Sunday, December 3, 2023

Maternal healthcare

The imbalance in distribution of healthcare professionals in the State, as Nagaland Page has highlighted recently, accentuates a persistent and depressing situation all too familiar to the rural populace: Lack of access to timely maternal healthcare. Every year, precious lives are lost to multiple factors such as lack of awareness as well as financial means among the people, but above all, lack of public healthcare access in the remote areas. In Nagaland, the current Maternal Mortality Rate (MMR) per lakh live births is 97. For every one lakh children born, 97 mothers die in the process. The Infant Mortality Rate per thousand live births is 30 and the Under-5 mortality rate per thousand live births is 37. The Government has already identified that in addition to lack of awareness and ‘poor health seeking behaviour’ among the people, shortage of health facilities, poor communication and difficult terrain as major factors contributing to lack of access to healthcare in the State. Another reason cited is the poor referral transport network ~ mainly due to poor road connectivity, shortage of ambulances, lack of proper ambulance network management and lack of skilled personnel in emergency care. According to the Nagaland Sustainable Development Goals Vision 2030, released last year, the Government’s target is to reduce MMR to less than 70 per lakh live births; end preventable deaths of new-borns and children below 5 years of age; and reduce one-third of premature mortality due to non-communicable diseases through prevention and treatment. While poor road connectivity in the State is not limited to rural areas, it is however more acutely felt in the remote villages. There is no arguing the fact that getting patients to health facilities could be significantly improved if there was better road connectivity between the small towns, villages and district headquarters. On top of that, people suffer due to illiteracy. They tend to rely on shamans and prayers instead of availing medical services and go to the health centres only as a last resort ~ usually when the patient is in a critical state and is beyond saving. This is where the authorities need to understand that the establishment of health centres is not sufficient by itself. Improving awareness of the services available there is just as significant. The administration can choose to provide healthcare services widely across, but unless there is sufficient awareness about the facilities in the region, expectant mothers do not usually bother to get themselves treated. They rather show hesitancy when it comes to matters related to maternal healthcare ~ more so in remote areas where poverty, illiteracy and stigmas are rife. It is not just the women. The males of the house, usually oblivious to women’s issues, also fail to grasp the gravity of timely medical intervention and that culminates in a life and death situation for expectant mothers. An issue as important as maternal health cannot be studied in isolation. The provision of health services is only the first step in tackling the maternal health gap. In reality, the authorities should concentrate on improving general literacy around maternal healthcare, involving both women and men, and improving connectivity ~ sparing people an arduous walk or being carried on stretchers. The health centres should also be staffed with skilled attendants and stocked with essential medicine. Nagaland continues to experience an imbalance and unfair distribution of healthcare professionals, especially in remote regions, which needs to be immediately redressed. The gaps in maternal health should not unmanageable ~ it is more a case of casual negligence, hoping things will improve on their own. Though the targets set in the Vision Document are well-intended, we should not limit the extent of our resolve to only achieving satisfactory results. We should take steps to bring maternal mortality to a minimum, much less than the 70 set by the Nagaland Sustainable Development Goals Vision 2030.