Girish Sharma Bhopal
82 per cent State children are anaemic: SurveyAbout 82.6 per cent children in age group of 6 to 35 months are anaemic and 60 per cent children under three years of age are malnourished in Madhya Pradesh. This is the finding of latest 2005-2006 National Family Health Survey (NFHS-III) released recently by the Union Government.
This is the third in the NFHS series of surveys and provides information on population, health and nutrition in India and each of the State. This survey is based on a sample of households, which is representative at the national and State levels. In the same category, 75.2 per cent anaemic children are in urban areas while 84.9 per cent in rural areas. As compared to earlier figures, there has been a dramatic increase in anaemia in children in the State. As per NFHS II, only 71.3 per cent children were anaemic while data was not obtained in the NFHS I. In spite of various schemes being undertaken by the State, condition of children is going from bad to worse.
Similarly, in case of married women between 15 to 49 years, 57.6 per cent are anaemic, out of which 48.3 per cent are in urban and 61 per cent in rural areas. The State already has very high maternal mortality rate and anaemia is one of the major contributors to the same. This will have serious implications as far as the condition of women health is concerned. Anaemia is comparatively less in men. As per the data, only 24.4 per cent married men between the age group of 15-49 are anaemic.
The figures state that malnourishment among children has increased in Madhya Pradesh. As per the NFHS data, 60 per cent children under three years of age are malnourished in the State. They are underweight and too thin for their age.
Women and Child Development department has been claiming that it had brought down the malnourishment. But it has actually increased from 54 to 60 per cent when compared with NFHS II data. Madhya Pradesh is among the States with highest number of malnourished children.
The fact sheets provided by NFHS on key indicators and trends were based on the fieldwork conducted by 18 research organisations between December 2005 and August 2006.
Published in The Pioneer, Bhopal Edition December 24, 2006
Girish Sharma Bhopal
82 per cent State children are anaemic: SurveyAbout 82.6 per cent children in age group of 6 to 35 months are anaemic and 60 per cent children under three years of age are malnourished in Madhya Pradesh. This is the finding of latest 2005-2006 National Family Health Survey (NFHS-III) released recently by the Union Government.
This is the third in the NFHS series of surveys and provides information on population, health and nutrition in India and each of the State. This survey is based on a sample of households, which is representative at the national and State levels. In the same category, 75.2 per cent anaemic children are in urban areas while 84.9 per cent in rural areas. As compared to earlier figures, there has been a dramatic increase in anaemia in children in the State. As per NFHS II, only 71.3 per cent children were anaemic while data was not obtained in the NFHS I. In spite of various schemes being undertaken by the State, condition of children is going from bad to worse.
Similarly, in case of married women between 15 to 49 years, 57.6 per cent are anaemic, out of which 48.3 per cent are in urban and 61 per cent in rural areas. The State already has very high maternal mortality rate and anaemia is one of the major contributors to the same. This will have serious implications as far as the condition of women health is concerned. Anaemia is comparatively less in men. As per the data, only 24.4 per cent married men between the age group of 15-49 are anaemic.
The figures state that malnourishment among children has increased in Madhya Pradesh. As per the NFHS data, 60 per cent children under three years of age are malnourished in the State. They are underweight and too thin for their age.
Women and Child Development department has been claiming that it had brought down the malnourishment. But it has actually increased from 54 to 60 per cent when compared with NFHS II data. Madhya Pradesh is among the States with highest number of malnourished children.
The fact sheets provided by NFHS on key indicators and trends were based on the fieldwork conducted by 18 research organisations between December 2005 and August 2006.
Govt claim on institutional delivery at stake
Published in Central Chronicle
By Our Staff Reporter
Bhopal, Dec 23: Shivpuri district has been noticing a different trend these days, which has put all the great proclamations' of the state for promoting institutional delivery at stake. Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.
In the same league on December 13, last a Harijan, Sanida Bai along with her husband Kailash Jatav from village Badagaon came to the Shivpuri district hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside the hospital.
http://www.centralchronicle.com/20061224/2412025.htm
By Our Staff Reporter
Bhopal, Dec 23: Shivpuri district has been noticing a different trend these days, which has put all the great proclamations' of the state for promoting institutional delivery at stake. Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.
In the same league on December 13, last a Harijan, Sanida Bai along with her husband Kailash Jatav from village Badagaon came to the Shivpuri district hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside the hospital.
http://www.centralchronicle.com/20061224/2412025.htm
‘Institutional delivery’ means ‘delivery outside the hospital’ in Shivpuri
Shivpuri district has been noticing a trend these days which has put all the great proclamations’ of the state for promoting institutional delivery at stake.
Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.
In the same league on December 13 2006 a harijan namely Sanida Bai along with her husband of Kailash Jatav from village Badagaon came to hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside hospital – probably this is institutional delivery in Shivpuri !!
This is not first, one can see many of similar cases in last few months cases but probably they are getting more visibility now………by media.
Adapated from Dainik Bhaskar, Shivpuri edition, December 14, 2006 and other press cuttings
Families are coming forward for the deliveries to district hospitals and health centre but probably centre are not equipped to handle the same neither the human resource is willing. Whether it is attitudes of doctors or nurses or health staff or their absenteeism or inadequate infrastructure or lack of blood or medicines or corruption, one notices a treand in the district of deliveries outside the hospital or maternal deaths.
In the same league on December 13 2006 a harijan namely Sanida Bai along with her husband of Kailash Jatav from village Badagaon came to hospital while she was in her labour. But staff present there did not admit her in the hospital, reasons unknown. She and her family waited there for two hours in pain and she delivered the child on the road outside hospital – probably this is institutional delivery in Shivpuri !!
This is not first, one can see many of similar cases in last few months cases but probably they are getting more visibility now………by media.
Adapated from Dainik Bhaskar, Shivpuri edition, December 14, 2006 and other press cuttings
Struggling for her daughters treatment for last 21 day in state capital
Dina Pragyapaiti is from Chhattarpur district and he has come to state capital with lots of hopes for treatment of his girl child aged 12 years. She is suffering from vascular disease and suffers from acute pain in her fingers. A per media report doctors at the hospital say that his treatment will cost Rupees one lakh only as he does not have any money they have not only refused the treatment but even the admission in the hospital. When contacted by the media the Dr M P Chincholkar said that we cannot treat her and many diseases are such which do not have any treatment so why admit?
Published in Dainik Bhaskar Bhopal edition Decemeber 23, 2006
Comments - If this is the reply – It’s inhuman…We urge all media professionals to please raise this issue in way they can.
Published in Dainik Bhaskar Bhopal edition Decemeber 23, 2006
Comments - If this is the reply – It’s inhuman…We urge all media professionals to please raise this issue in way they can.
Thursday, December 21, 2006
Mother’s concern raised by women in Panna
Madam ANM hardly comes to our village! Where should we go for vaccination? Why do pregnant women need the third check up? These are examples of some of the questions raised by women to the Chief Medical and health officer of the district at Women Samellan held on December 7, 2006 at District Panna of the State of Madhya Pradesh. Panna District not only has high rates of maternal deaths but also has very low level of institutional delivery, only 7 % deliveries happen in the institutions. The women convention was organised by Jan Adhikar Manch, a network of civil society organisations in the state.
Dr Sinha, Chief Medical Health Officer and Laximanarayan Diwedi from Panchyati Raj and Social Welfare Department were present to listen to woes of women who participated in the samellan. Sandesh Bansal of State coordinator of Jan Adhikar Manch women have need to be come forward for their rights or else maternal deaths will continue to happen. Every five minutes a women dies in the country due to complication in pregnancy.
Adapted from press reports in Dainik Bhaskar, Dainak Braham, and Nav Swadesh of Panna dated December 8, 2006
Dr Sinha, Chief Medical Health Officer and Laximanarayan Diwedi from Panchyati Raj and Social Welfare Department were present to listen to woes of women who participated in the samellan. Sandesh Bansal of State coordinator of Jan Adhikar Manch women have need to be come forward for their rights or else maternal deaths will continue to happen. Every five minutes a women dies in the country due to complication in pregnancy.
Adapted from press reports in Dainik Bhaskar, Dainak Braham, and Nav Swadesh of Panna dated December 8, 2006
Wednesday, December 20, 2006
High Maternal Mortality in the Heart of India
By Anil Gulati
21 December,2006Countercurrents.org
Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.
But unfortunately the kushwai health centre, where they had come with lot of hopes, did not had a medical doctor for last one and half years. One male health worker mans the centre. Though, he puts in his best but that may not be enough for women like Munna and others who need medical support.
