Last week, The Lancet released the Global Burden of Disease 2015 study. On the global front, there is good news: Between 1990 and 2015, deaths of children under five have gone down by half. But for India, the news was sombre: India has had the highest number of such deaths at 1.3 million in 2015. In first-ever estimates of the number of stillbirths, the study counted 2.1 million such instances in 2015. The number of stillbirths in India was estimated at 0.61 million. Of 195 countries studied, 122 countries have met the Sustainable Development Goal (SDG) target to reduce the number of women dying from pregnancy-related causes to less than 70 for every 100,000 live births by 2030.
The study also indicated why India is still struggling to tackle such deaths, and the reason is not new: Poor last-mile delivery of health programmes such as the Janani Suraksha Yojana (JSY) conditional cash transfer programme. While the JSY has been successful at increasing reproductive health-care services, it has not been as effective at reaching poor rural women, the socio-demographic group that is already at highest risk of adverse pregnancy outcomes, the study said. Last year, a Hindustan Times report said that many hospitals even at the district level failed to meet the basic requirement of the programme such as free transport, food, medicines, check-ups and other facilities for pregnant women and even starting awareness programmes for the population they service.
While investing in health services to improve its record, India must not forget the important link that exists between meeting the challenge of maternal/child health and education. According to the United Nations, improving access to education is an essential building-block for increasing the number of trained health workers, particularly at the community level, and it also helps build the kind of behaviours and habits that have a positive impact on an individual’s health. Children who complete basic education eventually become parents who are more capable of providing quality care for their own children and who make better use of health and other social services available to them. Evidence indicates that when girls with a basic education reach adulthood, they are more likely than those without an education to manage the size of their families according to their capacities, and are more likely to provide better care for their children and send them to school.