On April 11, National Safe Motherhood Day, NGO Population Foundation of India makes recommendations on how the focus this year should be in strengthening the country’s maternal health measures
Besides the overwhelming burden of COVID-19 cases in India, the indirect effects of the pandemic are cause for concern, especially in the case of already vulnerable communities. As per a statement from the Population Foundation of India, women and children have been disproportionately affected, with studies registering a significant increase in the numbers of stillbirths and maternal deaths compared to pre-COVID periods. A recent review in The Lancet, of studies on maternal and child health outcomes, has confirmed that the impact of the COVID-19-associated lockdowns has been devastating for mothers and newborns. Low- and middle-income countries (LMICs) have been worst affected.
The release points out that as clinics and public health facilities were inaccessible to many during pandemic-related lockdowns, thousands were cut off from essential health services. The United Nations has estimated that this may have caused an additional 220,000 child deaths and 11,000 maternal deaths in South Asia alone. These numbers are likely to increase, with India potentially accounting for the largest proportions. In India, the number of women who received all four antenatal check-ups during the pandemic also dropped by 51 per cent and the number of institutional deliveries were down by 79 per cent. The demand for family planning services satisfied by modern methods fell by 67 per cent.
“We have witnessed a steep rise in maternal deaths during the COVID-19 pandemic. This crisis has shown us that we must strengthen health systems to cope with emergencies without impacting essential services,” said Poonam Muttreja, Executive Director, Population Foundation of India.
National Safe Motherhood day is celebrated on April 11 every year, on Kasturba Gandhi’s birth anniversary. This year, the focus must be on ensuring access to quality family planning services and reproductive health services for all, urges the NGO’s statement.
Maternal morbidity – or the long-term illness associated with pregnancy and childbirth – is also a critical but neglected area which needs focus, as it has physical, mental, social and economic consequences for women. This affects their children’s health as well, resulting in inter-generational consequences. “The focus of safe motherhood needs to be widened to include morbidity as an important aspect of maternal health,” says Muttreja.
A robust family planning programme is an important way of curbing preventable deaths. “More accessible and equitable family planning services that offers a wider choice of contraceptive methods to couples are a simple, low-cost intervention that can reduce maternal and child mortality by preventing early pregnancies and unwanted pregnancies at a later age,” says Muttreja.
At Population Foundation of India, we have engaged with policymakers, donors, NGOs and communities to consistently raise the discourse on the need for informed decision-making on women’s health. “We promote effective and gender-sensitive health and development strategies and policies. We have constantly emphasised the importance of planned families, birth spacing and delayed marriage as strategies to improve maternal health,” Muttreja adds.
Gender inequality, gender-based violence and lack of agency continue to impact women’s ability to access maternal and ante-natal health services. In India, regressive gender norms continue to result in a preference for sons, leading to frequent pregnancies. Further social norms around child and early marriages also impact maternal and child health.
While the full impact of the pandemic on the public health system will not be clear for some time, COVID-19 has underscored that stronger maternal and child care systems are a critical requirement of health system strengthening going forward, the statement concludes.