Inspite of reaching the primary health centre, she did not get any help. She has to travel another eight kilometers to Burhar, the place where there is a community health centre. The centre is fortunately newly built and has facilities for delivery. Munna did develop some complications during the delivery but fortunately survived to see her new born.
She was lucky but thousands of women which die in the state are not. App 10,000 women die every year in Madhya Pradesh during pregnancy or within 42 days after pregnancy. Majority of these could be prevented. Medically these deaths may be due to hemorrhage, infection, eclampsia or unsafe abortion or any of three delays. But fact is there exists a yawning gap in our health system which stands in between life and death of women in the state. This gap has linkage to availability and access to health services, infrastructure, awareness among communities of not only the services but even recognizing danger signs, issue of how where they can access the services etc. Studies also tells us that for every maternal death in India, 20 more women suffer from the impaired health.
But if the situation at ground is like this, and has been there. What is the state’s response to an issue like this? Does it impact the political leaders, their discourse? Does issue of women dying in the state is debated in discussions where funds are allocated or decisions are made? Does state’s machinery care for it? Does civil society raise its concern?
The year 2004
To answer some of these questions a dip stick assessment was done in year 2004 at various levels within civil society, debates in the state assembly, media analysis. Outcomes were revealing. First of all the issue concerned only few in health department. There were only handful of civil society partners, and their major role was to support service delivery system. As such there was no push or urgency to bring change. Interestingly, the issue had never being debated on the floor of the state assembly, a place where elected representatives ‘of the people, for the people and by the people’ decide. It did not impact them, many of them were not even aware of the fact that state has this high number of maternal deaths? An issue like this was never raised by the political leaders in the debates which happen there – an issue of total neglect at the highest political body. Media covered ‘event news’ around the safe motherhood day, probably they never got the right information too.
Present
That was a starting point, but nevertheless situation has changed today. Today state recognizes it as a major issue when it comes to women and children. State calls for an action. It is on high priority list of the political head of the state, state party is being questioned on the number of deaths, gaps on the infrastructure and many related points. Today more than 150 civil society organizations are raising concern on the issue and demanding urgency and urgency of action in the state.
How it happened and what does it impact and what strengths does it generate? Movements don't just happen; the energy that underlies them must be marshaled, channeled, and focused. The principal means by which this is achieved in our society, and within our political tradition, is through advocacy networks and coalitions.
Networks like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Jan Adhikar Manch and Collective for advocacy, resource and training, Madhya Pradesh Samaj Sewa Sanstha, Mahila Chetna Manch, and many others have not only contributed to help bring the issue at an individual level but as a part of informal collation added to that force which helped bringing the agenda on political normative framework. Some of the strengths which this informal network helped bring were the numbers of civil society partners raising concern on the issue spread across different regions of the state. From a handful few now it is more than 150 civil society partners in the state working in all divisions to bring the issue to forefront. The turn around is also in their way of working from being a service delivery partners or a social mobilization partners in supportive and submissive role in a new avatar of advocacy partner. In this new role civil society speaks on the issue of right to health, its violation, demands state’s accountability to provide for safemotherhood. In this new business influencing people who make decisions which impact human lives is the key.
The primary target of the civil society was to bring the issues which impact lives of women at the villages, blocks and districts to the agenda of the people who make or influence decisions, i.e. state assembly debates, political leaders, members of legislative assembly, ministers, media, rights commission etc. They had been to some part successful. ex-pression of this concern was undertaken by directly meeting and sensitizing political leaders. The evidences highlighting gap were shared with political leaders, urging them to rise above politics and give a strong call for action. These non governmental organizations wrote memorandums, shared information and collected evidences for the same purpose. Media engagement also supported by providing an enabling environment for change. Strong evidences i.e. case of maternal deaths which can be presented, health system gaps were highlighted which added pressure on the state and the leaders to react. Resultant of this solid gains achieved. Today questions on maternal mortality are being raised in the state assembly, the highest policy making body of the state. It is not just few many voices are being publicly heard on the issue. There is a increased concern within media.
From nowhere it came to a point where state publicly acknowledge the problem, and its commitment to act. Many new polices and schemes have been announced and that too in the rapid succession. This amount of concern and even expressed publicly by leaders had never been seen earlier in the state on the issue of maternal mortality. But that is not enough today empowered civil society and media is always looking with eagle’s eye on the new measures of the state and vocally points out the gaps This is a positive sign, where people are voicing their opinion. But it is not easy as said. Political leaders have started picking up real cases of deaths, gaps in infrastructure in the state, violation of rights, gaps in policies and seeking answers to what is being done by the state to response to the situation.
Advocacy experts tell us that ‘people centered advocacy’ is the best, i.e. position when people who suffer can speak for themselves. A step has been taken in the same direction by the engaged networks. Madhya Pradesh Jan Adhikar Manch in their work with communities helped to bring the issue to debate in various gram sabhas which were held by panchayats in Gwalior – Chambal division. Similarly women who had participated in various women conventions hosted by Madhya Pradesh Samaj Sewa Sanstha came forward and wrote about the problems women face in rural areas when it comes to issue of safemotherhood and why do women die in their villages while giving birth. As per sources of Madhya Pradesh Samaj Sewa Sanstha more than 200 women have written to the Chief Minister. On a simple fifty paise post card, they wrote by theselves and it was send to the Chief Minister. It looks simple but powerful, if it gets to his eyes. Recently a large number of women from villages across Madhya Pradesh have joined a signature (or thumb-impression) campaign to press for their right to health and to call upon the Government to ensure that the dream of safe motherhood becomes a reality. As a part of a special drive to raise concern on this crucial issue, more than 20,000 women from different villages of the State are now in the process of signing (or placing their thumb impression) on a various banners demanding the right to health and calling upon the State to ensure that the dream of safe motherhood becomes a reality. Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha are the civil society partners who are collecting these signatures/thumb impressions of women. They say that they do so after they are adequately sensitizing them on the issue of maternal mortality. Then if they feel that some concrete action is needed to improve the situation, they come and sign. Plan is to present the banners with their signatures to policy makers.
One might say that this is good effort, which indeed it is to bring the agenda of maternal mortality on to the political and action framework but it is still a long way to go. This is true. But if one looks back one and half years where there was hardly any concern, hardly anyone called for action, except few that too ‘within the box’. The focus was limited. From nowhere it has come somewhere, which is an important achievement by any means. Need of the day is to provide possible answers to the state, which is willing to listen. Answers which can help deliver results, within the context of the field realties and socio – cultural aspects – a new call to many !
Contact
Anil Gulati E mail – anilgulati5@gmail.com
21 December,2006Countercurrents.org
Munna was nine months pregnant. She did experience pains few days back, when her husband and mother-in-law rushed her to the nearest primary health centre in Kushwai of the District Shahdol in the State of Madhya Pradesh in India. They had to make her travel by bus from their village, and then in pain Munna had to walk, which she could barely to reach the health centre.
But unfortunately the kushwai health centre, where they had come with lot of hopes, did not had a medical doctor for last one and half years. One male health worker mans the centre. Though, he puts in his best but that may not be enough for women like Munna and others who need medical support.
Inspite of reaching the primary health centre, she did not get any help. She has to travel another eight kilometers to Burhar, the place where there is a community health centre. The centre is fortunately newly built and has facilities for delivery. Munna did develop some complications during the delivery but fortunately survived to see her new born.
She was lucky but thousands of women which die in the state are not. App 10,000 women die every year in Madhya Pradesh during pregnancy or within 42 days after pregnancy. Majority of these could be prevented. Medically these deaths may be due to hemorrhage, infection, eclampsia or unsafe abortion or any of three delays. But fact is there exists a yawning gap in our health system which stands in between life and death of women in the state. This gap has linkage to availability and access to health services, infrastructure, awareness among communities of not only the services but even recognizing danger signs, issue of how where they can access the services etc. Studies also tells us that for every maternal death in India, 20 more women suffer from the impaired health.
But if the situation at ground is like this, and has been there. What is the state’s response to an issue like this? Does it impact the political leaders, their discourse? Does issue of women dying in the state is debated in discussions where funds are allocated or decisions are made? Does state’s machinery care for it? Does civil society raise its concern?
The year 2004
To answer some of these questions a dip stick assessment was done in year 2004 at various levels within civil society, debates in the state assembly, media analysis. Outcomes were revealing. First of all the issue concerned only few in health department. There were only handful of civil society partners, and their major role was to support service delivery system. As such there was no push or urgency to bring change. Interestingly, the issue had never being debated on the floor of the state assembly, a place where elected representatives ‘of the people, for the people and by the people’ decide. It did not impact them, many of them were not even aware of the fact that state has this high number of maternal deaths? An issue like this was never raised by the political leaders in the debates which happen there – an issue of total neglect at the highest political body. Media covered ‘event news’ around the safe motherhood day, probably they never got the right information too.
