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Maternal Healthcare in NRHM: Progress, Pitfalls & Prospects.



  Oct 11, 2023

The National Rural Health Mission (NRHM): An Overview of Maternal Healthcare



Introduction:

The NRHM, initiated in 2005, prioritized the reduction of maternal mortality in India. By leveraging ASHAs and offering incentives such as cash transfers and free ambulance services, the mission aimed at increasing institutional obstetric care.

The Issue:

While data showcased an impressive rise in institutional deliveries and a notable reduction in maternal mortality, ground realities painted a different picture.
Women’s health advocates reported instances where women were still losing their lives due to preventable reasons. They further highlighted the problems of obstetric violence and mistreatment of women, especially in health institutions.

Government Steps:

Launching the NRHM in 2005.

Offering conditional cash transfers and free ambulance services.

Training doctors and nurses for obstetric care.

Initiating LaQshya in 2017, focusing on enhancing the quality of care in maternal sectors of public health facilities.

Challenges:

Gender and Socio-economic Inequalities: These factors influence how health systems respond to maternal health needs. Women from certain socio-economic backgrounds faced more challenges accessing care.

Institutional Barriers: Despite the advancements under NRHM, there were still issues with inadequate training, poor facility management, and instances of disrespect and abuse towards pregnant women.

Health System Gaps: Even though more women accessed institutional deliveries, the quality of care was still questionable. In many cases, the required medical interventions were delayed or inappropriate, leading to preventable fatalities.

Accountability Issues: Deaths and issues were either not adequately reported or misrepresented to shift the blame from institutional failings.

Unfinished Work:

Addressing Intersectional Gender Inequality: While NRHM and LaQshya have made strides, there’s still much to do in terms of ensuring respectful maternity care for all women, regardless of their socio-economic background.

Improving Accountability: Instead of using maternal deaths as a blame game, they should serve as learning opportunities to prevent future such incidents. The system needs to ensure that healthcare providers are accountable and focused on enhancing patient safety.

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