— Monimala Devi Motherhood and parenthood are universal issues. In developing nations like India, the major share of parental responsibility generally falls upon the mother. Biologically too, the active part of the responsibility is on the woman, the men playing a passive role. With the evolution of human society, especially after the discovery of agricultural practices, women were gradually confined to home for taking care of children and men involved with the outside world, and clear division of labour emerged. But, over a period of time and with the changing economic scenario, a large number of women came out from the age-old domestic arena. This assertion of equal footing with men has put additional pressure on the working woman as the overall responsibility of motherhood continues to rest largely with them. The society wants a happy healthy young generation that can lead to the development of mankind. Moreover, the working woman has to prove that despite her foray into the job market, she is an equally good (if not better) mother compared to the housewives or her counterparts of yester years.
In the context of global objective of “Health for All by 2000 AD” announced The National Health Policy in 1983 set some normative goals relating to maternal and child health care as reduction in infant mortality rate to less than 60 per thousand live births and reduction in maternal mortality to below 200 per one lakh live births etc. As a result the former, the decades of 1980s and 1990s have seen showing tremendous improvement in decreasing infant and child mortality around the world especially in developing countries. But as far as maternal death is concerned, the scenario is still shocking. Every minute, somewhere in the world, a woman dies following pregnancy or related complications resulting in large number of deaths of mothers each year. Besides this many more suffer disabilities related to child birth that can affect them for the rest of their lives. Around 99 per cent of these deaths take place in the developing world. In the developed world, the maternal mortality ratio averages around 21 maternal deaths per 100,000 live births, whereas, in developing countries the ratio is 20 times higher at 440. Deaths during pregnancy or childbirth are unlike other deaths in developing countries. Maternal deaths in these nations mostly take place not because of disease, but mainly due to some other socio-economic factors. Maternal deaths are all the more tragic because they can be prevented by simple and cost-effective ways. The direct causes of maternal deaths are hemorrhage, infections, obstructed labour, hypertensive disorders in pregnancy, and complications of unsafe abortion. Infections, blood loss and unsafe abortion account for the majority of deaths and these can be tackled by health workers possessing midwifery skills. Moreover, the management of infection, shock, blood loss and convulsions, and surgical procedures, such as caesarean delivery, do not require high technology equipment or expensive drugs.
Reducing maternal mortality is not necessarily and solely dependent on economic development of a nation. Essential services needed to tackle the problem of maternal mortality needs to train health workers so that they can assist every delivery, have access to essential obstetric care for mothers and their infants when complications arise, and family planning information and services so that unwanted pregnancies and unsafe abortions can be avoided. For example, half of all pregnant women in the world are anemic. Anemia is easily treatable which is left untreated in most of the cases and it
significantly heightens vulnerability to maternal death. Almost all nations can afford to invest for these key interventions. What is lacking is not the level of national wealth, but the level of commitment to do so. Maternal health should be taken care of by improving awareness, education, availability of health care and, most importantly, by raising the status of women within society. We should empower women to have voice in decision making and to gain awareness about the importance of pre- and postnatal care. In many places of India, for example, women health workers learn the importance of good nutrition and health care through skills training workshops. As village leaders, they ensure that health care is available and effective for the women in their community. In Africa also, in addition to participating in skills training workshops, women also receive maternal checkups and are able to have safe deliveries at health care centers.
A sound health policy is sine qua non of healthy human resource of any nation. Recently, the Government of India is formulating and aggressively popularising health policy under the scheme of National Rural Health Mission (NRHM). In Assam, the present Health Minister is quite serious about providing facilities for the masses in general and the rural people in particular. The state government recently launched many schemes in order to revitalize the whole public sector medical and health care system and amongst these, providing an incentive of a substantial amount of money for child-delivery in government hospitals, and other schemes, have been introduced. These financial incentives not only provides monetary benefits to the child-bearing mothers, but also adds to the multifarious dimensions of overall health and development like pre and post natal care, effective tackling of birth control, documentation for proper planning and policy making and so on. Despite having surpassed 5 decades of planning in the post-independence era, Assam’s health records are extremely poor. For example, the infant and maternal mortality rates are one of the highest in the country in Assam, compared to the other states and Union Territories. However, during the last few years, infant and maternal mortality rates have fallen to some extent, though it is still higher than the national average. The governments at the Centre and also at the state level, have definitely taken up ambitious programmes for implementing immunization for children, that in itself is mandatory part of total health for the future generations, but these programmes need to be far more effective. People irrespective of their background or place of stay like rural or urban are still not fully aware regarding these schemes. Moreover, the public health delivery system is very much mired in age old red-tape and bureaucracy that results in lower effectiveness and efficacy due to which, common people are wary of making use of the facilities provided. It is tragic to note that it takes a whole day, and sometimes a few days, to get ‘a birth registered or one has to spend lot of time in accessing other facilities for expecting or lactating mothers.
The Government of India passed the Maternity Act as early as in 1961 and this Act regulates the employment of women in certain establishments for certain periods before and after child-birth and to provide certain facilities. In Assam, this Act came into force on December 16, 1963. Despite enactment of such advanced law, the provisions of this Act are routinely violated or tampered with and in many cases women are denied their rights. There are examples of such violations when women employees under maternity leave are denied the financial dues like salary, etc. And the irony is that violations of the Maternity Law can be traced from tea garden workers to people engaged in higher educational institutions, corporate sector and so on. Proper implementation of the Maternity Act, or for that matter, any other Act concerning human rights, needs full awareness of not only the women folk, but all the stakeholders of the society. And this requires easy and compulsory availability of the copies of the Act, and all the Amendments made there after followed by sensitization of the people that motherhood is the theorem of sustainability of life, including for those people who are in the habit of opposing equal rights for women. In all institutions and the organisation like the Women Commission, should regularly verify whether the provisions of the Act are compulsorily adhered to and any violation should be dealt strictly. As these benefits, unlike the other financial benefits, cannot be availed later or will of no use, if it is denied during the appropriate period. Moreover, denial of such rights can have tremendous negative effect on the maternal as well as feotus health. Healthy and happy future generations can be envisaged only when proper care, and grant of practical benefits, are ensured for the expecting and lactating mothers, irrespective of the fact whether the woman is working or a homemaker.
(The writer teaches Economics in DDR College, Chabua) ASSAM TRIBUNE
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