November 02, 2012

Capacity Building Workshop on Maternal Death Review

NAMHHR organized a capacity building workshop on Maternal Death Review in collaboration with Commonhealth in New Delhi from 10th-14th Oct. The workshop was organized as NAMHHR
recognizes the importance of conducting Maternal Death Reviews as a step towards system strengthening and correction that will contribute to a reduction in maternal deaths.

The objective of the workshop was to enable civil society to build their capacities to use the comprehensive and strengthen MDR tool focusing on medical, social and legal aspects. The MRD tool used for this workshop was designed in a way that captures social determinants which are a major cause of these maternal deaths.  Dr. T.K. Sundari Ravindran, Dr. Subha Sri,  Ad. Anubha Rastogi and Ms. Jashodhara Dasgupta facilitated the workshop. 28 participants from states of West Bengal, Uttar Pradesh, Gujarat, Odisha, Bihar, Rajasthan, Delhi and Madhya Pradesh participated in it.

NAMHHR hopes to contribute further by using the MDRs to promote accountability and health system improvements through supporting civil society capacities to conduct surveillance of maternal deaths, use the MDR tool and analyze the findings.

Chronicles of Deaths Foretold

NAMHHR organised an Advocacy Seminar titled- CHRONICLES OF DEATHS FORETOLD- Using Maternal Death Reviews to prevent maternal mortality and morbidity in India, 9th October 2012 in New Delhi where civil society activists from 12 states came together on a common platform to have a dialogue with the government and technical experts. The Dialogue brought together senior officials from the Ministry of Health and Family Welfare, technical agencies like WHO, UNFPA, UNICEF and donors. 

Civil society members from 8 states across India who have been documenting maternal deaths and studying the causes presented their findings in the seminar. The documentation of maternal deaths in these states raised important questions relevant to the prevention of maternal mortality and morbidity in India. Health activists also presented their recommendations to representatives from the Ministry of Health and Family Welfare, calling for greater attention to home births to make them safer; greater monitoring of the Continuum of Care instead of only JSY; and a systematic process of conducting Maternal Death Review in all states, with a publishing of what learning has been gained from these reviews.

In response to the presentations and recommendations, Dr. Manisha Malhotra, Deputy Commissioner Maternal Health, GOI Ministry of Health and Family Welfare, chair of the session, shared that “ the time had come for civil society and the government to work together to promote quality maternal health services in the country.” She sought civil society collaboration to conduct Maternal Death Reviews in the community to track those incidents that fail to get recorded officially. The event received favourable coverage in the media. 

Indira Gandhi Matritva Sahyog Yojana (IGMSY) Report Dissemination Event

NAMHHR organised an event to share its study on Indira Gandhi Matritva Sahyog Yojana(IGMSY) and launch its report- The Crisis of Maternity: a compilation of two studies on healthcare and maternity protection for women wage workers in the informal sector in India on 19th September in New Delhi. The book was launched by Dr. Syeda Hameed, Member, Planning Commission 

The event brought together representative from the Ministry of Women and Children and the Ministry of Health and Family Welfare, journalists from print media and representatives from NGOs, alliances and networks.  

Speaking at the launch, Ms Jashodhara Dasgupta representing NAMHHR welcomed the government’s recent scheme to provide maternity benefits to all women, called INDIRA GANDHI MATRITVA SAHYOG YOJANA (IGMSY or Indira Gandhi Maternity Support Scheme) and hoped the studies would feed into the evaluation of the pilot phase of the IGMSY Scheme. However, she said NAMHHR was very concerned that the preconditions for obtaining the benefit, mainly that the beneficiary woman should not have more than two living children, would unfortunately exclude the 60% of women (aged 15-49) who are either Dalits, Tribals or have least education, and 63% of poor women (Lingam and Yelamanchili, 2011). 

Quoting the findings from the recent study conducted by the partners of NAMHHR: Monitoring IGMSY (pilot phase) from an Equity and Accountability Perspective, Advocate Sashi Bindhani of SODA (Odisha), shared that the study examined in detail the situation of 57 women in four blocks (45 revenue villages) in four states of India, all of whom stand excluded due to the eligibility criteria of the IGMSY scheme: almost all of whom were Dalits, Scheduled Tribes and those who lack other social security benefits. The study found that all of them had gone through three to seven pregnancies, where each episode of maternity exacerbates their vulnerability due to increased impoverishment and high expenses. With high pregnancy wastage and poor availability of health care, they are never sure whether their baby will survive, despite which the state has penalized them for having more than two living children. 

Dr. Sebanti Ghosh of ASHA (West Bengal) pointed out that despite their contribution to the economy of the country, and their productive and reproductive contributions to the community, women wage workers in the informal sector (148 million) remain deprived of full maternity benefits, forcing them to continue with physically strenuous wage work till the eighth month and shorten their post partum rest. In the absence of food security, they are compelled to compromise on their own requirements, even in pregnancy. Supplementary nutrition is crucial at this juncture; however, the Public Distribution System and Anganwadi services were reported to be irregular and inadequate. An ill equipped health system compounds the problem. Pregnancy and childbirth is seen as a period of financial crisis as it may mean increased expenses and several weeks or months away from work. 

Ms Kalyani Meena of Prerana Bharti (Jharkhand) concluded that given the abysmal conditions of women workers in the informal sector, the IGMSY scheme in its very design defeats the purpose that it sought to address by imposing preconditions of parity. She presented NAMHHR’s strong recommendation that unconditional maternity benefits, universal health coverage, and universal food security for all women, without any conditions, is a primary requirement for the improvement of maternal nutrition, reduction of maternal anaemia and prevention of maternal mortality.

Addressing the gathering during the event, Dr. Syeda Hameed stated that the study raised important issues and brought to light the fact that the 2 child exclusionary criteria of the IGMSY was an out-dated concept which needed to be removed in order to enable the most vulnerable women to benefit during the critical period of maternity.

Please read news coverage on:   

Maternal Mortality and Morbidity in Jharkhand: The way forward

National Alliance on Maternal Health and Human Rights (NAMHHR) in collaboration with Public Health Resource Network (PHRN)  organized a civil society meeting on Maternal Mortality and Morbidity in Jharkhand: Godda and beyond on 4th August in Ranchi.

27 participants from 16 organizations came together and developed a set of recommendations for Government and planned a follow up strategy. The recommendations were presented to Dr. Sumant Misra, Director, Health Services, Department of Health and Family Welfare, Government of Jharkhand who was keen to take it forward.  Please click here for reading the recommendations developed during the meeting-