Present
That was a starting point, but nevertheless situation has changed today. Today state recognizes it as a major issue when it comes to women and children. State calls for an action. It is on high priority list of the political head of the state, state party is being questioned on the number of deaths, gaps on the infrastructure and many related points. Today more than 150 civil society organizations are raising concern on the issue and demanding urgency and urgency of action in the state.
How it happened and what does it impact and what strengths does it generate? Movements don't just happen; the energy that underlies them must be marshaled, channeled, and focused. The principal means by which this is achieved in our society, and within our political tradition, is through advocacy networks and coalitions.
Networks like Madhya Pradesh Voluntary Health Association, Madhya Pradesh Jan Adhikar Manch and Collective for advocacy, resource and training, Madhya Pradesh Samaj Sewa Sanstha, Mahila Chetna Manch, and many others have not only contributed to help bring the issue at an individual level but as a part of informal collation added to that force which helped bringing the agenda on political normative framework. Some of the strengths which this informal network helped bring were the numbers of civil society partners raising concern on the issue spread across different regions of the state. From a handful few now it is more than 150 civil society partners in the state working in all divisions to bring the issue to forefront. The turn around is also in their way of working from being a service delivery partners or a social mobilization partners in supportive and submissive role in a new avatar of advocacy partner. In this new role civil society speaks on the issue of right to health, its violation, demands state’s accountability to provide for safemotherhood. In this new business influencing people who make decisions which impact human lives is the key.
The primary target of the civil society was to bring the issues which impact lives of women at the villages, blocks and districts to the agenda of the people who make or influence decisions, i.e. state assembly debates, political leaders, members of legislative assembly, ministers, media, rights commission etc. They had been to some part successful. ex-pression of this concern was undertaken by directly meeting and sensitizing political leaders. The evidences highlighting gap were shared with political leaders, urging them to rise above politics and give a strong call for action. These non governmental organizations wrote memorandums, shared information and collected evidences for the same purpose. Media engagement also supported by providing an enabling environment for change. Strong evidences i.e. case of maternal deaths which can be presented, health system gaps were highlighted which added pressure on the state and the leaders to react. Resultant of this solid gains achieved. Today questions on maternal mortality are being raised in the state assembly, the highest policy making body of the state. It is not just few many voices are being publicly heard on the issue. There is a increased concern within media.
From nowhere it came to a point where state publicly acknowledge the problem, and its commitment to act. Many new polices and schemes have been announced and that too in the rapid succession. This amount of concern and even expressed publicly by leaders had never been seen earlier in the state on the issue of maternal mortality. But that is not enough today empowered civil society and media is always looking with eagle’s eye on the new measures of the state and vocally points out the gaps This is a positive sign, where people are voicing their opinion. But it is not easy as said. Political leaders have started picking up real cases of deaths, gaps in infrastructure in the state, violation of rights, gaps in policies and seeking answers to what is being done by the state to response to the situation.
Advocacy experts tell us that ‘people centered advocacy’ is the best, i.e. position when people who suffer can speak for themselves. A step has been taken in the same direction by the engaged networks. Madhya Pradesh Jan Adhikar Manch in their work with communities helped to bring the issue to debate in various gram sabhas which were held by panchayats in Gwalior – Chambal division. Similarly women who had participated in various women conventions hosted by Madhya Pradesh Samaj Sewa Sanstha came forward and wrote about the problems women face in rural areas when it comes to issue of safemotherhood and why do women die in their villages while giving birth. As per sources of Madhya Pradesh Samaj Sewa Sanstha more than 200 women have written to the Chief Minister. On a simple fifty paise post card, they wrote by theselves and it was send to the Chief Minister. It looks simple but powerful, if it gets to his eyes. Recently a large number of women from villages across Madhya Pradesh have joined a signature (or thumb-impression) campaign to press for their right to health and to call upon the Government to ensure that the dream of safe motherhood becomes a reality. As a part of a special drive to raise concern on this crucial issue, more than 20,000 women from different villages of the State are now in the process of signing (or placing their thumb impression) on a various banners demanding the right to health and calling upon the State to ensure that the dream of safe motherhood becomes a reality. Madhya Pradesh Voluntary Health Association, Madhya Pradesh Samaj Sewa Sanstha are the civil society partners who are collecting these signatures/thumb impressions of women. They say that they do so after they are adequately sensitizing them on the issue of maternal mortality. Then if they feel that some concrete action is needed to improve the situation, they come and sign. Plan is to present the banners with their signatures to policy makers.
One might say that this is good effort, which indeed it is to bring the agenda of maternal mortality on to the political and action framework but it is still a long way to go. This is true. But if one looks back one and half years where there was hardly any concern, hardly anyone called for action, except few that too ‘within the box’. The focus was limited. From nowhere it has come somewhere, which is an important achievement by any means. Need of the day is to provide possible answers to the state, which is willing to listen. Answers which can help deliver results, within the context of the field realties and socio – cultural aspects – a new call to many !
Contact
Anil Gulati E mail – anilgulati5@gmail.com
Tuesday, December 19, 2006
Call for 'Right to Safe Motherhood'
UNI release at www.netindia123.com Bhopal, December 18, 2006 9:40:27 PM IST
Women participants from various districts of Madhya Pradesh today called for a 'Right to Safe Motherhood' during a convention being organised here by the Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality.
More than 150 women from Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalpur, Dhar, Bhopal, Mandsaur, Jhabua and other districts are taking part, a release said. ''Mobilised communities can make the system work and it is time we come together and channelise our energy for decreasing maternal death,'' said MPVHA Executive Director Mukesh Sinha.
Speaking as a guest, UNICEF State Representative Hamid El Bashir said that it is imperative for Madhya Pradesh to move resolutely from the realm of words to the realm of concrete action, which could help bring about a positive change in the lives of women at village level.
''Safe motherhood is a human rights issue. Though this state's Maternal Mortality Ratio has declined it is still very high and Madhya Pradesh figures among six states that have the maximum number of maternal deaths in the country,'' he added.
Mr Bashir felt that the state needed to invest in infrastructure, upgrade health centres, increase the number of blood banks and help build capacity of human resource. UNICEF's Project Officer (Health) Ramani Atkuri spoke on the technical aspects of maternal mortality and interacted with the women on the problems they faced at the village level. UNICEF Communication Officer Anil Gulati, Dr Ajay Khare of the People's Health Movement and MPVHA President B K Nilosey also spoke.
The women posed several questions such as unavailability of health services, lack of awareness about schemes, lack of proper information on problems, untrained midwives, poor roads, anaemia, malaria etc, the release added.
http://www.netindia123.com/showdetails.asp?id=541353&cat=India&head=Call+for+'Right+to+Safe+Motherhood'
Women participants from various districts of Madhya Pradesh today called for a 'Right to Safe Motherhood' during a convention being organised here by the Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality.
More than 150 women from Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalpur, Dhar, Bhopal, Mandsaur, Jhabua and other districts are taking part, a release said. ''Mobilised communities can make the system work and it is time we come together and channelise our energy for decreasing maternal death,'' said MPVHA Executive Director Mukesh Sinha.
Speaking as a guest, UNICEF State Representative Hamid El Bashir said that it is imperative for Madhya Pradesh to move resolutely from the realm of words to the realm of concrete action, which could help bring about a positive change in the lives of women at village level.
''Safe motherhood is a human rights issue. Though this state's Maternal Mortality Ratio has declined it is still very high and Madhya Pradesh figures among six states that have the maximum number of maternal deaths in the country,'' he added.
Mr Bashir felt that the state needed to invest in infrastructure, upgrade health centres, increase the number of blood banks and help build capacity of human resource. UNICEF's Project Officer (Health) Ramani Atkuri spoke on the technical aspects of maternal mortality and interacted with the women on the problems they faced at the village level. UNICEF Communication Officer Anil Gulati, Dr Ajay Khare of the People's Health Movement and MPVHA President B K Nilosey also spoke.
The women posed several questions such as unavailability of health services, lack of awareness about schemes, lack of proper information on problems, untrained midwives, poor roads, anaemia, malaria etc, the release added.
http://www.netindia123.com/showdetails.asp?id=541353&cat=India&head=Call+for+'Right+to+Safe+Motherhood'
Missing girls in Madhya Pradesh
Letter to the Hoot: Recent articles in the media have tried to give visibility to an issue which is prevalent yet neglected.
