Safer maternal health in rural Uttar Pradesh: Do primary health services contribute?
RamaRao,Saumya; Caleb-Varkey,Leila; Khan,M.E.; Townsend,John W.
Health Policy and Planning 16(3): 256-263
Publication date: 2001
India accounts for about one-quarter of maternal deaths worldwide, with the most recent statistics showing an average maternalmortality ratio of 407 per 100 000 live births at the nationallevel. The government had hoped to reduce maternal mortalityto 200 by 2000, but it is clear that this was not achieved.This paper explores the reasons why the most populous stateof Uttar Pradesh continues to have one of the highest reportedmaternal mortality ratios in India. Data from two districtsof Uttar Pradesh on mother and child health-care utilizationand the readiness of the public sector to provide antenataland emergency obstetric services are used to illustrate thereasons why maternal mortality has not declined. While blueprintsfor safe motherhood programmes exist, the equipment and technicalcompetence to provide services is weak at the present moment.Reductions in maternal mortality would require interventionsto improve service delivery as well as community mobilizationto improve utilization of services, especially in life-threateningsituations.