The National Rural Health Mission (NRHM), initiated in 2005, has been pivotal in prioritizing the reduction of maternal mortality across India. By leveraging the services of Accredited Social Health Activists (ASHAs) and providing incentives such as conditional cash transfers and free ambulance services, the mission aimed to enhance institutional obstetric care for women.
Despite the positive data indicating a significant rise in institutional deliveries and a noteworthy drop in maternal mortality, the ground realities present a contrasting narrative. Women's health advocates have reported tragic instances where women continue to lose their lives due to preventable causes. Moreover, issues of obstetric violence and mistreatment within health institutions have been highlighted as critical areas needing attention.
Gender and socio-economic disparities significantly influence how health systems cater to maternal health needs. Women from disadvantaged backgrounds often face additional barriers to accessing necessary care.
Even with the advancements made under the NRHM, there remain persistent issues related to inadequate training, poor facility management, and troubling instances of disrespect and abuse towards pregnant women.
While more women are accessing institutional deliveries, the quality of care provided is still a concern. In many instances, essential medical interventions are either delayed or inadequately performed, resulting in preventable fatalities.
There are significant concerns regarding accountability, as deaths and related issues are often underreported or misrepresented, shifting the blame away from institutional shortcomings.
Although the NRHM and LaQshya have made notable strides, there is still a considerable amount of work needed to ensure that all women receive respectful maternity care, irrespective of their socio-economic status.
It is essential that maternal deaths are not used as a tool for blame but rather as opportunities for learning to prevent future occurrences. The healthcare system must focus on ensuring that providers are accountable and dedicated to enhancing patient safety.
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