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  • Title: Child survival: maternal factors.
    Author: Rajaram P.
    Journal: Indian J Matern Child Health; 1990; 1(2):39-45. PubMed ID: 12319229.
    Abstract:
    The aim of government is to produce a healthy society through policy and practices that do not discriminate against the most vulnerable, for instance, poor pregnant women. The quality of a society can be measured by the delivery of health care and by child survival. India has been successful at industrialization and establishment of a fine infrastructure for health care delivery, yet health service delivery is poor and infant mortality and morbidity are high. Poor pregnancy outcomes are related to maternal health and health care. Under 33% of pregnancy women receive any prenatal care and under 20% receive trained assistance during delivery. Social customs that denigrate women are common. Feminism has not affected the masses of women in India, where hatred of the female gender still exists. The hatred begins at the birth of the female child. India has a high sex ratio of more males to females and has high illiteracy among females. Maternal mortality in developing countries is 200 times higher than in developed countries. The consequences are loss of life and loss of a caretaker for the children left behind. Government policies on maternal and child health care delivery have emphasized the child at the expense of maternal care. Family planning has received the bulk of funding under the Indian Family Welfare Program. Policy has focused on child survival yet ignored maternal morbidity and mortality. Child survival is affected by prenatal care, prenatal management, maternal age, maternal nutrition, the process of childbirth, treatment of obstetric emergencies, and treatment of birth injuries. The first 38 weeks of fetal development has a greater risk of danger and accident than the next 38 years following the birth. Indian women facing potential pregnancy risks walk many kilometers to a prenatal clinic and then wait for hours standing in long lines for registration; the actual examination by "experts" takes only minutes. Final determination of risk may take 2-3 visits with no assurance of admission to a hospital, or there may be early release because the bed is needed for another at-risk patient. 60-90% of births to rural mothers worldwide are attended by local trained or untrained birth attendants. Improper conduct during the delivery process and postnatal care of the infant affect the health outcome of infants. Hemorrhage, anemia, toxemia, and infections are the killers, and better management the solution.
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