Has any progress been made in developing nations?

There has been a steady decline in fertility, maternal, infant and child mortalities in India and a decline in the prevalence of severe manifestations of nutritional deficiencies but India still is far from achieving the Millennium Development Goal targets¹.

Some of the reasons for this include -social inequities, disparities in health systems between and within states, and consequences of urbanisation and demographic transition¹.

What has the Indian government done to improve the situation so far?

Different strategies have been taken by the Government of India to improve the health of mothers and the infants⁵.Some of the national programs that India started to deal with the current problems are Reproductive and Child Health Programme, National Rural Health Mission and Integrated Child development services¹.

Moreover Janani Suraksha Yojana is another scheme started by the Indian government to promote deliveries in institutions whereby cash is given to poor women who give birth to babies in health institutions¹. There have been efforts out into trying to establish antenatal clinics in periphery, provision of early detection of pregnancy, regular check-up of blood pressure, haemoglobin, foetal growth free of cost, starting 24 hours normal delivery services in all community health centres and most of the primary health centres, having vehicles to take pregnant women to the facility, establishment of first referral units equipped with gynaecologists, paediatricians, anaesthetists and blood transfusion facility so as to reduce negative outcomes at birth².

There has been formulation of policies and programmes for reproductive health that incorporates most of the interventions across the life-cycle¹.

Is it enough?

But despite reproductive and child health being a priority (45–47% of health sector budget has been allocated to family welfare in 5-year plans since 1985), India has long been investing less than 1% of its gross domestic product on health¹.

Absence of well-functioning health systems is indicated by the inadequacies related to planning, financing, human resources, infrastructure, supply systems, governance, information, and monitoring¹.

Moreover the coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum¹.

Increases in the numbers of deliveries in institutions have not been matched by improvements in the quality of intrapartum and neonatal care. There is an enormous shortage of skilled health care workers, nurses and midwifes.¹

There has been no systematic effort to address reproductive health and child health and inadequate nutrition among the individuals living in urban areas who are poor¹.

1.  Paul VK, Sachdev HS, Mavalankar D, Ramachandran P, Sankar MJ, Bhandari N, et al. Reproductive health, and child health and nutrition in India: meeting the challenge. The Lancet. 2011;377(9762):332-349.

2.  Datta D, Datta PP. Maternal Mortality in India: Problems and Strategies. Asian Journal of Medical Research. 2012;2(1):33-35.