Policy & Issues

Mothers lose out

HEALTHY BONDING: Nourishment starts in the womb.   | Photo Credit: Rajesh Kumar Singh

India has performed poorly on the mother and child front with its rank on the Mother's Index dropping to 76 in the list of 80 “less developed countries'' category as against 75th position in 2011, a latest report has said. Afghanistan has shown an improvement while China is way ahead of India, it says.

The Mother's Index is based on a number of criteria such as lifetime risk of maternal death, per cent of births attended by skilled health personnel and other risk factors related to maternity. The report by Save the Children has singled out Bihar as a global best-practice.

Relative to most other developing countries, India underperforms or scores below average on all indicators on the Mothers' Index apart from two – contraceptive prevalence (49 per cent) and access to safe water (92 per cent). On both, India scores slightly above average (which is 46 per cent and 89 per cent, respectively (3 percentage points above average on both measures).

India grossly underperforms on skilled birth attendance (which is 53 per cent, relative to an average of 88 per cent) and child malnutrition (underweight prevalence is 43 per cent, relative to the 9 per cent average). At 43 per cent of under-five children underweight, India has the highest rate of child malnutrition (given by underweight) of all less developed countries and the 2nd highest rate in the world (tied with Yemen), after Timor-Leste. Its rate of skilled birth attendance is the 5th lowest.

India's poor performance on female education (girls can expect to receive 10 years of formal schooling) also places India among the bottom 10 in Asia while Bangladesh and Nepal are rated in the report as ‘good' for their practices on infant and toddler feeding, Afghanistan and India are rated as ‘fair' and Pakistan and Vietnam as ‘poor.'

“Even though India has made efforts to improve maternal health by encouraging institutional deliveries and taking other measure, the benefits have not yet appeared to bring about a shift. This report shows that even now almost half of our births take place in the absence of skilled health personnel. This has a direct bearing on mothers' health and, due to the strong dependence of children on mothers, also on children's health,” said Thomas Chandy, Save the Children India CEO.

Save the Children's global flagship report, State of the World's Mothers, highlights that the best method for protecting the pregnant mother and her baby from the vicious cycle of malnutrition is to focus on the child's first 1,000 days starting from pregnancy. The report revealed that, in developing countries like India, breastfed infants are at least six times more likely to survive in the early months than non-breastfed children. Yet less than 40 per cent receive the full benefits of exclusive breastfeeding.

The report has analysed the countries of the world in three categories – the least developed, the less developed and the developed.

The report also rates countries in their performance on maternal and child health and notes that even as some countries in Asia have made progress in the last one year. The report shows Afghanistan has risen from the bottom place of the Mothers' Index - a place it had occupied for the last 2 years; Niger has fallen back to bottom place. Norway is on top.

Improvements in maternal and child health and education explain Afghanistan's new position: In just five years (2003-08), skilled birth attendance in Afghanistan rose from 14 to 24 per cent. From 2005-2010, female life expectancy rose by almost 5 years, and the number of years a girl receives schooling rose by a year and a half from 2005-09.

In South Asia, Sri Lanka remains exemplary with its excellent indicators on women's and children's health. Sri Lanka is at the 42nd rank this year among the less developed countries. China is far ahead of India at rank 14, which is an improvement from its 18 rank last year.

The report details a vicious cycle of malnutrition. Mothers, who may themselves have suffered from stunting as a child is more likely to give birth to underweight babies who have not been adequately nourished in the womb. If a mother is impoverished, overworked, poorly educated and in poor health, she may not be able to feed the baby adequately. These effects after age two are largely irreversible. In India, Bangladesh and Nepal, more than 10 per cent of women aged 15-49 suffer from stunting. In South Asia, up to 35 per cent of women are classified as excessively thin.

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Printable version | Dec 1, 2021 9:46:15 AM | https://www.thehindu.com/sci-tech/health/policy-and-issues/mothers-lose-out/article3421332.ece

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