December 18, 2014

Hear the VOICES!!!!

Hundreds of Women Demand High Level Committee to Review National Family Planning Programme

Hundreds of women and men from as many as 10 states in the country came together in Delhi on 17th DEC for a Public Hearing to relate the experiences they had undergone while availing of family planning services in the government health system. The testimonials of the victims, presented before an eminent panel of experts and others including Member of the National Human Rights Commission Justice Cyriac Joseph, raised important questions on issues of informed choice, quality of care, youth perspective and male responsibility.
 
Outraged by the entirely preventable deaths of 13 young women in Bilaspur, Chhattisgarh who were merely seeking safe contraception, the National Coalition Against Coercive Population Policies and Two-child Norm, the National Alliance for Maternal Health and Human Rights (NAMHHR) and 45 other civil society organizations and networks like HealthWatch Forum Uttar Pradesh and Maternal Health Campaign Madhya Pradesh held the Public Hearing to show that what happened in Chhattisgarh was not an isolated incident. The hearing brought to the fore experiences with the family planning health system from the states of Uttar Pradesh, Madhya Pradesh, Haryana, Delhi, West Bengal, Gujarat, Maharashtra, Bihar, Jharkhand and Rajasthan.
They issued an urgent Call to Action asking the government to immediately set up a high level expert committee to review the family planning program in India and reorient it such that it is aligned with reproductive health rights of women and needs of the population. The Call to Action has also asked to shift the distorted focus of annual budgets away from sterilization of women and promote meaningful involvement of men in taking contraceptive responsibility and promotion of spacing methods.
It asked to immediately remove all incentives (such as lotteries and awards) to the acceptors of sterilizations and disincentives to persons with more than two children, in all policies and schemes of the state and central governments.  It also wanted a immediate end to all mass sterilization camps and urged that all sterilization operations and IUCD insertions must be conducted in well functioning health facilities following standard operating procedures laid down by the government.

Describing the quality of care in sterilisation and other family planning camps, Jhamman Bai, a woman leader from the Mahila Swasthya Adhikar Manch, Uttar Pradesh, said poor women from the villages are made to lie on thin mats in corridors and courtyards while the health institutions lacked even basic facilities like toilets. She added that women were often not given sterilisation certificates and therefore could not prove that the operation had indeed taken place if something went wrong. Activist Devika Biswas said that in Kaparfora in Bihar a camp was held in a school in defiance of the Supreme Court orders. There was no pre-operative screening done here and even very young women were being herded into the camp with scant respect for privacy and dignity. A man from Madhya Pradesh said that even though he had undergone sterilisation his wife had conceived and when he complained about the failed operation to health authorities they taunted him about his wife’s morality.
The testimonies clearly brought out that as a result of poor quality of sterilisations, women ended up conceiving again, facing medical complications and in some cases even dying. Generally complications were not treated by the public health system and women ended up spending large sums of money for private treatment. In cases of failure or death when women and men or their families demanded for insurance promised by the government they were discouraged or even threatened.   
The hearing also highlighted the fact that often consent was taken in a situation when the woman was on an operation table and worse still was sterilized without consent, as in a case from Uttar Pradesh where the doctor herself had decided that the woman had too many children. Pratibha, an activist from Human Rights Law Network pointed out that these violations were taking place not just in far flung rural areas not also in the national capital of Delhi.
An analysis of budget allocation at the hearing by Sona Mitra of the Centre for Budget and Governance Accountability illustrated that the family planning policy of the government is grossly biased in favour of female sterilization with over 90 percent of the allocated family planning expenditure going to it while male responsibility and other contraceptive methods have scarcely any allocation. Moreover a large part of the health budget is spent on cash incentive schemes like Janani Suraksha Yojana (JSY) to the neglect of strengthening of public health infrastructure.

