The key strategy of the Government of India towards reducing maternal mortality has been to institutionalize childbirths and incentivize women for this through conditional cash transfer programs. While this has led to a large increase in institutional births over the last 15 years, there is a lot of evidence that Quality of Care in institutions has remained suboptimal. One of the key factors contributing to this has been the shortage of trained human resources to provide skilled and quality care to women in health facilities. In order to address this, the government launched a midwifery program in 2018, aiming to train nurses as midwives who will manage midwifery-led birthing units within the public health care system. However, there is already a large shortage of nurses within the health system, thus reducing the already inadequate pool of nurses.
CommonHealth is a rights-based, multi-state coalition of organization and individuals which has been working in the field of reproductive health for many years, and advocates for increased access to sexual and reproductive health care and services to improve health conditions of women and marginalized communities. It seeks to build evidence to change the current techno-centric and non-rights-based women’s health discourse, with the eventual goal of using this evidence for advocacy to improve program implementation and policies. CommonHealth has been advocating for a midwifery-led maternal health care program for several years. In this current scenario where the government is pushing forward a techno-centric health facility-based model of midwifery, CommonHealth would like to build a discourse around women-centered maternal health care.
Women have voiced the need for receiving respectful and dignified healthcare when availing of childbirth services from public health facilities, and there is much evidence to show the disrespect and mistreatment women face at the hands of healthcare providers while availing of maternal health services. There is hence a need to broaden the indicators used to measure maternal health, which must also include the quality of care provided and women’s satisfaction with the same. Going beyond these indicators, there is a need to understand ‘Concept of Maternal Health Care’ from the perspective of women to make the shift from health facility based model of midwifery to women-centered maternal health care. This would also include the exploring existing issue of over-medicalization of maternal health care in some parts of the country, including extremely high proportion of caesarean sections, while other parts of the country continue to be under-resourced.
Towards developing such a discourse, CommonHealth therefore plans to hold a series of consultations beginning with grassroots women and frontline workers in different parts of the country with the support of our members, and also with experts from different disciplines for their inputs into building a technically sound, and women-centered, framework for maternal health care
Aim: To understand what women centered maternal health care would be, what its different components are, and to build a discourse around it.
Towards developing a discourse around women-centered maternal health care, CommonHealth plans to seek inputs from grassroots women, Front Line Workers and experts through various consultations.
It is working with nine partners in the states of Uttar Pradesh, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu, Maharashtra and Odisha to document women’s voices from ground on what an women centered maternal care should look like.