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In recent years, India has made remarkable strides in addressing gaps in maternal healthcare delivery. Between 2006-07 and 2018-20, the nation witnessed a reduction in its Maternal Mortality Ratio from 254 to 97 deaths per 100,000 live births. Nevertheless, significant disparities persist between states in achieving respectful and high-quality maternal care. Moreover, specific vulnerable populations, particularly those from tribal and rural backgrounds, disproportionately experience complications and mortality associated with childbirth and the postpartum period.
To speed up advancements in comprehensive care for women, especially in underserved areas, it is crucial to reframe how we discuss women's health services, with a particular focus on maternal care. A multifaceted approach is essential, combining efforts to improve clinical outcomes, shift societal norms, and promote gender-sensitive reforms among healthcare providers and patients alike.
These initiatives align with the Government of India’s strategies, which aim to pinpoint areas needing enhancement in maternal care during pregnancy while also tackling the root causes of poor maternal health outcomes through carefully tailored programs. These programs address critical issues such as chronic undernutrition, anemia, limited autonomy, and low literacy levels. Taking decisive actions can help position India towards reaching the WHO’s Global Strategy for Women’s, Children’s and Adolescents’ Health, which outlines a pathway to eliminate avoidable maternal, newborn, and child deaths by the year 2030.
To improve access to care for pregnant women in at-risk communities, it is vital to harness cross-sectoral expertise and resources, foster effective collaborations, and empower healthcare providers to drive meaningful change. Such measures can contribute to reducing health inequities and promoting gender equity.
Obtaining more extensive health coverage for mothers and children remains a key goal. However, obstacles such as the sparse distribution of medical facilities and inadequate staffing hinder access to healthcare in rural and remote locales. The involvement of ASHA and Anganwadi workers plays a critical role in closing these gaps, as they can cultivate stronger community trust by incorporating local practices and cultural beliefs. This can facilitate the timely identification of high-risk pregnancies, guarantee appropriate guidance for antenatal and postpartum care, promote institutional deliveries, and more. Additionally, training auxiliary nurse midwives, staff nurses, and general practitioners on best practices for managing high-risk pregnancies and live births can greatly enhance the quality of healthcare services provided in India.
In order to address the issues of infant and maternal mortality in India while enhancing healthcare quality, several initiatives have been implemented. One such initiative is the Alliance for Saving Mothers and Newborns (ASMAN), a pilot project initiated by Tata Trusts along with other organizations in targeted regions. This initiative concentrates on the crucial 48 to 60 hours surrounding childbirth and the post-partum phase. It provides assistance through technology-driven nurse mentorship, in-facility evaluations to highlight gaps in infrastructure or training, digital platforms for remote support, and ongoing educational resources for nurses. As a result of this project, numerous mothers and newborns have had their lives saved throughout India. These efforts showcase the potential advancements achievable through collaboration and the establishment of platforms that tackle urgent challenges such as postpartum depression.
While safeguarding maternal health, it is equally essential to ensure that mothers receive proper nutrition, especially after childbirth and during breastfeeding. This focus is crucial considering the realities faced on the ground; many women in India begin pregnancy already experiencing anemia (57%), being underweight (19%), or being obese (24%), which can elevate the risks of postpartum hemorrhage, inadequate infant growth, or gestational diabetes if not addressed properly. Nutrition during and after pregnancy is crucial not only for the mother’s overall health and energy but also for the child’s development.
Advocating for a balanced, nutritious diet that includes sufficient amounts of protein, iron, vitamin B12, omega-3 fatty acids, and other necessary nutrients through a variety of foods is essential to meet nutritional requirements, promote optimal growth for the baby, and ensure a secure pregnancy. Some of these nutritional needs exceed standard daily requirements, necessitating the consumption of high-quality food sources. Additionally, it is important to recognize the long-term adverse impacts of maternal nutrition on health and development, and thus craft programs that educate and address these specific challenges. When women engage with maternal healthcare services, there exists a significant opportunity to encourage them to evaluate other health indicators. For the limited number of women in India who pursue prenatal care, this may serve as one of the rare occasions they interact with the healthcare system. Prompt management of health conditions is crucial for women's well-being, creating a vital opportunity to promote screenings for prevalent female health issues, such as breast and cervical cancers. Early identification can lead to timely treatment and better health results.
Enhancing maternal health continues to be an important objective—not just to protect every mother while ensuring they are treated with dignity and respect, but also to contribute to the advancement of the nation.
