Lack of awareness, primary health care accessibility major factors
SRINAGAR: Each year, 300 mothers die during childbirth and allied pregnancy related complications in the Kashmir Valley. This alarming statistic is buried in the focus on child mortality in Kashmir and maternal mortality rate tends to be ignored.
In Kashmir, Baramulla district has the highest maternal mortality risk with 54% of more than half of the women of reproductive age having died in the period 1998 -2003.
According to a survey carried out by the Centre for Disease Control and Prevention, the causes and reasons for these deaths include haemorrage, obstructed labour, cardiomyopathy, sepsis, obstetric embolism and pregnancy induced hypertension. The report further indicates that 64% women died due to post-partum depression and haemorrage within 42 days, 56% died in the first 24 hours. Other factors contributing to the high mortality rate include socio-economic, geographic and cultural factors.
The report further states that 50% of the women do not have access to basic healthcare facilities in far flung areas. Only 7 % of the hospitals- only in the urban vicinity- have the capacity to provide comprehensive emergency obstetric care in the valley. The major problems pertain to lack of awareness and transportation problems in rural areas. This has led to limited accessibility to basic health care especially during pregnancy, according to the report. Most of the ante- and postnatal care is used by only 30% rural women in Kashmir during pregnancy, confirms the report.
According to World Health Organization (WHO), India is one of the countries which has highest maternal mortality rate as per 2012 statistics. The report also states that there has been improvement for the past two years- a 20% decrease in maternal mortality rate in India. However, there is a lot that needs to be done for the women who are uneducated and have less awareness and accessibility to basic healthcare facilities.
A survey conducted by Ministry of Health and Family welfare demonstrates that there has been 35% decrease in maternal mortality rate from 2013-2014 with 70% women in the state using antenatal care services. As per the survey only 55 deaths were witnessed during the year 2013 and 62 deaths during the year 2014 in the state of Jammu and Kashmir.
Poor nutrition, lack of sanitation and home births are cited as being among the vital causes of high maternal mortality rate in India.
The mortality rate in Kashmir would not improve unless the availability, accessibility and awareness among Kashmiri women particularly of rural areas would not improve. Most of the deaths occur during home births especially in rural areas where roads are tough and people are conservative, said Dr. Saleema, a well known gynaecologist of the valley.
Dr. Humaira Ali, a gynaecologist from SKIMS said, the problem is that the health care at primary level has not been strengthened and this has directly led to the high maternal mortality as well as child mortality in Kashmir. The arrival of patients coming from far flung areas to the city hospitals for treatment gets delayed initially because of distance and accessibility; the patient has to travel a lot which sometimes creates complications in pregnant ladies and they die before reaching hospitals on time.
We can save these lives only when primary health set up is strengthened and women folk particularly of rural areas have to visit doctor on timely basis, so that complications wont arise and mother and child both are in better condition, she added more.
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