Gonzalez 1

Maternal, Infant, and Child Health in India

California State University Channel Islands

Health 405

Professor Betancourt

Jennifer Gonzalez
 Gonzalez 2

Living in the 21st century has come with many advances in different areas. Advances

through technology, medical, and scientific. These have all brought advances that benefit

thousands if not millions of people, cities, and countries as a whole. However, that is not always

the case for some. India is one of these few countries that lacks in some areas. Throughout this

paper we will be looking at how India’s healthcare system and traditions address maternal care.

When you look at the health care system you see each country has its own system. Some

countries are far more developed than others. The United States for example is more developed

in terms of maternal health than India. The question that is going to remain under consideration

is why? And how can India catch up? Maternal health is something through recent years that has

been increasing with severity. According to Praveen, one of the most shameful human

developments is seeing the huge gap between developed and developing countries in regards to

maternal deaths (2010). Maternal death is the “greatest health divide in the world.” This topic is

interesting to me for various reasons. One of the reasons for choosing this topic is to be able to

learn how maternal health varies in different countries. Another reason is because India has one

of the high maternal death rates and I wanted to do more research as to why that is. Lasty, I want

to be able to know how traditions and cultures impact maternal health.

According to Prem, India accounts for 17% of the world’s population, yet it also counts

for 19% of maternal deaths globally (2013). This means there are more maternal deaths in India

for the amount of population there is. Over the course of the years since the late 1980’s there

have been attempts to try and implement programs for maternal health improvements.

Regardless of these attempts there has been a constant battle between two patterns that stop from
 Gonzalez 3

improvements. The two factors that are obstacles for this attempt are socioeconomic status and

cultural traditions.

In a recent study conducted by Praveen, there was evidence that suggested that many

people in India still have traditional births at home. This contributes to the high rates of maternal

deaths. Women and children are the ones that are especially targeted as they are more prone to

deal with such issues. When you look at the way that women give birth at home, it can lead to

more complications. Complications that include but are not limited to haemorrhage, sepsis,

obstructed labor, etc. Typically the women that give birth at home live on or below the poverty

line and can not afford to pay for a hospital delivery (2010).

Cultural traditions are not the only thing that impact maternal health, but also

socioeconomic status. A study conducted by Shankar investigates how delivering a baby impacts

financial stability. This study was conducted in the state of Haryana, a section of India. There

were five different perspectives that were investigated: public sectors, out-of-pocket

expenditures,percentage of women with no expenses, catastrophic expenses, and lastly

impoverishment due to out of pocket deliveries. The study dug into the public and private sectors

that have to do with the finances and delivery. The study conducted resulted in 65% of child

births being given through the public sector. There was an estimate of 82% of the deliveries in

Haryana were covered through the public and private sectors. 17% of births were given through

private sectors. Looking at the results they do vary depending on the district that is being

searched. Each district has different socioeconomic status. Through this district we were able to

see that there was a strong use of private and public sectors used for delivery (2015).
 Gonzalez 4

Maternity, infant, and child care is one of the public health problems India still struggles

with. This is a big health problem because India is overpopulated and some people do not have

the financial stability to have proper medical attention. Many people resort to having at home

births which can lead to difficulties during birth and possibly death for the mother or child. There

is a lack of sanitation, medical resources, and space. These factors can all contribute to maternal

death.

While there has been an decrease of maternal deaths by 5% from recent years. India still

has one of the highest percentages. According to Jose, there has been a four plan strategy that has

been proposed to try to lower the percentage to reach National Health Policy. The strategy is

The RAFT strategy. This includes reviewing medical records, death certificates or autopsy

reports of mothers who have passed away. It also includes access to respectful healthcare and

funding to provide better infrastructures, medicine, and interventions. Lastly it includes having a

better trained staff. Each of these four parts from the strategy places an important part for an

improvement (2018).

Reviewing medical records and autopsy reports ensures that the causes for maternal death

is understood. Also, being able to review these gives percentages per state instead of a whole.

The percentages of maternal death vary from state to state because the cause varies from state to

state. The second part includes access to health care for all women related to maternal health.

Many women can be given the opportunity to educate and empower women about family

planning, sexual health, and reproductive health. Being able to reach these women can give them

a better understanding and gives them the materials they need to be able to learn from past

experiences. This could be beneficial to be able to educate women and hopefully be able to
 Gonzalez 5

reduce any pregnancy or labour issues. In addition, there should be skilled and well trained

obstetric care to be able to save the lives of expecting mothers. Many rural areas tend to have

irregular water and electrical supply being more likely to get an infection. According to Jose, one

third of the hospitals do not have labor rooms, no access to essential drugs and do not have an

accessible blood bank. Having more trained staff and being able to have access to these resources

can have a huge impact on the decrease of maternal deaths. Finally, in order to have all of these

steps work properly there has to be a more trained personnel so they know how to handle

diagnoses and care (2018).

The population that is targeted for this health promotion is mainly Indian women in rural

areas. Regarding child birth and throughout their pregnancy women do not have much of a voice

about the pregnancy. It is in Indian tradition that women are to eat less during their pregnancy

and also that the temperature of the food has a lot to do with the health of the child. India’s

tradition is to have a son of preference therefore they follow certain traditions to have a son.