Female foeticide and infanticide is not a new phenomenon, but debate on it is growing. Stories from Punjab, Haryana, Delhi, Gujarat get space in media, which is genuine as they have the lowest child sex ratio in the country. A few months back the news channel Sahara Samay had undertaken some sting operation on nursing homes in states including Madhya Pradesh which were illegally undertaking use of pre natal diagnostic technique for purpose of sex determination of the foetus, banned as per PC & PNDT Act. Some NGOs had filed the first public interest litigation in the state on the issue, which was covered by newspapers like Hindustan Times, The Hindu, Pioneer and Rajya Ki Nai Dunia.
This children’s day there was a first lead story in Dainik Bhaskar from Morena, a district in the state of Madhya Pradesh which has the lowest sex ratio in the state i.e. 837 girls per 1000 boys. The story helped to raise concern on the declining sex ratio in the state, which remains unnoticed by many decisionmakers and media. The story did bring out the focus on the issue of female infanticide prevalent in our society. It pegged the child sex ratio in some parts of the district as 400 girls per 1000 boys. Though statisticians may debate this, but fact of the matter is that girls are being knowingly killed , which still remains unnoticed by many. That story which was call to action and prompted many others to follow. Dainik Jagran another leading daily in the state wrote an editorial on the issue, which was much needed. Following this there was a recent article in the Hindi magazine Maya by Dr Manohar Agnani. He has being a front runner in raising concern on the issue of female foeticide and in his article points out that it is not only Morena but is prevalent in other districts of the state too. He talks of a village in the district Shivpuri which may have sex ratio as low as 600/ 1000. He adds that time has come that we start talk about the solutions. It may be pertinent to mention about Dr Manohar Agnani’s recent book on female foeticide. It has been titled as Missing Girls and was published by ‘Books for Change’.
Recent articles in media in the state have tried to give visibility to an issue which is prevalent yet wilfully neglected by us. These stories should be a call to people within media, civil society and all of us who feel pained to convert this into a sustained and regular concern feeding media with needed evidence and stories which are newsy and backed by substance to make sure that not only people who make policies but society as a whole rises to put a stop to this killing of girls. This may be just one way to raise concern by engaging media though the solution still lies within all of us.
Anil Gulati, Bhopal.
November 25, 2006
http://www.thehoot.org/story.asp?storyid=Web5917615202Hoot23724%20PM2414&pn=1
Female foeticide and infanticide is not a new phenomenon, but debate on it is growing. Stories from Punjab, Haryana, Delhi, Gujarat get space in media, which is genuine as they have the lowest child sex ratio in the country. A few months back the news channel Sahara Samay had undertaken some sting operation on nursing homes in states including Madhya Pradesh which were illegally undertaking use of pre natal diagnostic technique for purpose of sex determination of the foetus, banned as per PC & PNDT Act. Some NGOs had filed the first public interest litigation in the state on the issue, which was covered by newspapers like Hindustan Times, The Hindu, Pioneer and Rajya Ki Nai Dunia.
This children’s day there was a first lead story in Dainik Bhaskar from Morena, a district in the state of Madhya Pradesh which has the lowest sex ratio in the state i.e. 837 girls per 1000 boys. The story helped to raise concern on the declining sex ratio in the state, which remains unnoticed by many decisionmakers and media. The story did bring out the focus on the issue of female infanticide prevalent in our society. It pegged the child sex ratio in some parts of the district as 400 girls per 1000 boys. Though statisticians may debate this, but fact of the matter is that girls are being knowingly killed , which still remains unnoticed by many. That story which was call to action and prompted many others to follow. Dainik Jagran another leading daily in the state wrote an editorial on the issue, which was much needed. Following this there was a recent article in the Hindi magazine Maya by Dr Manohar Agnani. He has being a front runner in raising concern on the issue of female foeticide and in his article points out that it is not only Morena but is prevalent in other districts of the state too. He talks of a village in the district Shivpuri which may have sex ratio as low as 600/ 1000. He adds that time has come that we start talk about the solutions. It may be pertinent to mention about Dr Manohar Agnani’s recent book on female foeticide. It has been titled as Missing Girls and was published by ‘Books for Change’.
Recent articles in media in the state have tried to give visibility to an issue which is prevalent yet wilfully neglected by us. These stories should be a call to people within media, civil society and all of us who feel pained to convert this into a sustained and regular concern feeding media with needed evidence and stories which are newsy and backed by substance to make sure that not only people who make policies but society as a whole rises to put a stop to this killing of girls. This may be just one way to raise concern by engaging media though the solution still lies within all of us.
Anil Gulati, Bhopal.
November 25, 2006
http://www.thehoot.org/story.asp?storyid=Web5917615202Hoot23724%20PM2414&pn=1
Women ask right to safemotherhood
Published at www.mpnewsonline.com
Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality in Bhopal have called for 'right to safe motherhood'. More than 150 women from districts like Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same. Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities could make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.
Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action, which can help bring positive change in the lives of women at village level. Talking about safe motherhood, he said that it was a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states, which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. Dr Ramani Atkuri, UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.
Earlier, during opening session Anil Gulati, UNICEF’s Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country. During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.
Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.
http://www.mpnewsonline.com/index%20181206.htm#Women_ask_right_to_safe_motherhood_
Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association (MPVHA) on the theme of maternal mortality in Bhopal have called for 'right to safe motherhood'. More than 150 women from districts like Chhatarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same. Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities could make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.
Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action, which can help bring positive change in the lives of women at village level. Talking about safe motherhood, he said that it was a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states, which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. Dr Ramani Atkuri, UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.
Earlier, during opening session Anil Gulati, UNICEF’s Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country. During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.
Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.
http://www.mpnewsonline.com/index%20181206.htm#Women_ask_right_to_safe_motherhood_
Women express concern over MMR in MP
By Our Staff Reporter
Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association on the theme of maternal mortality in Bhopal have called for 'right to safemotherhood'.
More than 150 women from districts like Chhattarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same.
Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities can make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.
Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action which can help bring positive change in the lives of women at village level. He in his address to women called safemotherhood as a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. State needs to take steps to assure safemotherhood, which is mandated by CEDAW and Constitution of India. He also distributed prizes to the winners of the various quizzes held at the convention. Dr Ramani Atkuri. UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.
Earlier during opening session Anil Gulati UNICEF Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country.
During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.
Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.
Bhopal, Dec 18: Women from various districts of the state who are participating in the women convention being organized by Madhya Pradesh Voluntary Health Association on the theme of maternal mortality in Bhopal have called for 'right to safemotherhood'.
More than 150 women from districts like Chhattarpur, Sidhi, Satna, Panna, Khargone, Indore, Jabalapur, Dhar, Bhopal, Mansaur and Jhabua are participating in the same.
Mukesh Sinha Executive Director of MPVHA opening up the convention said how mobilized communities can make the system work and it is time we come together as one and channel our energies for decreasing maternal death in the state.
Speaking as the Guest at the convention, Hamid El Bashir, State Representative of UNICEF office for Madhya Pradesh said that it is imperative that state now has to move resolutely from realm of words to real of concrete action which can help bring positive change in the lives of women at village level. He in his address to women called safemotherhood as a human right issue. Though MMR of the state has come down but still it is very high and state still features among six states which contribute maximum number of maternal deaths in the country. We are behind the target. State needs to invest in infrastructure, upgrades its health centre's, upgrade and increase number of blood banks, help build capacity of the human resource, immediately fill in all the vacant positions in the state. State needs to take steps to assure safemotherhood, which is mandated by CEDAW and Constitution of India. He also distributed prizes to the winners of the various quizzes held at the convention. Dr Ramani Atkuri. UNICEF's Project Officer Health spoke on the technical aspects of maternal mortality and interacted with the women on the problem they face at the village level.
Earlier during opening session Anil Gulati UNICEF Communication Officer spoke on their role at community and village level and how they can make a difference and Dr Ajay Khare of People's Health Movement spoke on the need to address the issue and how painful it is to see the divide between rich and poor in terms of health care in the state and country.
During the convention Women raised many queries like unavailability of health services, unawareness about various schemes, lack of proper information on many problems they face, un trained dais, bad roads, anemia, malaria etc, which indirectly impacts maternal mortality in their areas.
Women also presented the signatures banners to Hamid El Bashir, State Representative as token of their concern on the number of maternal deaths and condition of women health in the state. Prof B K Nilosey President MPVHA encouraged the women volunteers present at the convention.
Monday, December 18, 2006
8 hunger deaths in Badwani
HT Correspondent
Bhopal, December 17,2006
AT LEAST eight malnutrition deaths have been reported in six villages of Sendhwa development block of Badwani district between August and December this year, according to the Right to Food Campaign (RFC) support group.
Addressing a press conference here on Sunday, the RFC support group said the ground reality was very different from that projected by the State Government.
The group members said they would soon file litigation with the National Human Rights Commission (NHRC) regarding malnutrition in Madhya Pradesh.