Responding to the stories, Justice Cyriac Joseph said, “These are stories of heartrending cruelty and it reflects not just human rights violations but also our insensitivity as a society.” He informed the audience at the Public Hearing that on November 12 the NHRC had issued notices to the government of India and to the Chhattisgarh government asking them for an explanation of the tragedy within two weeks. A month down the line the NHRC is yet to hear from them and is now pursuing the matter.
Ramakant Rai the activist who filed a writ petition in the Supreme Court in 2003 that led to the passing of the order on quality standards for female sterilisation, said, “Sterilisation is not treatment for a disease, it is an elective surgery and therefore those providing it are fully accountable to ensure that there are no adverse outcomes.” He regretted that despite the SC orders not much had changed on the ground.
AR Nanda, former secretary of the ministry of health and family welfare, regretted that although the National Population Policy of India, 2000, completely abjured targets and called for quality of care, yet so many years later “we still find targets informally imposed upon providers and motivators. He insisted, “India must uphold the international agreements and commitments made at ICPD 1994 for addressing rights violations, penalties must be imposed by the state if quality norms are flouted and independent monitoring of quality of care must take place.”
Please click here for  Call For Action
Please find the links to the media report son the public hearing : 



December 02, 2014

Maha-Rally : Abki Baar Humara Adhikar! & People’s Assembly



ABKI BAAR HUMARA ADHIKAR

There are unprecedented attacks today on the hard-won economic and social rights of poor people.
The government has repeatedly reduced the entitlements of NREGA workers and even proposes to
dilute the law. Devastating amendments to the Forest Rights Act and Land Acquisition Act are also
being planned. The deadline for implementation of the National Food Security Act has been repeatedly postponed, illegally. Even the Right to Information and Whistleblower’s Act are being undermined. Against this background, thousands of workers, farmers, pensioners, slum dwellers and other underprivileged people  gathered at Jantar Mantar on 2nd December to assert their economic and social rights (“Ab ki baar, Humara Adhikar”). Please find the demands on Health Sector.

Right to Health care
  1. Enact a right to health act and organize a public system to provide universal, free health care
  2.  Double Union govt. health budget in real terms in next 2-3 years.
  3.  Launch national scheme to provide full range of free essential medicines and diagnostics
  4. Regulate private medical sector and protect patient’s rights 
  5.  Stop privatization of public health services
  6.  Absorb commercial insurance based health schemes into public system
  7.  Fill vacancies of trained doctors, nurses and other healthcare personnel































NAMHHR actively involved in the 2 days peoples assembly(30th & 1st)  and Rally (2nd) coordinated by various civil society organisations from all over the  India. This meeting was held in the Ambedkar Bhawan in Delhi. The major thematic areas of the people' hearing and rally were: 

Food security
Health Care
Education
Pension
MGNREGA
Right to Work in urban areas
Defending rights of workers and labour laws
Land rights and resisting displacement
Forest rights
Right to Water







November 28, 2014

Sterilisation deaths in Chhattisgarh!!!!

Statement On
Sterilisation deaths in Chhattisgarh Nov 2014 

The Jan Swasthya Abhiyan, Sama Resource Group for Women and Health, Commonhealth and National Alliance for Maternal Health and Human Rights (NAMHHR) are shocked at the death of 11 women and the critical condition of 50 other women due to the callous negligence of the Health Department, Government of Chhattisgarh. The deaths and morbidities are a result of a botched-up sterilization operation camp organized by a private hospital under the National Family Planning Programme in Takhatpur Block of Bilaspur District on 8 November 2014. Horrifically, during this camp, 83 women were subject to surgeries in a short span of 5 to 6 hours. Amongst those who have died are Dalits, tribals and Other Backward Classes, leaving behind shattered families and young children. This has resulted in gross violation of the reproductive and health rights of the women.
This tragedy raises grave questions about the unsafe, unhygienic conditions and the slipshod attitude under which these operations were conducted. Moreover, the women who are presently critical continue to get treatment in dismal conditions exposing them to further risks and danger.
The surgeries were conducted in complete violation of the Supreme Court orders (Ramakant Rai Vs Govt. of India, 2005 and Devika Biswas Vs Govt. of India, 2012). These orders instruct that a maximum of 30 operations can be conducted in a day with 2 separate laparoscopes only in government facilities. Also, one doctor cannot do more than 10 sterilizations in one day.  Despite this, the surgeon in Chhattisgarh performed about three times the permissible number of surgeries (83) in less than 6 hours in a private hospital which has reportedly remained closed for 15 years. This is evidence of how these operations were not done under standard protocols.

