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Maternal Health

Introduction

maternal health

Maternal Health in Focus

India’s maternal mortality rate reduced from 212 deaths per 100,000 live births in 2007 to 178 deaths in 2012. The advance is largely due to key government interventions such as the Janani Shishu Suraksha Karyakaram (JSSK) scheme which encompasses free maternity services for women and children, a nationwide scale-up of emergency referral systems and maternal death audits, and improvements in the governance and management of health services at all levels.

However, adolescent and illiterate mothers and those living in hard to reach areas still have a much greater chance of dying in childbirth. Adolescent girls outside Indian cities are especially vulnerable as teenage marriage and pregnancies are very high in rural and remote areas of the country.  

 


Big Picture

Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth ; 20 per cent of these women are from India. 

Annually, it is estimated that 55,000 women die due to preventable pregnancy-related causes in India. 

Good news: The Maternal Mortality Ratio – the number of maternal deaths per 100,000 live births – reduced from 212 in 2007 to 178 in 2012. UNICEF and its partners contributed to this reduction through schemes such as JSSK.

Mothers in the lowest economic bracket have about a two and a half times higher mortality rate. 

 


UNICEF In Action

UNICEF India supports the Indian government at national and regional levels to improve the quality and coverage of high impact maternal health services and to increase community demand for the services. Its focus is on efforts to address the needs of adolescent mothers who are more at risk of complications during pregnancy and the delivery and post-delivery periods.

UNICEF supports cross-sector efforts to improve maternal health in partnership with the organization’s Nutrition, Communication for Development (C4D) and Child Protection sections. 
 
Key achievements and the way forward
 
Evidence for policy and planning: UNICEF has supported the national Ministry of Health and Family Welfare (MoHFW) to develop evidence-based guidelines and protocols such as the Maternal and Newborn Health Toolkit, Maternal Death Review Guidelines and technical treatment protocols.

These documents are the basis for setting up quality of care benchmarks at health facilities so that women can receive services with dignity. 
 
Maternal Death Review: UNICEF India in 2014 also supported modelling and scale up of a unique software for Maternal Death Review (MDR) in five states. The software provides timely data on the causes and location of maternal deaths. It is planned to scale up the software in 10 more states in 2015 and eventually nationwide by 2016.

Historically, Maternal Death Reviews have been a very good tool to support improvements in health systems by analyzing the key causes of deaths among pregnant women and those who have delivered. 
 
Capacity-building: UNICEF India supports capacity-building and on-the-job coaching (supportive supervision) for improved maternal health. In 2013 and 2014, in addition to supporting courses for skilled birth attendants, UNICEF supported the MoHFW to pioneer a short-term training for midwives and doctors on maternal health using models and dummies.

First-ever skills labs in Bihar and Madhya Pradesh were supported by UNICEF. The learnings from these skills lab fed into national guidelines and directives and, eventually, the establishment of four national skills labs that cater to all states in India. UNICEF will continue to support capacity-building using such approaches to ensure that women, especially pregnant women and adolescents, receive quality services with dignity. 
 
Utilization with equity of Maternal Health Services: UNICEF India supports the capacities of health managers and supervisors at district and block-level to plan, implement, monitor and supervise effective maternal health care services with a focus on high-risk pregnant women and those in hard-to-reach communities. The evidence generated from this supportive supervision and monitoring then feeds in the regular planning and supply management for health facilities.