The group has demanded a white paper on malnutrition status of children of Saharia and Barela tribes, Rs 800 crore budget for supplementary nutritious food, arrangements for intense monitoring of malnutrition, particularly in endemic tribal pockets and fixing responsibility on senior officials in areas where malnutrition deaths have been reported.
The press conference was organised ahead of the `Bal Adhikar Samvad’ to be held in New Delhi on December 19 where a report titled `Focus on children under six’ will be released by eminent economist Amartya Sen and other dignitaries.
Representatives of the RFC support group members (representatives of various voluntary organisations) supported the recently released data of the National Family Health Survey III (NFHS-III) that shows the malnutrition per cent in the State has gone up to 60 per cent. They presented some data from Badwani district in support of their claim.
Dr Ghanshyamdas Verma of Adharshila Learning Centre, Sakad Sendhwa Badwani and Mukesh Dudwe of Adivasi Mukti Sangathan working with Barela tribal in Badwani district claimed that out of the 147 children in the six villages of Chatli, Kunjri, Bhurapani, Pipaldhar, Merkhedi and Sakad in Sendhwa block, eight had died during last five months, owing to malnutrition.
Of these five deaths allegedly occurred in Sakad village. Of the 147 children 46 children are in grade III and 17 children in grade IV of malnutrition (the severest situation) while 16 and 46 respectively are in grade I and II.
Workers alleged malnutrition grading by the State Women and Child Department was doubtful as most of the ground level workers of the department (mainly anganwadi workers) were not trained for the purpose and weighing machines did not function properly at many places. They also alleged that in many cases the block level officers sent across bogus data to district officials and these data form the basis of Government figures.
Representatives said apart from moving the NHRC in the matter, they will be conducting in-depth studies in tribal areas to bring forth the actual situation, will be compiling a report on the implementation of Sup-reme Court orders and will id-entify malnutrition endemic areas in the State and demand intervention. Umesh Vashisht, Uma, Prashant and Sachin Ja-in of the support group were present at the press conference.
As published in Hindustan Times Bhopal December 18, 2006
Bhopal, December 17,2006
AT LEAST eight malnutrition deaths have been reported in six villages of Sendhwa development block of Badwani district between August and December this year, according to the Right to Food Campaign (RFC) support group.
Addressing a press conference here on Sunday, the RFC support group said the ground reality was very different from that projected by the State Government.
The group members said they would soon file litigation with the National Human Rights Commission (NHRC) regarding malnutrition in Madhya Pradesh.
The group has demanded a white paper on malnutrition status of children of Saharia and Barela tribes, Rs 800 crore budget for supplementary nutritious food, arrangements for intense monitoring of malnutrition, particularly in endemic tribal pockets and fixing responsibility on senior officials in areas where malnutrition deaths have been reported.
The press conference was organised ahead of the `Bal Adhikar Samvad’ to be held in New Delhi on December 19 where a report titled `Focus on children under six’ will be released by eminent economist Amartya Sen and other dignitaries.
Representatives of the RFC support group members (representatives of various voluntary organisations) supported the recently released data of the National Family Health Survey III (NFHS-III) that shows the malnutrition per cent in the State has gone up to 60 per cent. They presented some data from Badwani district in support of their claim.
Dr Ghanshyamdas Verma of Adharshila Learning Centre, Sakad Sendhwa Badwani and Mukesh Dudwe of Adivasi Mukti Sangathan working with Barela tribal in Badwani district claimed that out of the 147 children in the six villages of Chatli, Kunjri, Bhurapani, Pipaldhar, Merkhedi and Sakad in Sendhwa block, eight had died during last five months, owing to malnutrition.
Of these five deaths allegedly occurred in Sakad village. Of the 147 children 46 children are in grade III and 17 children in grade IV of malnutrition (the severest situation) while 16 and 46 respectively are in grade I and II.
Workers alleged malnutrition grading by the State Women and Child Department was doubtful as most of the ground level workers of the department (mainly anganwadi workers) were not trained for the purpose and weighing machines did not function properly at many places. They also alleged that in many cases the block level officers sent across bogus data to district officials and these data form the basis of Government figures.
Representatives said apart from moving the NHRC in the matter, they will be conducting in-depth studies in tribal areas to bring forth the actual situation, will be compiling a report on the implementation of Sup-reme Court orders and will id-entify malnutrition endemic areas in the State and demand intervention. Umesh Vashisht, Uma, Prashant and Sachin Ja-in of the support group were present at the press conference.
As published in Hindustan Times Bhopal December 18, 2006
Sunday, December 17, 2006
Hospital staff demands money for delivery
(Please note - State proclaims to have many schemes which provide for financial support to promote institutional delivery)
‘Sir staff demands money for delivery’ was the reply from when a state government team comprising of the Zonal director and CMHO visited the hospital at Laxmi Ganj.
The rate card which one patients has to shelve - Rupees nine hundred for boy and five hundred for girl – the money goes to the staff posted there. Though the team promised action and took the statements. When the medicine store was checked it was found that it had medicines but same were being prescribed and the patients had to buy it from outside. Labour ward was shabby, oxygen cylinders did not have any oxygen even the oxygen tube was not in order. Though many patients admitted in the wards were from BPL families but hardly any of the got any benefit rather than had to pay for the delivery at this hospital.
Adapted from Dainik Bhaskar Gwalior news on December 2, 2006
‘Sir staff demands money for delivery’ was the reply from when a state government team comprising of the Zonal director and CMHO visited the hospital at Laxmi Ganj.
The rate card which one patients has to shelve - Rupees nine hundred for boy and five hundred for girl – the money goes to the staff posted there. Though the team promised action and took the statements. When the medicine store was checked it was found that it had medicines but same were being prescribed and the patients had to buy it from outside. Labour ward was shabby, oxygen cylinders did not have any oxygen even the oxygen tube was not in order. Though many patients admitted in the wards were from BPL families but hardly any of the got any benefit rather than had to pay for the delivery at this hospital.
Adapted from Dainik Bhaskar Gwalior news on December 2, 2006
Saturday, December 16, 2006
Right to safemotherhood - an elusive dream
Gwalior , December 12, 2006
Village Sarari Khurd, Sheopur - has a primary health centre but no doctor. Since when it does not have doctor, even villagers can’t remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipments and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometers of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there, are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily).
District has population of app. 6 lakhs residing in 533 villages. It has one district hospital with a capacity of 175 beds. In the 175 bedded hospital, 150 beds have never being changed since last 15 years. Though state is pushing institutional delivery but districts like Sheopur hardly have any infrastructure to match the same push. Number of beds in labour ward remain same, neither the position of gynecologist, lying vacant has been recruited, medicines are always in shortage. In situation like this big question is that how can mothers get right to safe motherhood – a right which needs to be demanded in the state of Madhya Pradesh.
Adapted from op-ed published in Acharan, Gwalior December 12, 2006
Village Sarari Khurd, Sheopur - has a primary health centre but no doctor. Since when it does not have doctor, even villagers can’t remember the same. The centre is opened by hardly fours days a week by local nurse. It neither has any facility nor any equipments and hardly has been cleaned ever. This is not the situation of one health centre, 20 kilometers of Sarari Khurd is Karahal. Karahal has community health centre. Though it opens every day but three positions out of the four to be posted there, are vacant. Karahal block officially has a facility of mobile health van to reach out to inaccessible areas. But it has just one mobile health van. If the same works daily it will reach the same village after a gap of 35 days (please note if it works daily).
District has population of app. 6 lakhs residing in 533 villages. It has one district hospital with a capacity of 175 beds. In the 175 bedded hospital, 150 beds have never being changed since last 15 years. Though state is pushing institutional delivery but districts like Sheopur hardly have any infrastructure to match the same push. Number of beds in labour ward remain same, neither the position of gynecologist, lying vacant has been recruited, medicines are always in shortage. In situation like this big question is that how can mothers get right to safe motherhood – a right which needs to be demanded in the state of Madhya Pradesh.
Adapted from op-ed published in Acharan, Gwalior December 12, 2006
Women don’t get benefits of various schemes
Concern over high IMR/ MMR
Tikamgarh December 8, 206
As part of save our mothers campaign, Jan Adhikar Manch held a women samellan at Topkhana ground, Tikamgrah. Large number of women from rural areas had participated in the same. The issue of schemes not reaching the poor and many women dying enroute to the hospital even before reaching the hospital was raised by Saroj Rajput member state women commission. She said that need today is generate awareness and motivate women to go for an institutional delivery. Similarly Madhu Khare participating in the meeting said that there is a strong need to help improve facilities available at the health centre.