The announcement of Rs 4 lakh compensation and suspension of officials (Director–Health Services; State Family Planning Nodal Officer; BMO,Takhatpur; the operating Surgeon; and Bilaspur CMHO) are not adequate to ensure that such incidents do not happen again. The systemic failures which led to this incident need to be addressed.
While understanding the specific lapses in the way the sterilization camp in Chhattisgarh was organized, one should not forget the role played by the wrong policies and practices of the governments in the area of family planning services. Such ‘Camps’ keep getting routinely organized everywhere in the country in an irresponsible manner.  Health providers in many parts of India, universally confess that they are under pressure to fulfil unwritten targets coming from the top.  The state still focuses on permanent methods of family planning rather than temporary methods. In addition to this the two-child norm significantly contributes to the pressures for sterilization. All this despite the Government of India’s promises of ‘Repositioning Family Planning’ – to move away from permanent methods to spacing methods, to increasing access to safe and effective contraceptives.
At the London Summit on Family Planning (2012), the Government of India committed to additionally providing 48 million women and girls with access to contraceptives by 2020. However, around 1 in 5 women of reproductive age do not have access to contraception such as condoms and OC pills. India’s promises at the Family Planning 2012 Global Summit will reinforce the pressures of meeting ‘targets’, which has dangerous and long-term implications for the health of the people. 

  This incident must be declared a disaster/emergency, and we demand that:
  • ·      Immediate responsibility needs to be fixed in terms of criminal negligence not only on the  medical team which performed the operations, but also in identifying higher officials of the  state who sanctioned this particular camp. 
  • ·     A proper epidemiologically-sound investigation into this incident should be carried out. A  three-member probe team has been constituted but these members are a part of the state, which signals a serious conflict of interest and thus, there should be an independent inquiry   committee.
  • ·           Further deaths and damage should be minimized. It must be ensured that technically the most competent medical care is provided to the women to avoid further deaths. 
  • ·          The ‘camp method’ of sterilization needs to be stopped with immediate effect as quality of care is seriously compromised in mass sterilization programme to meet earmarked targets. 
  •      Women, adolescents and men need to be provided with safe choices for contraception. Emphasis should also be placed on male sterilization such as vasectomy, which involves comparatively lesser health risks.
  • ·          Quality of contraceptive services, including counseling, has to be monitored both from within the system and from outside through community monitoring.
  • ·     The family planning programme needs upheaval and a re-analysis, in order to protect the reproductive and health rights of women.



November 20, 2014

Chhattisgarh Sterilization Deaths !

