Lucknow, India - Tens of thousands of Indian women and girls are dying during pregnancy and childbirth, despite government programs guaranteeing free obstetric health care, Human Rights Watch (HRW) said in a newly released report.
The report, No Tally of the Anguish, describes the harrowing conditions that lead to devastating maternal mortality in India. Despite national commitments to decrease incidents of maternal death through the National Rural Health Mission, the mortality rate is currently one in 70, as compared to one in 7,300 in the developed world. While the nation-wide rate has decreased in recent years, individual states have shown an increase in maternal mortality. Significant disparities are also visible, with the prevalence of deaths occurring among the Dalit, lower castes and tribal communities.
HRW’s research in Uttar Pradesh, a state that has one of the highest maternal mortality ratios in India, uncovered four primary reasons for the prevalence of maternal deaths: barriers to emergency care, poor referral practices, gaps in continuity of care, and improper demands for payment as a condition for delivery of healthcare services. There is also a major failure in capturing and recording information about how many women are dying.
“Unless India actually counts all the women who die because of childbirth, it won't be able to prevent those thousands of unnecessary deaths,” said Aruna Kashyap, a researcher for HRW. “Accountability might seem like an abstract concept, but for Indian women it's a matter of life and death.”
In addition, the majority of community health care facilities identified are not equipped for emergency care, and when women are referred to other facilities, they receive little or no referral support, particularly regarding transportation. In order to confront these issues, the HRW calls for ongoing monitoring and critical investigation of current health facilities and practices.
“India has recognized that thousands and thousands of its women are dying unnecessarily, and it could be leading the world in reversing that deadly pattern,” said Kashyap. “But for all India's good intentions, the system still leaves many women at risk of death or injury.”