As published in the Dainik Bhaskar
Tikamgarh December 8, 206
As part of save our mothers campaign, Jan Adhikar Manch held a women samellan at Topkhana ground, Tikamgrah. Large number of women from rural areas had participated in the same. The issue of schemes not reaching the poor and many women dying enroute to the hospital even before reaching the hospital was raised by Saroj Rajput member state women commission. She said that need today is generate awareness and motivate women to go for an institutional delivery. Similarly Madhu Khare participating in the meeting said that there is a strong need to help improve facilities available at the health centre.
As published in the Dainik Bhaskar
Sunday, December 03, 2006
Aren't these hunger deaths ?
Rolly, Sheopur, Madhya Pradesh
Published at www.mynews.in
You may give a piece of bread to a hungry person, and when the cravings of hunger return someone else must administer to his wants again; to put that person in a position to earn his own subsistence is true charity. In this way you direct his feet on the path of true independence. He is then only dependent on his own exertions and on the blessings of his God. -Daniel H. Wells. In May 2006 Dilli Dakha lost their first child when she was one and a half years old, after this, they had a child, Sugreev who is two years old now. The couple then lost their twin daughters Ganga and Jamuna and according to the mother Dakha she was not able to feed them, as there was no milk. She says that she is only able to eat one Roti with onion once a day. Her family’s diet does not include any pulses or vegetables because they cannot afford it. Her husband earns around Rs.20 per day on the days he goes out to work, which is very less. After her third delivery she has started loosing her eyesight, which is largely due to the deficiency of vitamin A. Dilli Dakha and her husband belong to Sahariya tribe. Sahariyas or the tribals who call themselves “Sehera or Sair” claim to be the first of the tribes of the country. They were dependent on forest for survival for generations and lived a subsistence life with limited needs. Their traditional means of earning a livelihood was one of agriculture, gathering forest products and hunting. Ignored by the society, inhuman behaviour of system and deprived of their basic needs they are a community that has been subject to a lot of social, economic and political discrimination.
Life has not been easy for the Sahariyas after their eviction from the forests. Unable to bear the political, social and economic exploitation and discrimination meted out by the people who live in villages these tribals moved over to live in Saharanas (Sahariya Hamlets) away from the villages. For past couple of years Sahariya in Madhya Pradesh have been in the news. The reasons are many like drought, vulnerability, exploitation and irresponsibility of the state etc, which is constantly making them victims of death. But even then one does not find any change in the pathetic conditions that exist in the area. Sahariya children are the worst affected due to poverty, lack of livelihood resources and Govt. policies. Data from Government of MP's Bal Sanjeevani Abhiyan (8th Report) indicate that 58% of the children in the age group 0-6 in the district suffer from malnutrition. These indicators show that Sahariya’s are one of the poorest and most deprived communities in the entire country. It is representative of the hilly and forested, SC-ST dry lands of India, where poverty and malnutrition are concentrated. Within this overall picture, the appalling levels of deprivation of the tribal population of the Sheopur district, the Sahariyas, adds another dimension to the whole problem.
According to the information by the Regional medical research centre for tribals, Jabalpur that the Infant Mortality rate (per 1000 lives births) of Sahariya is 88 and 93.5% of Sahariya children are victims of severe malnourishment and 15% are almost on the verge of death, due to malnourishment. The average life span of a Sahariya is 45 years, which is 25% less than that of an average mans life span.74.3% children’s were underweight and 75.4% are stunted. It is difficult to trace even a single child, youth or a family that is not a victim of severe malnourishment and anemia. However the health and nutritional status of these children is the last priority on the list of the government. The figures for the Sahariyas place them amongst the worst in the world Sometimes, some schemes were enacted to provide temporary relief and then when the condition became stable, the administration adopted it’s as usual step motherly treatment to the community A village, Patalgarh has been in the news in February 2005, for the most distressing reasons- death of 13 innocent children .
The village, which is part of the Karahal Block, is situated at a distance of 70 kms from the district headquarters and 65 kms from the block headquarters. It can be reached by taking the Goras road from Karahal and one has to travel through the thick forest and bumpy, muddy roads. The village situated in the interior does not have even the basic infrastructural facility. In order to reach the village one has to travel almost 70 kms by road, crossing forest area. The nearest hospital is situated at a distance of 35 kms. This can be clearly understood if we look into the functioning of the Anganwadi centers and the Mid Day Meals scheme in the state, especially in Sheopur, a Sahariya dominated district in Madhya Pradesh. Previously there was no anganwadi in Patalgarh village and the nearest anganwadi is situated in Hirapur village, 17 kms away. A worker, Mithilesh who was holding a temporary post, looks after the temporary Anganwadi in Patalgarh village. According to the villagers there are 70 children in the village who have been enrolled in the Anganwadi. The enrolled children have been given Supplementary Nutritious Food only till January 2006. There is a Multipurpose Heath Worker for the village who manages to make a round once in a month.
However one cannot blame him for this because he has to look after 3 panchayats. He has also been entrusted the duty of registration of births and deaths and in the given circumstances he leaves out many children. This is the main reason why the government has been denying the deaths. Most of the new born die within one month and neither their birth nor their death gets registered. It was found that not only children in Patalgarh are dying but huge number of Maternal Deaths has also become a part of the daily life here. Now Right to Food alliance demanded a joint commission of enquiry from the Commissioners for fixing the accountability and to identify the policy level gaps. At this moment Joint Commission of Enquiry is in the process to finalize its report on the matter of malnutrition deaths. After these incidents Madhya Pradesh RtFC filed and interim application in the Civil Writ Petition 196/2001 to make state more accountable towards the issue But presently after the intervention of Supreme Court the story of Patalgarh was totally different, the village has the functioning Anganwadi, the ANM has also been appointed; there was no PDS access in January. But now, a "PDS tractor" brings grain to the village from the nearby Hirapur village (15 km away) once in a month. During the previous Supreme Court intervention, temporary cards were distributed in the village to enable PDS access to people. The cards were still in circulation, in spite of the assurance by the district administration that issue of fresh cards will be completed by August 2006. Under NREGA a road construction work was going ahead. The people of patalgarh are also getting minimum wages (Rs. 60 per day) and have to excavate 100 cubic feet per day.
Patalgarh is on priority of the government but the question is that there are many villages like Patalgarh which don’t get the attention of the administration and result of this negligence causes the death of innocent children. In spite of the death of Ganga and Jamuna and the death of 6 children and two mothers this year, life in Patalgarh village in Karahal Block of Sheopur District of Madhya Pradesh, seems to be pulling along as usual. The villagers as usual go about their work; the children in the village are running around oblivious of the grave situation that is building in the village. Death of the children like Ganga and Jamuna are nothing new to the district. Every summer many Sahariya Children like Ganga and Jamuna die and every death doesn’t make to the headlines of newspapers who are bothered more about the illness of Mahajans – pun intended – and Bachhans.
Link to the story : http://mynews.in/newsdetail.aspx?news_id=187
Published at www.mynews.in
You may give a piece of bread to a hungry person, and when the cravings of hunger return someone else must administer to his wants again; to put that person in a position to earn his own subsistence is true charity. In this way you direct his feet on the path of true independence. He is then only dependent on his own exertions and on the blessings of his God. -Daniel H. Wells. In May 2006 Dilli Dakha lost their first child when she was one and a half years old, after this, they had a child, Sugreev who is two years old now. The couple then lost their twin daughters Ganga and Jamuna and according to the mother Dakha she was not able to feed them, as there was no milk. She says that she is only able to eat one Roti with onion once a day. Her family’s diet does not include any pulses or vegetables because they cannot afford it. Her husband earns around Rs.20 per day on the days he goes out to work, which is very less. After her third delivery she has started loosing her eyesight, which is largely due to the deficiency of vitamin A. Dilli Dakha and her husband belong to Sahariya tribe. Sahariyas or the tribals who call themselves “Sehera or Sair” claim to be the first of the tribes of the country. They were dependent on forest for survival for generations and lived a subsistence life with limited needs. Their traditional means of earning a livelihood was one of agriculture, gathering forest products and hunting. Ignored by the society, inhuman behaviour of system and deprived of their basic needs they are a community that has been subject to a lot of social, economic and political discrimination.
Life has not been easy for the Sahariyas after their eviction from the forests. Unable to bear the political, social and economic exploitation and discrimination meted out by the people who live in villages these tribals moved over to live in Saharanas (Sahariya Hamlets) away from the villages. For past couple of years Sahariya in Madhya Pradesh have been in the news. The reasons are many like drought, vulnerability, exploitation and irresponsibility of the state etc, which is constantly making them victims of death. But even then one does not find any change in the pathetic conditions that exist in the area. Sahariya children are the worst affected due to poverty, lack of livelihood resources and Govt. policies. Data from Government of MP's Bal Sanjeevani Abhiyan (8th Report) indicate that 58% of the children in the age group 0-6 in the district suffer from malnutrition. These indicators show that Sahariya’s are one of the poorest and most deprived communities in the entire country. It is representative of the hilly and forested, SC-ST dry lands of India, where poverty and malnutrition are concentrated. Within this overall picture, the appalling levels of deprivation of the tribal population of the Sheopur district, the Sahariyas, adds another dimension to the whole problem.