         Press Release on Chhattisgarh Sterilization Deaths

NOV 2014 

Health Activists and women’s rights activists held a Press Conference on 19th November to draw attention to the range of issues raised by the recent tragic and completely avoidable deaths of more than a dozen women and the critical condition of many more following their laparoscopic sterilization in Bilaspur, Chhattisgarh.The manner in which the surgeries were performed, in complete violation of all standard operating procedures,and subsequent events amount to grave violation of some very basic health rights of the affected women.  In addition, they point to the callous and biased attitudes towards poor women that persist among health functionaries and policy makers, and the tenacious hold of the “targets” approach in the family planning programme despite statements to the contrary.  
The said sterilizations were performed at acamp held on 8 November 2014 in Takhatpur Block of Bilaspur District.  The camp had been organized by the State Department of Health under the National Family Planning Programme to perform laparoscopic tubectomies, and was conducted in the premises of a non-functioning and abandoned private hospital. Surgery should not be performed in a hospital that is abandoned and that does not have basic facilities. These operations are not urgent and are elective. There is no need to perform them in unsafe areas, abandoned hospitals or in make shift hospitals as is happening through the camps.
83 women -predominantly Dalit, tribal, and OBCs- were subject to sterilization within a short span of 5 hours. It needs to be pointed out that the sterilization procedures flouted two sets of Supreme Court Orders (Ramakant Rai Vs Govt. of India, 2005 and Devika Biswas Vs Govt. of India, 2012). These orders instruct that a maximum of 30 operations only can be conducted in a day,and only in government facilities with 2 separate laparoscopes; one doctor cannot perform more than 10 sterilizations in a day.  Notwithstanding such orders, we see that in Bilaspur a single surgeon performed about three times the permissible number of surgeries (83) in less than 5 hours in a private hospital which has reportedly remained closed for 15 years.  In
The state government has announced several measures – monetary compensation and support to the affected families for care of the children of the dead women; suspension of several officials, and appointment of an enquiry commission.  The High Court has also taken suo moto cognizance of the tragedy.  There are also statements that the doctor is not to be blamed and that the problem lay with contaminated medicines that were given to the women.  As health activists who have been repeatedly calling attention to the deep-rooted problems afflicting the health system in the country and advocating several remedial steps, we believe that these measures are not adequate and do not touch the systemic and policy factors that lead to such incidents.  We feel that these are attempts to obfuscate the actual causes of death and the reasons leading to the incident.   A series of issues need to be addressed in the immediate to medium to long term. 
In the short term, a thorough, impartial and unimpeded investigation and medical audit must be done immediately, by a competent team of medical and public health professionals, into the causes of the deaths and the illness of the women who underwent the sterilization.  Accountability and culpability need to be clearly fixed for the deaths of otherwise healthy women following a medical procedure.  That would be one of the first steps towards ensuring that mistakes and lapses are not repeated and such tragedies do not recur.Even 10 days later, such an investigation has not been announced by the state.
It is pertinent to remember that the failures in implementing guidelines and standards, and other kinds of violations in the sterilization component of the family planning programme have been repeatedly raised by civil society groups over the last decade or so, and are the subject matter of several petitions in the Supreme Court, such as the two referred to above.  Given that a lot of documentation already exists from several parts of the country, it is the need of the hour to compile all these evidences to learn the lessons and also ascertain why its implementation is so shoddy and poor.     
In the medium to long term, severalpolicy matters and systemic issues need to be addressed.Among these are: (i) to do away with the continued emphasis of the Family Welfare Programmes on female sterilization in the name of reproductive rights and reproductive health.  It is seen that despite all the talk and concerns expressed by the state and international agencies for women’s health and maternal health,at the ground level the action is centred on such sterilizations and institutional deliveries only for reducing maternal mortality.   The state still focuses on such permanent methods of contraception rather than provide safe temporary methods for spacing and increasing access to safe contraceptives. In addition to this,the two-child norm significantly contributes to the pressures for sterilisation.  Such ‘Camps’ (euphemistically called ‘fixed day static’ camps) are routinely organised in many States in the country in an irresponsible manner. Health providers in many parts of India confess that they are under pressure to fulfil unwritten targets coming from the top. 
(ii) to improve the dismal condition of the government health institutions, make them functional by improving availability of  doctors and other health personnel and medicines.  Why is it that despite years of planning and allocating money for health system improvements, under reproductive and child health, under the NRHM, and despite years of so-called technical assistance for improving health system management, there are no improvements at the ground level?    There is no substitute for increasing material, human and financial resources to strengthen the primary health institutions across the country.   
This terrible incident should be taken as a wake-up call.This incident must be declared an emergency, and we demand that:
1.    An independent and comprehensive epidemiologically-sound investigation into this incident should be carried out.   On the basis of the findings, responsibility must be fixed in terms of criminal negligence not only on the medical team which performed the operations, but also in identifying other officials who sanctioned and were involved in managing this particular camp.
2.  Negligence and contributory negligence may be fixed on all parties involved, including those providing contaminated surgical equipment, medicines, etc. State is vicariously liable and ought to pay higher compensations for the lives lost and also to those who are sick.
3.    Further deaths and damage arising of poor quality of health care system, lack of compliance with SOPs, inefficient oversight system for quality control of healthcare delivery at the grassroots, and medical negligence should be entirely eliminated.The govt should must be held Sterilization operations only in  well fully equipped  government hospitals and sterilized places, not abandoned hospitals that are shut, or in makeshift places, where sanitation and cleanliness is compromised and there is a high likelihood of women undergoing a procedure in acquiring infections.
The ‘camp method’ with incentives and targets of sterilization should be stopped with immediate effect. Instead, sterilization should be offered as one of the options among other safe, non hazardous, non invasive, long acting methods of contraception.  It should be provided as one of the services through an improved basic primary health care system.
5.     The family planning programme needs a thorough re-analysis and overhauling, that centre-stages the reproductive and health rights of women. Emphasis should be placed on male responsibility for family planning, and use of condoms and vasectomy without coercion which involves far lesser health risks.

