10/18/2007, 00.00
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India has first place for women who die in childbirth

by Nirmala Carvalho
Over 117thousand deaths for pregnancy and childbirth in 2005. Births take place in the home assisted by a midwife and in some states women never see a doctor during pregnancy. The Churches commitment in rural areas where public healthcare never arrives.

New Delhi (AsiaNews) – India holds the tragic first place of women who die during pregnancy or childbirth, with 117 thousand deaths registered in 2005, compared to 59 thousand in Nigeria, 32 thousand in Congo and 26 thousand in Afghanistan.  According to the World Health Organisations annual report on Maternal mortality published on October 12th in cooperation with the World Bank and UNICEF,  India along with another 10 countries has 65% of the 536 thousand women who died during pregnancy or childbirth in 2005.  One women out of every 70 dies for problems linked to pregnancy in the country.  99% of these deaths take place in developing countries, above all south Asia, where poverty malnutrition and disease are widespread.

The maternal mortality ratio (MMR) in India is 450 deaths per 100,000 live births. India’s neighbours are far better off. While Bangladesh reported 21,000 deaths with an MMR of 570, Pakistan recorded 15,000 deaths with MMR of 320, China had 7,800 deaths with MMR of 45 and Nepal 6,500 deaths with MMR of 830 in 2005. Sri Lanka recorded 190 deaths with MMR of 58.

An Indian Health Ministry report found that it is scarce access to public health services which is th root cause for deaths during pregnancy: almost one in four women (23%), who gave birth in the last eight years, received no antenatal care, ranging from 1% or less in Kerala and Tamil Nadu to 66% in Bihar. At least 40% of pregnant women did not get any antenatal care in Jharkhand, Arunachal Pradesh and Nagaland. Moreover, home births are still common in India - accounting for almost 60% of recent births, 37% of which were assisted by a traditional birth attendant, and 16% were delivered by a relative or other untrained person.

Dr Wilma Carvalho, a Gynacaeologist, St Ignatius Hospital, Honavar, Karnataka told AsiaNews that “many of the births take place in rural areas, where there exists a practice of using local village women. So when complications arise, the mother is unable to reach the hospital on time.  Even an illness, like hypertension which a woman suffers from- this is not detected.  Post-partum haemorrhage is another cause of maternal death and the lack of Blood Banks with tested blood is a major concern, there are very few Blood banks as stringent regulations needed to set up a Blood Banks.  An unfortunate practice is also the increasing ‘quacks’ who perform abortions spiralling the statistic’s of maternal deaths”.

Father Alex Vadakumthala, Executive Secretary, Health Commission of the Catholic Bishops' Conference of India told Asia News “one hand India is emerging as a developing country, on the other hand the basic health care needs of the people are not met. Unfortunately, in India, healthcare provisions to our rural masses are grossly insufficient. In the southern states like Kerala, Tamil Nadu, Karnataka, almost 60 %  of births take place in an institutional settings like hospitals, so in these states the maternity related deaths are comparatively lower.  Where as in the North a mere 15% to 20% births or deliveries take place in an institutional settings. The Catholic Church along with the Catholic Health Association of India is trying to provide trained persons and education. The Church, has almost 5.000 health care facilities spread across the country and 85% of these Centres are remotest rural villages, where there is no other alternative health centre. Sadly, however, even these are not sufficient according to the needs of our rural population.  The  Health Commission has  establishing 45 community care centres  in five  North Indian States - these are short stay homes where HIV positive expectant mothers  (as well as others)  are welcomed, so that health care is made accessible to these  pregnant HIV positive women and treatment is assured”.

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