They feel that they have to use herbal medicines to be able to have a son. Along with taking

herbal medicine, they also have traditional home deliveries with an attendant. Also, men are not

a part of the childbirth process as they are waiting on the outside with extended families. They

really focus on rituals of getting rid of the “evil eye” after giving birth. These are just some

cultural norms that are followed with Indian traditions. Many of these are part of the culture that

comes with possible risks of maternal death when there are possible complications.

Looking into the population you can see varies different types of social pressures that can

come from cultures. Women who live in a rural area are less likely to be able to have access to

health care. On the contrary people who live in urban areas have more access to healthcare. The
 Gonzalez 6

Indian government has also been trying to promote cash incentives for poor women to get them

to give birth in an actual facility instead of an at home delivery. It is a bit difficult to implement

these incentives because each state varies differently. Especially since women are not able to

make decisions on their own. Women are valued and respected within families, however some

are still mistreated within their own families. India is a male dominant society, which can bring

stress to a woman because the preferred gender is male. A son is honored and is seen uprooted to

continue the passage of the soul (Wells, 2014).

The RAFT program is aimed to be able to help women have a little bit more of western

practice, while still maintaining traditions. Being able to educate women about sexual, maternal,

and prenatal health can be a bit difficult when the society is male-dominate, but that does not

mean it is impossible. Being able to apply this program can be more beneficial for not only the

mothers, but also the fathers. When the mother is able to have a safe birth and healthy child, a

couple is able to have more children. Having knowledge about the safety and precautions that

can be taken to avoid any complications is something that this program aims for.

When you look into the problem of maternal health, you think of everything a mother

goes through for nine months. Feeling everything inside of her change and move, while her

appearance changes as well. Having a child grow inside of you is a feeling that is indescribable

and imagining losing a little human you have felt is unbearable. In some cases it is not only the

child, but also the mother that loses their life. It can be something painful that can be avoided

through learning how to properly care during pregnancy and after to have both mother and child

healthy.
 Gonzalez 7

Addressing the problem of maternal death is not something that is easy. There are

complications, setbacks, but also there is a small amount of success. Being able to change

somebodys’ culture and traditions is not easy. I feel that in order to be able to address this

problem you have to be able to understand what it is that needs to be done and how it is you can

help without overstepping. Being in a culture where things have to be done a certain way means

that change is going to be scary. My strategy to be able to address this problem would be to get

to know the people and understand the culture. Once that has been acknowledged, find a way to

introduce new techniques without undermining traditions. Being able to incorporate a little bit of

what they know to western medicine is something that I feel could make them still feel accepted.

Not leaving history behind is something no culture wants and my strategy would try to

incorporate a little piece of culture so that they would be able to accept proper treatment.

With all of these programs attempting to decrease the rate of maternal death, there has

been a campaign that has really fought and spoken for women across India. The White Ribbon

Alliance has been funded to be able to bring safe motherhood to India. They have worked

surveying more than 150,000 thousand women to see if what they feel they need to have better

maternal health. Being able to see these results demonstrates that 36% of women want access to

maternal entitlements, services, and supplies. These women want to have their voices heard and

not be scared when they decide to start a family. India has decreased the number of maternal

death rates, but still remains as the highest number.

I choose this program because they try to incorporate the voice of women. In an area

where the male society is dominant and seen superior to women this campaign fights for women

to have a voice for their health. Especially for maternal health where the woman is the one that is
 Gonzalez 8

carrying the child. This program/ campaign fights to work with policy makers to make change

for the better. It is not an easy route, but the main solution and ultimate goal is to decrease

maternal mortality and create women’s rights for health care. My health, My voice is the name of

this campaign created by White Alliance. The outcomes of this campaign are a step towards

creating a better life for future women. In 2017, the responses from the 150,000 women surveyed

were taken to the National Health Minister. There he promised to create a better form of

communication for women to speak about their concerns (Gillianhersh, 2020).

Maternal health care should be something women should have access to everywhere, but

unfortunately that is not the case. India is trying to beat this hard battle and has succeeded, but

still has a long way to go. Being able to fully implement these programs and campaigns can

change the lives of so many women. It is a basic right that these women have to not be afraid of

losing a child or themselves because they do not receive proper medical attention.
 Gonzalez 9

Work Cited

Gillianhersh. (2020, April 8). White Ribbon Alliance India. Retrieved from
https://www.whiteribbonalliance.org/india/

Jose, Jithin. (2018, June 11). Reducing Maternal Mortality in India: A four-pronged strategy.
IGC.https://www.ideasforindia.in/topics/governance/reducing-maternal-mortality-in-india-a-four-pro
nged-strategy.html

Mony, P., Krishnamurthy, J., Thomas, A., Sankar, K., Ramesh, B., Moses, S., . . . Baradaran, H.
(2013). Availability and Distribution of Emergency Obstetric Care Services in Karnataka State,
South India: Access and Equity Considerations. PLoS ONE, 8(5), E64126.

Praveen Kumar Pathak, Abhishek Singh, & S V Subramanian. (2010). Economic inequalities in
maternal health care: Prenatal care and skilled birth attendance in India, 1992-2006. PLoS ONE,
5(10), E13593.

Shankar, P., Pankaj,B., Rakesh, G., Atul, S.,.... (2015). Coverage and Financial Risk Protection
for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?. Plos
one.

Wells, Young-Oak. Dietsch, Elaine. (2014).Childbearing traditions of Indian women at home and
abroad: An integrative literature review. ElSevier.
https://www.womenandbirth.org/article/S1871-5192(14)00086-9/pdf