Jan Swasthya Abhiyan
Sama Resource Group for Women and Health
National Alliance for Maternal Health and Human Rights
Medico Friend Circle
All India Democratic Women’s Association
National Federation of Indian Women
Nirantar
Muslim Women’s Forum
Coalition against 2 Child Norm
Healthwatch Forum UP
Initiative for Health & Equity in Society
Diverse Women for Diversity
Human Rights Law Network




September 25, 2014

Meeting With Dr. T N Seema (Member of Parliament)

Meeting With Dr. T N Seema (Member of Parliament) 


A  team of NAMHHR SC members comprising of Dr. Abhijit Das, CHSJ; Sona Mitra and Priyanka, CBGA; Sandhya Y K from SAHAYOG met Dr. T N Seema, Member of Rajya Sabha and also a member of the Parliamentary Standing Committee on Health and Family Welfare on 10-09-2014 in New Delhi. 

The team gave Dr. Seema the NAMHHR report Maternal  Health and Nutrition in Tribal Areas: Report of the Fact-Finding Mission to Godda, Jharkhand,the CommonHealth Report, Maternal Death and Denial of Maternal Care In Barwani District Madhya Pradesh : Issues and Concerns and other important documents related to the maternal issues in India.


She agreed with the team that since different regions had different realities and requirements, there was a need to have solutions specific to the area, rather than pushing a 'one size fills all' solution. The team raised the issue of the intersectoral nature of maternal health which requires for different Ministries to work in cooperation with each other; for instance, nutrition which forms a core component of maternal health is the responsibility of Minsitry of Women and Child Development while maternal health is the responsibility of the Ministry of Health and Family Welfare.  The discussion also focused on issues related to maternal health bbudgeting. 

A Proud Moment...


Dead Women Talking : Launch of the Report
 


24th September 2014 was a proud day for the CSOs who work in the field of health. Yesterday when Dead Women Talking : A Civil Society Report on Maternal Deaths in India  released by Dr Syeda Hameed, former member of Planning Commission in New Delhi  fulfilled the aims of a rigorous group's several months works on recording  and analysing the maternal death happened in the Country. The launch was organised in the  India International Centre Annexe, New Delhi.

The report is an outcome of a coordinated civil society effort led by CommonHealth, a national level coalition working on maternal-neonatal health and safe abortion. Twenty one  civil society and community based organizations including NAMHHR compiled stories of 124 maternal deaths occurring over a two year period across 10 states of the country.
The Meeting was cherished with the presence of the eminent panellists like Professor Lakshmi Lingam, Professor and Deputy Director, Tata Institute of Social Sciences, Hyderabad Dr Sridhar Srikantiah, public health specialist and Dr Ritu Priya, Professor, Centre of Social Medicine and Community Health, Jawaharlal Nehru University. The Audience included Leading Public health Activists, Researchers, Civil Society Organisations reporters  and NAMHHR members Dr. Sebanti Gosh, Priya John, Jayashree Velankar and Jashodhara Dasgupta and representatives  from the  leading media. Please find the News article came in Indian Express Pune edition : http://epaper.indianexpress.com/344712/Indian-Express-Pune/25-September-2014#page/23/1

