How many of us have seen photographs of, and admired, the tea gardens of Assam? And surely we’ve also seen the women working in gardens, but we forget about them no sooner than we move on to the next topic.
These women, unfortunately, have very little access to a fundamental human right—maternal healthcare. According to the SRS (sample registration system) data 2012, the Maternal Mortality Rate (MMR) of Assam is 328, much higher than the national average of 178. “Among the tribals of Assam, MMR is even higher at around 390 (SRS bulletin 2011),” said Dr Tsering Wangdi, Gynaecologist at GNRC Hospital, Guwahati. She cites the following reasons for the cause.
1. Lack of affordability, accessibility and quality healthcare in interior areas.
2. Lack of infrastructure, manpower (especially doctors) and skilled birth attendants in remote areas. In Assam, there is a shortfall of 1,237 sub-centres. The number of obstetrics and gynaecology specialists is 40 against the required number of 109.
3. Poor referral system and transport facilities are a big hindrance. Patients requiring higher level of care fail to get appropriate treatment for the severity of their disease.
4. Lack of awareness among the rural/ tribal population about the need for regular antenatal check-up, leading to the failure to avail the benefits of various health programmes/schemes for pregnant women, including free delivery and nutritional supplements.
5. Poor female literacy rate is also to be blamed. One perfect example is of Kerala, which has the highest female literacy rate as well as also the lowest MMR (66) in the country.
As the world struggles to focus on the importance of this critical developmental issue, MMR needs to be tackled at every level. Besides that Dr Wangdi informs that “a holistic approach with equal participation by the government, public sectors, NGOs, individual practitioners and grassroots workers will play an important role in curbing the problem.”