Reproductive, Maternal and Children's Health

Introduction to Social Determinants Approach Maternal Deaths

India's health system has a history of gross neglect largely based on equity and universal care. It is important to evaluate existing health care norms as it has a direct impact on the social and economic health of the economy.

SDG goals critical reflection for progress the country selected is India. India is as it is home to 1/6th of humanity it is critical to evaluate India s performance SDG is an affixing framework that calls for a sustainable future and collective response from India for achieving socio-economic development and understanding the country current position.

SDG Goals

SDG 3.1 goal selected for the country is reducing the maternal mortality ratio to less than 70 per 100000 live births. SDG goal 3 is determined to ensure healthy lives and promote wellbeing for all promote. Maternal Mortality ratio (MMR) is described as the number of maternal deaths during a given period per 10000 live births during the same period. It depicts the risk of maternal death and captures the risk of death in a single pregnancy. Maternal mortality is referred to as the death of women in the period of 42 days of termination of pregnancy or due to complications within (Niti Ayog, 2019).

India’s Progress and Key Challenges

India has used NITI Ayog for aligning collaborations and programs and corresponding actions to SDG actions. It facilitates actions to relevant stakeholders. The recent bulletin shows India s progress in reducing the mortality rate. The current MMR stands at 113 from 130 previously assed in the 2015-17 measure (Census India, 2020). The geographic dispersion shows southern states as better positioned in comparison to north counterparts. The lack of family planning as a guide to women for the responsible decision on fertility shows unawareness of a long population. 

The gender-based violence in India is represented by societal and cultural norms impacting women’s reproductive health. India is the largest country in South Asian countries and is one of the seventh-largest in the world by area (UN Stats, 2020). Reproductive health refers to the mental and social wellbeing. India currently does not has strong reproductive health that can be attributed to unwanted pregnancy, abuse, and exploitation. India has taken steps in the measure to strengthen its maternal health. According to WHO (2020). India has made considerable progress in recent years with a maternal mortality rate of 77% to 130% per 100000 in live births in 2016. The key challenges in India include ministerial coordination and inadequate convergence between allied physical, social-economic well-being. Currently, the government is laying emphasis on improving the convergence. The ministry of women and Child Development has made provisions for supplementary food as micronutrient fortified for pregnant women and breastfeeding mothers. The Pradhan Mantri Mateu Vandana Yojna is a maternity benefits program in all districts within the country. The government has aimed to develop a position to ensure to improve the SDG goals MMR reduction shows concern with a large share of childbirth relates to experience as risk evaluation. India’s MMR is better than it's south Asian counterparts as Pakistan, Bangladesh, but is lower than Sri Lanka (Worldbank, 2019) The geographic spread and state evaluation show state as Rajasthan, Odisha, and Bihar has brought down the total and average to decline by 15%. The government has launched LaQshya and Pradhantri Mantri Surakshit Mateitucs Abhiyan to reduce maternal mortality due and morbidity and stillbirth associated with care bund delivery. (Ministry of Health and Family Welfare, 2017). India has made a massive strategic investment in the National Health mission

to contribute to the health workforce, commodities and technologies, development of health in community empowerment are vital for India to improve reproductive health. India has seen significant improvement in maternal health care services with a decline in the maternal mortality rate. Education attainment is critical in imparting self-worth and self-confidence for addressing reproductive issues in India. There is substantial inequality at regional geographic and social levels. In India, 39% of neonatal death occurs on the first day of life. Social factors such as religion plays an important role in promoting inequalities in the utilization of antenatal care service (Ali, 2020). The failure of strategies adopted by the National Rural Health Mission to bring equality in states of service delivery with inadequate supervision, shortage of medicine, and absence of health provider. The three states have already reached the target of SDG 3 of MMR of less than 70 per 100000 live births that include Kerala, Maharashtra, and Tamil Nadu (Ministry of Health and Family Welfare, 2017).

The key challenges in reducing the maternal mortality rate are lack of referrals and emergency transport. Structural factors as system based vulnerabilities have an adverse impact on vulnerable due to family planning program in the states. Among the northern states, Uttar Pradesh has the highest MMR 285 maternal deaths. 70 % of maternal deaths happen within the age of 20-29 years where the fertility rate is high (Census India, 2020). Development programs by the government as Janani Shishu Suraksha Karyakaram as entailment for free diagnostics, fee blood transfusion was extended to preferment women delivering in a public health institution.

A Maternal Death Review has been institutionalized by the government in India for socio-economic, cultural determines as well as the gap in the system. The government has set up Monthly village and nutrition days for the provision of maternal care. More than 11.9 million have been registering under this program. This has an impact on delivery care shifts from 47% to 78.9%. (Ministry of health and family welfare, 2017)

Conclusion on Social Determinants Approach Maternal Deaths

The analysis outlines the maternal mortality rate in India has shown significant improvement in conduct with guidelines mentioned by SDG. The progress however highlights socio-economic indicators and huge interstate disparities based on state government and non-extensive reach of National programs such as National health rural mission. India s development narrative can display commitment towards delivery care and governance for the delivery of plans outlined for achieving SDG 3.1 goal selected for the country is reducing the maternal mortality ratio as per SDG.

Reference for Social Determinants Approach Maternal Deaths

Ali, B., Chauhan, S.(2020). Inequalities in the utilization of maternal health care in Rural India: Evidence from National Family Health Survey III & IV. BMC Public Health 20 (1), 361-369 https://doi.org/10.1186/s12889-020-08480-4

Census India (2020). MMR Bulletin. Retrieved from https://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR%20Bulletin%202016-18.pdf

Ministry of Health and Family Welfare. (2017). Maternal and adolescent healthcare. Retrieved from https://main.mohfw.gov.in/sites/default/files/03Chapter.pdf

Niti Ayog. (2019). SG India INdex. Retrieved from https://niti.gov.in/sites/default/files/SDG-India-Index-2.0_27-Dec.pdf

UN stats. (2020). SDG Metadata. Retrieved from https://unstats.un.org/sdgs/metadata/files/Metadata-03-01-01.pdf

Worldbank. (2019). MMR Indicator. Retrieved from https://data.worldbank.org/indicator/SH.STA.MMRT?locations=LK

WHO. (2020). Social determinants approach maternal deaths. Retrieved from https://www.who.int/maternal_child_adolescent/epidemiology/maternal-death-surveillance/case-studies/india-social-determinants/en/

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