Please find the links for the report : 
  1. Dead Women Talking - Report
  2. Executive Summary of the Report
  3. Dead Women Talking - Table

September 17, 2014

Maternal Health and Nutrition in Tribal Areas - Report Launch


Maternal Health and Nutrition in Tribal Areas 
 Report Launch 

Beside the governmental data on Declining  Maternal death Rate and improved maternal health; there are massive gaps when it come to the reality . To find out the reality, a team comprising of Vasavi Kiro (ex member of the Jharkhand Women’s Commission), Dr. Abhijit Das (Member of Advisory Group on Community Action, NRHM) and Jashodhara Dasgupta from  NAMHHR, along with other civil society members undertook a fact finding from 20th to 23rd of November 2013 in Sunder Pahari block, Godda District. The team also tried to explore issues of service provisioning and suggest alternate strategies to improve health and nutrition services in the area  in the tribal areas of Jharkhand.
The FFM team visited three villages selected on the basis of different tribal communities,  varying distance from the block CHC, as well as different accessibility to roads. The team also visited one Community Health Centre (CHC), one First Referral Unit (FRU) and the Godda District Hospital; where the health providers and managers were asked about their assessment of barriers and challenges. 
The Fact-Finding Mission Report was launched in Godda on 1st September 2014 by the D-RCH (former Civil Surgeon) Dr. Pravin Chandra, WHO representative and the Medical Officers in Charge of the Sunderpahari CHC and Mahagama FRU. During the District Dialogue attended by tribal women, Sahiyas and civil society activists of Santhal Parganas, the doctors admitted some continuing challenges like vacancies and lack of skilled staff in the CHC, and the problem of live-saving blood transfusion, which could not be provided in the entire district. The Report was also  shared with the different media in Ranchi and MLA Bandhu Tirkey also joined us and he also did a launch with the media people. 

The profile of the visited area
Godda district is part of the Santhal Parganas division of Jharkhand which is dominated by tribal communities. Sundarpahari is a backward block in Godda.  The block has an entirely rural population, with 79% belonging to the Scheduled Tribe category, and more than half the villages are inhabited by particularly vulnerable tribal groups (PVTGs). Nearly 50% of land in Sundarpahari block is forested and hilly and most habitations are not connected to the few roads that exist. The literacy rate in Sundarpahari is 27%, and AHS 2011-12 data indicates that childbirth at home is 75.2% for district Godda

Summary Findings
  • ·         Giving Birth at home

All the women had given birth at home even though some had complications and near-miss experiences. There was also a maternal death in one of the villages. Yet the women did not consider going to the local health facilities as an option, and had no information about JSY or JSSK. 
  • ·         No Access to Basic Health Facilities

These women did not have access to basic health services such as ANC, and even immunization services for children was unavailable  in the case of PVTG communities.
  • ·         The ANMs did not go to the villages

The ANMs did not go to the villages for either ante-natal care or for home births; the health sub-centres were not easily accessible for many hamlets in the village, and the VHND was not taking place in even half the villages of this block owing to shortages of human resources and transportation issues.
  • ·         No functioning of  blood storage and transfusion facility

In the entire district although a large number of the pregnant women present with high anemia and  comprehensive emergency obstetric care had to be accessed (by those who could afford it) in Bhagalpur Medical College in Bihar. In other blocks where ante-natal care is provided, it is not identifying any danger signs such as anemia, malnutrition or pre-eclampsia.
  • ·         Free supply of grains- traditional Practices were neglected

 The PDS does not incorporate the local grains that are richer in nutrients and instead provides the standard cereals that are given all over the country. The traditional food patterns of the tribal communities which were linked to the forests and the robust practice of mixed organic farming has been disturbed by the introduction of PDS grains. Local practices and resources have been ignored and women have been asked to take iron-tablets during pregnancy instead of promoting consumption of local iron rich foodstuff.
  • ·         No efforts to integrate the tribal health system