According to the information by the Regional medical research centre for tribals, Jabalpur that the Infant Mortality rate (per 1000 lives births) of Sahariya is 88 and 93.5% of Sahariya children are victims of severe malnourishment and 15% are almost on the verge of death, due to malnourishment. The average life span of a Sahariya is 45 years, which is 25% less than that of an average mans life span.74.3% children’s were underweight and 75.4% are stunted. It is difficult to trace even a single child, youth or a family that is not a victim of severe malnourishment and anemia. However the health and nutritional status of these children is the last priority on the list of the government. The figures for the Sahariyas place them amongst the worst in the world Sometimes, some schemes were enacted to provide temporary relief and then when the condition became stable, the administration adopted it’s as usual step motherly treatment to the community A village, Patalgarh has been in the news in February 2005, for the most distressing reasons- death of 13 innocent children .
The village, which is part of the Karahal Block, is situated at a distance of 70 kms from the district headquarters and 65 kms from the block headquarters. It can be reached by taking the Goras road from Karahal and one has to travel through the thick forest and bumpy, muddy roads. The village situated in the interior does not have even the basic infrastructural facility. In order to reach the village one has to travel almost 70 kms by road, crossing forest area. The nearest hospital is situated at a distance of 35 kms. This can be clearly understood if we look into the functioning of the Anganwadi centers and the Mid Day Meals scheme in the state, especially in Sheopur, a Sahariya dominated district in Madhya Pradesh. Previously there was no anganwadi in Patalgarh village and the nearest anganwadi is situated in Hirapur village, 17 kms away. A worker, Mithilesh who was holding a temporary post, looks after the temporary Anganwadi in Patalgarh village. According to the villagers there are 70 children in the village who have been enrolled in the Anganwadi. The enrolled children have been given Supplementary Nutritious Food only till January 2006. There is a Multipurpose Heath Worker for the village who manages to make a round once in a month.
However one cannot blame him for this because he has to look after 3 panchayats. He has also been entrusted the duty of registration of births and deaths and in the given circumstances he leaves out many children. This is the main reason why the government has been denying the deaths. Most of the new born die within one month and neither their birth nor their death gets registered. It was found that not only children in Patalgarh are dying but huge number of Maternal Deaths has also become a part of the daily life here. Now Right to Food alliance demanded a joint commission of enquiry from the Commissioners for fixing the accountability and to identify the policy level gaps. At this moment Joint Commission of Enquiry is in the process to finalize its report on the matter of malnutrition deaths. After these incidents Madhya Pradesh RtFC filed and interim application in the Civil Writ Petition 196/2001 to make state more accountable towards the issue But presently after the intervention of Supreme Court the story of Patalgarh was totally different, the village has the functioning Anganwadi, the ANM has also been appointed; there was no PDS access in January. But now, a "PDS tractor" brings grain to the village from the nearby Hirapur village (15 km away) once in a month. During the previous Supreme Court intervention, temporary cards were distributed in the village to enable PDS access to people. The cards were still in circulation, in spite of the assurance by the district administration that issue of fresh cards will be completed by August 2006. Under NREGA a road construction work was going ahead. The people of patalgarh are also getting minimum wages (Rs. 60 per day) and have to excavate 100 cubic feet per day.
Patalgarh is on priority of the government but the question is that there are many villages like Patalgarh which don’t get the attention of the administration and result of this negligence causes the death of innocent children. In spite of the death of Ganga and Jamuna and the death of 6 children and two mothers this year, life in Patalgarh village in Karahal Block of Sheopur District of Madhya Pradesh, seems to be pulling along as usual. The villagers as usual go about their work; the children in the village are running around oblivious of the grave situation that is building in the village. Death of the children like Ganga and Jamuna are nothing new to the district. Every summer many Sahariya Children like Ganga and Jamuna die and every death doesn’t make to the headlines of newspapers who are bothered more about the illness of Mahajans – pun intended – and Bachhans.
Link to the story : http://mynews.in/newsdetail.aspx?news_id=187
Saturday, December 02, 2006
lack of blood bank kills two in Bhind
Published in Pioneer, December 2, 2006
Staff Reporter Bhopal
Rekha Bhadoriya, Kiran Jatav die for want of blood, proper careTwo pregnant women, Rekha Bhadoriya and Kiran Jatav Sarkar, lost their lives within an hour at the district hospital of Bhind on Thursday, due to the alleged gross negligence of the hospital authority.
Rekha Bahdoriya, in the seventh month of pregnancy, was admitted to the hospital after she suffered from bleeding. The hospital, however, did not have a functional blood bank facility and she lost her life due to lack of blood.
Similarly, Kiran, wife of Mukesh Jatav of Bhind, was also pregnant and complained of pain on November 10. Her family brought her to the hospital and doctors advised some routine tests (haemoglobin and blood group) to be done. She was prescribed a medicine for stomach ache and was sent back.
Kiran gave birth to a baby at home on November 16. But after she showed signs of delivery complications, her family rushed her to the hospital. The doctors in the hospital reviewed her condition after an hour where allegedly she was not given any treatment. Her family waited with hope that doctors would take care of her for another two hours but by the time the doctors could make up their minds to treat her, she was no more.
The hospital administration complained about the lack of adequate financial resources. "We do not have sufficient number of beds in the maternity ward and that's why Kiran could not be admitted," said the hospital superintendent, on the condition that her name was not to be published.
The superintendent also said that owing to fact that the hospital blood bank does not function, the blood loss suffered by Rekha could not be compensated.
http://www.dailypioneer.com/indexn12.asp?main_variable=BHOPAL&file_name=bhopal12%2Etxt&counter_img=12
Staff Reporter Bhopal
Rekha Bhadoriya, Kiran Jatav die for want of blood, proper careTwo pregnant women, Rekha Bhadoriya and Kiran Jatav Sarkar, lost their lives within an hour at the district hospital of Bhind on Thursday, due to the alleged gross negligence of the hospital authority.
Rekha Bahdoriya, in the seventh month of pregnancy, was admitted to the hospital after she suffered from bleeding. The hospital, however, did not have a functional blood bank facility and she lost her life due to lack of blood.
Similarly, Kiran, wife of Mukesh Jatav of Bhind, was also pregnant and complained of pain on November 10. Her family brought her to the hospital and doctors advised some routine tests (haemoglobin and blood group) to be done. She was prescribed a medicine for stomach ache and was sent back.
Kiran gave birth to a baby at home on November 16. But after she showed signs of delivery complications, her family rushed her to the hospital. The doctors in the hospital reviewed her condition after an hour where allegedly she was not given any treatment. Her family waited with hope that doctors would take care of her for another two hours but by the time the doctors could make up their minds to treat her, she was no more.
The hospital administration complained about the lack of adequate financial resources. "We do not have sufficient number of beds in the maternity ward and that's why Kiran could not be admitted," said the hospital superintendent, on the condition that her name was not to be published.
The superintendent also said that owing to fact that the hospital blood bank does not function, the blood loss suffered by Rekha could not be compensated.
http://www.dailypioneer.com/indexn12.asp?main_variable=BHOPAL&file_name=bhopal12%2Etxt&counter_img=12
Friday, December 01, 2006
The health centre which does not have facility
Sheopur, Madhya Pradesh
Primary Health Centre at Village Dodar in Sheopur does not even have basic facilities which it should be having. Though people have been demanding the same for quite some time but this dream still eludes them.
The health centre which has to caters to many villages like Khojipura, Hasilpur, Badiya, Balwani, Khikhari, Manpur, Dhiroli, Makdhod and many others in its near vicinity. It neither has adequate infrastructure nor the adequate medical support which can help people of the block. It neither has X ray machine, nor the pathological laboratory. Even the behaviour of the staff is such that people feel that staff if and when it treats is like doing a favour to them. A lady recently lost her life during delivery in the hospital. There is no drinking water in the health centre? People are urging State and district administration to immediately look into the matter.
Published in Dainik Bhaskar, Sheopur Edition November 30, 2006
Primary Health Centre at Village Dodar in Sheopur does not even have basic facilities which it should be having. Though people have been demanding the same for quite some time but this dream still eludes them.
