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Less than zealous medical fraternity
The Pradhan Mantri Surakhshit Matritva Abhiyan is a unique project to save the lives of pregnant women in the country's rural areas. Unfortunately, not many private doctors and allied specialists are registering for the scheme
If implemented earnestly and obstetricians/radiologists/physicians in the private sector show care, compassion and commitment to provide free antenatal care and counselling at least 12 days in a year at a Government health centre — as has been required under the Pradhan Mantri Surakhshit Matritva Abhiyan (PMSMA) — life of many pregnant women in the country’s rural areas can be saved.
However, sadly, death continues as not many from the private sector are coming forward to voluntarily register with the scheme.
Till April this year, just 3689 private medical professionals have registered with the PMSMA , which was launched in November 2016, with Madhya Pradesh topping the list with 625 volunteers, followed by Rajasthan (533); Uttar Pradesh (455); Maharashtra (342); and Karnataka (296), as per the Union Ministry of Health and Family Welfare’s website.
Given the fact that the Federation of Obstetrics & Gynaecological Societies of India (FOGSI) has over 32,000 members who can chip in, as also many from the Indian Medical Association (IMA), the scheme is certainly moving at a dismal pace.
Intriguingly, both the organisations have pledged their support to the scheme. However, it seems that much is not being done to encourage their members to register with the PMSMA which targets at pregnant women from lower income groups, especially in rural and inaccessible region where, at times, though infrastructure is available, there is a shortage of human resources. This takes it toll on the health of rural women.
It is true that there must be several reasons, apart from financial and accessibility (given that at times centres are located in the interiors), one can still expect from the gynaecologists and radiologists to commit themselves to the scheme and save unfortunate women from death during delivery.
In a country which claims to have managed comfortable economic growth, the health picture of pregnant women in the rural sector is truly very grim.
It is shocking that nearly 44,000 women die every year while giving birth in the country. This is estimated on the latest available data on MMR which is 167 per 1,00,000 live births. India has failed to meet its Millennium Development Goals (MDGs) target of bringing down maternal deaths to under 140
by the year 2015.
In India, one pregnant woman dies every 12 minutes, with 45,000 dying each year. Of them, less than one in five (19.7 per cent) undergo prenatal health checks.
Assam tops the list with 300 deaths followed by Uttar Pradesh and Uttarakhand with MMR of 285 each, Rajasthan (244), Odisha (222), Madhya Pradesh (221), Chhattisgarh (221), Bihar (208), Jharkhand (208) and Punjab (141).
Approximately, 6.1 lakh infants die within the first 28 days of life. Many of these deaths are preventable if quality care is provided to pregnant women during the antenatal period and the high risk factors such as severe anemia, pregnancy-induced hypertension etc, are detected on time and managed effectively.
Under the new programme, women in their second and third trimester will receive free antenatal care and counselling on the ninth of every month. The sessions include free tests such as blood pressure, sugar level, weight, haemoglobin, and blood test and toxicology screening, to make it considerably easier to identify high-risk cases early on in the pregnancy, and help ensure that women are immediately provided with necessary treatment to ensure the safety of both mother and child.
Expecting mothers experience severe changes in their bodies’ hormones and internal environment, which can result in high stress levels and harm the child’s development. These need to be managed.
No doubt, the contribution of the medical professionals can help the Government in providing comprehensive and quality antenatal care to pregnant women especially those from rural and hard to reach areas and vulnerable populations.
However, presently, the commitment and zeal to help the poor is missing among many from the medical fraternity. If this slow pace of registration with the PMSMA for rural women continues, the scheme might die a slow death. This cannot be allowed to happen.
(The writer is Special Correspondent, The Pioneer)
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