Given the geographical situation of Godda district, it is difficult for health services to reach communities located deep in the forests. The tribal communities are seen as ignorant and uneducated, and their practices are looked down upon. The health system has made no efforts to integrate the tribal health system (based on local herbs) and integrate some of the good practices so that the tribal feel less reluctant to use the health facilities.
  • At health facilities in tribal areas 
  • Inter-departmental convergence
  • Re-orientation of community and facility health providers
  • Integration of healthcare with the nutrition services
  • Community Monitoring and Accountability by strengthening the capacity of members of Village Health, Sanitation and Nutritional Committees



The Report of the meeting and Press clippings are attached in this blog post; please find the links below. 

  1. CSO Action Plans
  2. Godda Report Chapter - 5- Hindi Translation
  3. Participant List
  4. Meeting Minutes



August 07, 2014

A Stepping Stone!!


A Stepping Stone!! 

NAMHHR filed a petition on July 1st week by human rights lawyer Anubha Rastogi—with technical support from the Center for Reproductive Rights—on behalf of the National Alliance for Maternal Health and Human Rights (NAMHHR). Justices Navin Sinha and Rangnath Chandrakar of the High Court of Chhattisgarh at Bilaspur issued an order on July 18 to the Chhattisgarh Government to address allegations that women in the state lack sufficient access to safe abortion services.

August 01, 2014

Working with HRBA



Working with HRBA



NAMHHR conducted a Strategic Development Workshop named " WORKING WITH THE HUMAN RIGHTS-BASED APPROACHES FOR PREVENTION OF MATERNAL MORTALITY AND MORBIDITY IN INDIA" on  24th June, 2014 at India Habitat Centre in  New Delhi. In this significant meeting there were in-depth discussions on the Technical Guidance Note (https://drive.google.com/file/d/0B-fynPVsu-vxTXJaeXoyUmc5YzA/edit usp=sharing ) which is a United Nations document that provides technical guidance to governments on implementing policies and programmes to reduce maternal mortality and morbidity in accordance with human rights standards. The objectives of the meeting were: to develop a shared understanding of the relevance of using human right base approach (HRBA)  for preventing MMM , to brainstorm on ways of using human rights-based tools such as the Technical Guidance and the UPR process with senior officials of the  Health and Family Welfare department, Parliamentary Standing Committee, National Human Rights institutions and /or Judiciary and Civil society and research institutions

In course of the discussions held in four sessions, the participants developed an understanding of the Technical Guidance note, an overview of the situation of maternal health in India and the Universal Periodic Review process (http://www.ohchr.org/en/hrbodies/upr/pages/BasicFacts.aspx)The workshop was attended by twenty seven distinguished guests from eighteen organizations. 




To access the presentations of the workshop please follow this link:
  1. OCHR Technical Guidance on preventing MMM- Jasodhara Dasgupta 
  2. https://drive.google.com/file/d/0B-fynPVsu-vxdXFvc3pzZEM1Smc/edit?usp=sharing
  3. Presentation on the Situational Analysis




July 28, 2014

Maternal Near Miss meeting in Aurangabad


Maternal Near Miss meeting in Aurangabad (3rd – 5th July)