The health centre which has to caters to many villages like Khojipura, Hasilpur, Badiya, Balwani, Khikhari, Manpur, Dhiroli, Makdhod and many others in its near vicinity. It neither has adequate infrastructure nor the adequate medical support which can help people of the block. It neither has X ray machine, nor the pathological laboratory. Even the behaviour of the staff is such that people feel that staff if and when it treats is like doing a favour to them. A lady recently lost her life during delivery in the hospital. There is no drinking water in the health centre? People are urging State and district administration to immediately look into the matter.
Published in Dainik Bhaskar, Sheopur Edition November 30, 2006
Tuesday, November 28, 2006
Civil hospital faces shortage of gynecologist
Sewada Tehsil, Madhya Pradesh
The civil hospital here has seven sanctioned posts of the medical doctors but only two are posted. Not to talk of doctors even equipments and X ray machines are not working and they are like a showpiece in the hospital.
This is the situation at the main hospital at the tehsil. This looks quite good from outside but internally it faces heavy crunch in terms of the staff. For last five years this hospital is working on the strength of two doctors though the sanctioned posts are seven. Many pregnant women do not get delivery here as lady doctor is not there. Only one fourth of deliveries do happen here which are referred from PHC Indergarh. Even the two posted doctors most of the time are engaged in the various campaigns or meetings while patients suffer !
A published in Dainik Bhaskar November 20, 2006
(Blog’s comments : State’s Health & Family Welfare Minister Ajay Bishnoi had accepted in response to the question in the floor of the house that there is shortage of gynecologists in the state - out of the total 138 posts in the district 40 are vacant. Though state is aware of the fact but there is not definite plan in recruiting them !)
The civil hospital here has seven sanctioned posts of the medical doctors but only two are posted. Not to talk of doctors even equipments and X ray machines are not working and they are like a showpiece in the hospital.
This is the situation at the main hospital at the tehsil. This looks quite good from outside but internally it faces heavy crunch in terms of the staff. For last five years this hospital is working on the strength of two doctors though the sanctioned posts are seven. Many pregnant women do not get delivery here as lady doctor is not there. Only one fourth of deliveries do happen here which are referred from PHC Indergarh. Even the two posted doctors most of the time are engaged in the various campaigns or meetings while patients suffer !
A published in Dainik Bhaskar November 20, 2006
(Blog’s comments : State’s Health & Family Welfare Minister Ajay Bishnoi had accepted in response to the question in the floor of the house that there is shortage of gynecologists in the state - out of the total 138 posts in the district 40 are vacant. Though state is aware of the fact but there is not definite plan in recruiting them !)
Monday, November 27, 2006
AIDWA’s troupe gives call to women on their right to health in Sheopur
All India Democratic Women Association as way to commemorate its 25th anniversary is taking out special troupe in Sheopur on November 11, 2006 .Troupe is conducting it street plays and sabhas to create awareness on the issue of women’s health and motivate them to ask for their rights.
As published in Swadesh, Sheopur edition, November 7, 2006
As published in Swadesh, Sheopur edition, November 7, 2006
Sunday, November 26, 2006
HUNGER DEATHS HAUNT STATE
As published in The Hindustan Times, Bhopal, November 25, 2006
by Sravani Sarkar
A JOINT Commission of Enquiry (JCE), instituted by the Commissioner, Supreme Court, has substantiated reports of malnutrition deaths in Sheopur and termed the predominantly Saharia tribe district as ‘one of the malnutrition hot spots in the world’.
In its report the five-member JCE forewarned the district administration of severe drought in the coming summer owing to monsoon failure this year.“Unless the steps outlined by the commission are taken urgently and in earnest, we could see a huge human tragedy unfolding next year,’’ the report has warned.
The JCE was instituted by commissioner Dr N C Saxena and special commissioner Harsh Mander at the intervention of advisor to the commissioner Dr Mihir Shah following reports of malnutrition deaths in the district during the last two years. It had received complaints of child deaths from villages – 11 of them from one village Ranipura.
The commission visited the affected parts of Sheopur on October 5 and 6 and submitted its report to Dr Saxena on Friday. The JCE comprised PS Vijay Shankar as the representative of Dr Mihir Shah, two civil society representatives Dr S K Singh and Dr Vijay Gupta, joint director of Women and Child Development R N Raghuvanshi and divisional joint commissioner of health, Gwalior, Dr Mohan Singh. A copy of the report has also been sent to the district collector with the directive to submit an action-taken report (ATR) to Dr Mihir Shah latest by December 31.
Decrying the row between social activists and the administration in trying to “prove” or “disprove” the deaths due to starvation, JCE says “the undeniable fact is that Sheopur is one of the malnutrition hot spots of the world”. The report has held the pathetic health facilities and poor implementation of various government programmes mainly responsible for the situation.
The report further deplores the fact that even after the JCE visit malnutrition deaths did not stop in the district. “Most alarmingly, we have received unconfirmed reports after the visit of the JCE that all the four children included in the list of severely malnourished by the local administration (Bansi, Sonu, Sukhlal and Kiran) have died. This points to the dangerous level to which the current situation can escalate,’’ the report observes.
Sravani Sarkar, Bhopal November 25, 2006
“All this points to a complete failure of governance, of the failure of the state to provide the very basic entitlements to its citizens, in this case the nation’s future— its children,’’ it adds. The JCE has come out with 42 recommendations for immediate action. They include immediate attention to the severely malnourished and chronically ill children, setting up of fully staffed 13 new primary health centres (PHCs) and 38 new sub-health centres, proper implementation of health schemes, urgent steps to meet the target of 850 anganwadi centres in the district in six months as per the Supreme Court directive, proper implementation of midday meal scheme and the National Rural Employment Guarantee Scheme, increasing public distribution system (PDS) outlets in the tribal areas, enforcing of SC orders on purchase of grain and ensuring that all members of primitive tribe families get Antyoday Anna Yojana cards.
http://www.hindustantimes.com/news/5922_1853055,0015002100000000.htm
by Sravani Sarkar
A JOINT Commission of Enquiry (JCE), instituted by the Commissioner, Supreme Court, has substantiated reports of malnutrition deaths in Sheopur and termed the predominantly Saharia tribe district as ‘one of the malnutrition hot spots in the world’.
In its report the five-member JCE forewarned the district administration of severe drought in the coming summer owing to monsoon failure this year.“Unless the steps outlined by the commission are taken urgently and in earnest, we could see a huge human tragedy unfolding next year,’’ the report has warned.
The JCE was instituted by commissioner Dr N C Saxena and special commissioner Harsh Mander at the intervention of advisor to the commissioner Dr Mihir Shah following reports of malnutrition deaths in the district during the last two years. It had received complaints of child deaths from villages – 11 of them from one village Ranipura.
The commission visited the affected parts of Sheopur on October 5 and 6 and submitted its report to Dr Saxena on Friday. The JCE comprised PS Vijay Shankar as the representative of Dr Mihir Shah, two civil society representatives Dr S K Singh and Dr Vijay Gupta, joint director of Women and Child Development R N Raghuvanshi and divisional joint commissioner of health, Gwalior, Dr Mohan Singh. A copy of the report has also been sent to the district collector with the directive to submit an action-taken report (ATR) to Dr Mihir Shah latest by December 31.
Decrying the row between social activists and the administration in trying to “prove” or “disprove” the deaths due to starvation, JCE says “the undeniable fact is that Sheopur is one of the malnutrition hot spots of the world”. The report has held the pathetic health facilities and poor implementation of various government programmes mainly responsible for the situation.
The report further deplores the fact that even after the JCE visit malnutrition deaths did not stop in the district. “Most alarmingly, we have received unconfirmed reports after the visit of the JCE that all the four children included in the list of severely malnourished by the local administration (Bansi, Sonu, Sukhlal and Kiran) have died. This points to the dangerous level to which the current situation can escalate,’’ the report observes.
Sravani Sarkar, Bhopal November 25, 2006
“All this points to a complete failure of governance, of the failure of the state to provide the very basic entitlements to its citizens, in this case the nation’s future— its children,’’ it adds. The JCE has come out with 42 recommendations for immediate action. They include immediate attention to the severely malnourished and chronically ill children, setting up of fully staffed 13 new primary health centres (PHCs) and 38 new sub-health centres, proper implementation of health schemes, urgent steps to meet the target of 850 anganwadi centres in the district in six months as per the Supreme Court directive, proper implementation of midday meal scheme and the National Rural Employment Guarantee Scheme, increasing public distribution system (PDS) outlets in the tribal areas, enforcing of SC orders on purchase of grain and ensuring that all members of primitive tribe families get Antyoday Anna Yojana cards.
http://www.hindustantimes.com/news/5922_1853055,0015002100000000.htm