Maternal Health

and
Care in India
-By Group 2
Presented by-
Amit Chhabra.
Kalpna Verma.
Divya Kumawat.
Komal Sharma.
Ankur Sooden.
Abhay Sharma.
Amit Kaushal.
Deepak Yadav.
Deepshika.
Maneesha Batra.
Contents
Definition
Measures of Maternal Health
Scenario in India
General Factors affecting Maternal Health
Specific Factors affecting Maternal Health
Programs and there impact
Future
Definition
Maternal Health refers to the health of women during
pregnancy, childbirth and the post partum period.

Maternal health care is a concept that encompasses

family planning, preconception, prenatal, intranatal
and postnatal care.
Measures of Maternal Health
Maternal Mortality Ratio/Rate
Nutritional Status(Anemia Prevalence)
Antenatal care (Timing of 1st visit and the number of visits)
Age at 1st Pregnancy
Place of delivery
Assistance during delivery
Obstetric care accessibility
Delivery Complications
Fertility
Contraceptive Use
Service availability & Utilization
Components of maternal health care
Family Planning.

Preconception.

Antenatal care.

Intranatal care.

Postnatal Care.
 R R E N T S C E N A R I O
CU
Maternal Mortality in India
Very High Maternal Mortality
498 per 100000 live births 1998.
379 per 100000 live births 2001-2003.
254 per 100000 live births 2008.

Life time Risk maternal death

one in 48.

23 percent of Global burden.

India has more estimated maternal deaths
than any other country(1,36,000/year).

Every 5 minutes one women somewhere in

India die from complication of childbirth.

15 percent of all pregnant women develop life

threatening complication.
 Maternal Mortality in Major Indian
States (SRS 2008)
500
450
400
350
300
250
200
150
100
50
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Factors affecting Maternal
Health
General factors
1. Economic Status.
2. Literacy.
3. Population density??
4. Women empowerment.
5. Religion.
6. Social Rural – Urban.
7. Migration.
8. Healthcare services.
Specific Factors
1. Antenatal care.
2. Institutional delivery.
3. Skilled birth attendant.
4. Total fertility.
5. Post natal care.
6. Nutrition (anemia).
7. Contraceptive use.
8. Age at marriage.
Why women die ?
Early Marriage.
Reproductive age: a 30 year period.
High Fertility.
Too many.
Too frequent.
Too early.
Low women status.
Three delays.
Poor service infrastructure to timely manage
complication.
Analysis of some general
Factors affecting Maternal
Health
Statewise Percapita Income
Vs. MMR
 Relation between MMR and
Population Density

Shows that there is no particular relation between maternal deaths and population
density in a a state.
Analysis of some Specific
Factors affecting Maternal
Health
MMR & Institutional Delivery
MMR & Total Fertility Rate
MMR & CPR
MMR & 3 ANC
MMR & Assisted Birth
Post Natal Care and Maternal
Mortality
MMR and Iron and Folic Acid Tablets
Anemia and Maternal Mortality
 AT E R NA L H EA LTH
M
PRO G R A M S
Maternal Healthcare Program
Promotion of maternal and child health has been
one of the most important objectives of the
Family Welfare Program in India. Some of the
programs are :-
 CSSM.

 RCH I, II and NRHM.

 JSY.

 Vandematram scheme.

 Chiranjeevi Yojana.
RCH-
•Focus on overall reproductive health.
•Integration on maternal & child health with family planning &
RTI /STI.

JSY-
•Reduction in IMR , MMR.
•Focus on institutional deliveries.
Vandematram scheme-
This scheme is continuing under PPP.
Reduce the maternal mortality & morbidity.

Chiranjeevi Yojana-
Started in 2005 by Gujarat government in collaboration
with IIM AHEMDABAD & 1 NGO
Focus to provide delivery care to poor people of rural
areas.
Im p a c t o f
Progr a m m e s
70
62.1
60

46.9
50
40
40 34 INSTITUTIONAL
DELIVERY
SAFE DELIVERY
30

20

10

0
DLHS 1 DLHS 2
100
90
80 40.8
70 33.6
26
60 INSTITUTIONAL
BIRTH
50 ANC
40 TFR
50.7
30 43.9 44.2
20
10
3.4 2.9 2.7
0
NFHS 1 NFHS 2 NFHS 3
 NRHM Impact

MMR 301 IN 2001-03 254 IN 2004-06

IMR 58 IN 2005 53 IN 2008

TFR 2.9 IN 2005 2.7 IN 2007

MMR STATES
<440 U.P
480 ASSAM
300-400 RAJASTHAN
BELOW 100 KERELA
 MATERNAL HEALTH (RCH -II)
INDICATOR PRESENT STATUS GOAL FOR 2010
INSTITUTIONAL 46.9% 80%
DELIVERY
SAFE DELIVERY 62.1% 100%

IMR 63 30/1000 LIVE BIRTH

MMR 407 100 /LAKH LIVE BIRTH

The Way Forward….
Millennium Development Goal 5:
Improve maternal health
Target 5.A:
Reduce by three quarters, between 1990 and 2015, the maternal
mortality ratio
5.1 Maternal mortality ratio
5.2 Proportion of births attended by skilled health personnel

Target 5.B:
Achieve, by 2015, universal access to reproductive health
5.3 Contraceptive prevalence rate
5.4 Adolescent birth rate
5.5 Antenatal care coverage (at least one visit and at least four
visits)
5.6 Unmet need for family planning
Major Hurdles in achieving MDG 5
in INDIA
 Absence of focus on EmOC.
 Lack of qualified Midwives/birth attendents
 Lack of management capacity in the health system
 Low priority for health by the Indian Political
system
 Absence of comprehensive maternal care services
 What can be done to reduce maternal
deaths?
• Effective health services.
Upgrade infrastructure.
Develop effective referral (transport and
communication)systems.
Invest in human resources.
Improve accountability.
Introduce financing systems.
Develop an information system, embracing confidential
enquiries and audits of maternal deaths.
Skilled attendance at delivery/Institutional
delivery.
 Measures continued….

Access to emergency obstetric care.

Sustained political commitment.
Improved availability and use of data.
The International effort.
600

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1996 1998 2000 2002 2004 2006 2008 2010 2012 2014
TH A N K
YOU