    The Expert group meeting for " Drafting technical and operational guidelines for some maternal health issues such a Routine USG in pregnancy, Screening for Hepatitis and Syphilis in pregnancy, Maternal near miss and Cesarean section by surgeon" took place  on 3rd  to 5th July 2014  at Aurangabad. This meeting was organized by the Government of India and Maharashtra government and funded by UNFPA. The Government Of India invited NAMHHR to attend the expert meeting and Dr.Archana Kahrayal, Research Officer  from SAHAYOG  attended the meeting and shared her experience with other participants. 
      The 1st Expert Group meeting took place in the month of May (4th to 5th) 2014 at Nagpur for framing the guidelines for "Routine Ultrasonography  during pregnancy, screening for syphilis & Hepatitis B, preparing curriculum for Surgeons for conducting C –sections and Maternal Near Miss" with the help of experts in these fields which includes doctors and people from international organizations like UNICEF and UNFPA. 
     There, the experts from various fields related to health  had in depth discussions on maternal near miss cases , In that they discussed the  Facility based Maternal Near- Miss tool of Government of India, including criteria for maternal near miss cases. As a positive feedback they changed a few gaps in the tool.  The tool also includes gap analysis section in which apart from social gaps they have facility gaps also. This was also decided that now there will be Maternal Near- Miss committee combine with the MDR committee in all states according to the MDR Guidelines. 
In This meeting senior persons from Avni foundation also displayed maternal death tracking software which will be used in the future by government for tracking maternal death. 


June 12, 2014

National Convention on Maternal Health

 
National Convention on Maternal Health: Agenda for Second Generation Priorities in Maternal Health Programming
NAMHHR in collaboration with OXFAM

Making Maternal Health a Matter of Priority for the Nation: Drafting of a new road map for second generation priorities in maternal health.
Speaking at the National Convention on Maternal Health Shri Satyabrata Pal, Ex-member of the National Human Rights Commission stated that, “Women as a whole are marginalized and therefore their lives and health is not a matter of priority for the nation.”He called for putting an end to the abdication of responsibility between the state government and the Central Government.
The preventable tragedy of maternal deaths in India was comprehensively discussed at the National Convention on Maternal Health in India entitled Agenda for Second Generation Priorities in Maternal Health Programming’, held in New Delhi on the 20-21 March organized by the National Alliance for Maternal Health and Human Rights (NAMHHR) in collaboration with Oxfam India. The group felt that the unacceptable high rates of maternal mortality in a middle income country like India, needs to become a national priority.  Maternal health cannot be the problem of only the Ministry of Health and Family Welfare; it needs the coming together of different departments such as Roads and Transportation, Agricultural (as food policies affect food security), Science and Technology, Environment, etc to save the tens of thousands of lives of women in our country who die of preventable causes during maternity.
India’s maternal death rate was supposed to decrease by one-third to 109 per 100,000 live births by 2015. The nation stands on the threshold of this deadline with an average maternal mortality rate of 178 per 100,000 birth in 2010-2011, down from 254 in 2004-2006. But there is great variance even amongst these figures, with maternal mortality rates per 100,000 live births being as low as 66 in Kerala and 90 in Tamil Nadu, to shockingly high rates of 347 in Assam and 300 in Uttar Pradesh.
Dr. Syeda Hameed, Member of Planning Commission said that, “The recommendations and issues discussed by this group would contribute to the implementation of the 12th Five- year plan whose motto is inclusive growth. She asked the group to provide these inputs into the midterm appraisal of the Plan.”
Also present at the event was Shri Manoj Jhalani (JS, Policy MOHFW) who said that the ministry agreed with the analysis and concerns emerging and looked forward to the operational road map from such field based organizations who can give practical solutions.  He also highlighted that the government could put in place grievance redress mechanisms but the proper utilization of these by pregnant women needs an enabling environment.
 “The health system should not treat pregnant women just as patients but as empowered and active agents who have the right to choose the location and services that they want”, said Prof Ritu Priya from the Centre for Social Medicine and Community Health, JNU. She added that the Dais, ASHAs and ANMs can together form a team which could work to support women in rural areas throughout maternity.
 “For too long we have been counting maternal deaths without accountability towards the women at risk of losing their lives and the health system needs to learn how to prevent such deaths and make public the action being taken”, said Jashodhara Dasgupta, convenor of the National Alliance for Maternal Health and Human Rights  and the organizers of the event

The meeting brought together practitioners and researchers on maternal health, campaigners on various issues of human rights, public health and health systems experts, lawyers, budget analysts as well as representatives from the government and donors.