Government of India came up with the National Health Policy in 1983 to administer the functioning of public health sector in an effective manner. Ministry of Health and Family Welfare of India again introduced an updated National Health Policy (NHP) in 2002 taking into consideration the achievements and drawbacks of the 1983 policy so as to achieve an acceptable standard of good health of Indian population.
India accounts for almost a quarter for pregnancy and delivery related maternal deaths occurring worldwide. The National Health Policy 2002, and the National Population Policy (NPP) 2000 of India, expected to reduce Maternal Mortality (MMR) to 100/1,00,000 by 2010. The Millennium Development Goal on the other hand, aims at MMR reduced to 109 by 2015. This paper is a retrospective health policy advocacy that reviews the NHP goal of reducing MMR to 100/1,00,000. Further it also examines the efficacy of Janani Suraksha Yojana(JSY), under the NRHM in achieving the target set forth by NHP. The method used for analysis is based on the health Policy Triangle3 by Walt and Gilson and WHO’s six pillars of strengthening health system .
According to the World Health Organization (WHO), almost 53600 maternal deaths occur every year in the globe out of which 13600 takes place in India. The maternal ratio in 2003 was 301 (maternal deaths per 100000 live births) and 254/1, 00,000 in 2004-06. So there was the need to decline by 154 points to reach the goal. The MMR in Kerala and Tamil Nadu in the year 2004-06 was 95 and 111 respectively. During the year 2004-06, MMR was reported 480 in Assam, 312 in Bihar/Jharkhand, 335 in Madhya Pradesh/Chhattisgarh, 303 in Orissa, 388 in Rajasthan, and 440 in Uttar Pradesh/Uttarakhand. Though MMR, in India vary across different states it has been found that the North Indian States contribute to the deaths at a disproportionately high proportion. The trends on MMR over the last 10 years (1999-2000, 2007-2009) show declination by 35% i.e. 327 to 212 per 100000 live births on a national level6. Many of the intertwined factors such as social status, position of women, availability and accessibility of skills, materials and facilities for family planning and maternity care, inaccessibility of quality health care in rural areas, are responsible factors. Most of the causes of maternal mortality in India are preventable, which indicates the need to establish appropriate health care services in rural areas. Despite of the safe motherhood policies and programmatic initiatives, maternity has not significantly become safer in India over the last 20 years in comparison to the target set forward by NHP.
The NPP also seeks to increase the proportion of institutional deliveries to 80% by 2010. So, the National Rural Health Mission came up with a safe motherhood intervention called as Janani Suraksha Yojana8 (JSY) on 12th April 2005, for promoting institutional delivery. This resulted in the increase in number of beneficiaries 7.39 lakhs in 2005-06 to 1 crore in 2009-109. The comprehensive medical care during pregnancy, child birth and post natal care endeavored improvements in the level of institutional deliveries in low performing states to reduce the mortality10.
References:
National Mechanisms-Child Related Policies-National Health Policy 2002; Child Protection and Child Right retrieved from http://www.childlineindia.org.in/National-Health-Policy-2002.htm on 30th april, 2013
Vora S.K, Mavalankar V.D. (2009); Maternal Health Situation in India; A case study. Journal of Health Population and Nutrition.
http://goo.gl/Wmkq9
Annual Report to the People on Health (2010); p.7 Government of India, Ministry of Health and Family Welfare, New Delhi
Rai K. S, Mishra P. (2012); Public Health Approach to Address Maternal Mortality. Indian Journal of Public Health.
Dutta K D(2012); Strategies to Reduce Maternal Mortality and Morbidity in India: The Federation of Obstetric and Gynaecological Societies of India.
Also referred as National Maternity Benefit Scheme
Annual Report to the People on Health (2010); p.7 Government of India, Ministry of Health and Family Welfare, New Delhi
Agarwal SP(2005);Towards Achieving Millennium Development Goals in the Health Sector in India; Volume 6, No 4. Journal, Indian Academy of Clinical Medicine
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