If we invest in maternal health, we’re investing in our future. Discuss. (15 Marks)

Mentors Comments:

The health of women and children is at the forefront of the development agenda. Women and children stand at the end of the health-care queue. Increasing investment in their health is not only the right thing to do, but it is also critical for stable, peaceful and productive societies:

  • Investing in good health is cost-effective. Providing basic health care to women and children prevents illness and disabilities, saving billions of dollars that would otherwise have been spent on medical treatment. In many countries, every dollar spent on family planning saves at least four dollars that would have been spent treating complications arising from unplanned pregnancies.
  • Investing in women and children reduces poverty. Reducing out-of-pocket payments for women’s and children’s medical care will encourage access to health care while protecting poor families from financial hardship. This will allow them to provide for immediate needs and invest more in their future – for example, in housing, education, and income-generating activities. Healthy women work more productively and stand to earn more. Addressing under-nutrition in pregnant women and children can lead to an increase of up to 10% in an individual’s lifetime earnings. Poor sanitation leads to diarrhoea and parasitic diseases, which reduce productivity and keep children out of school.
  • Investing in health stimulates the economy. Maternal and newborn mortality alone causes global productivity losses of US$15 billion annually and hampers economic growth. Investing in children’s health has high economic returns, creating the foundation for a more productive future workforce. By not addressing under-nutrition, a country’s GDP may be lowered by as much as 2%. 

However, Jaccha-Baccha Survey (JABS) presents the bleak picture-

  • Unable to meet pregnancy needs – due to lack of knowledge or power, most of the sample households were unable to take care of the special needs of pregnancy, whether it was food, rest or health care. 
  • Food needs – Among women who had delivered a baby in the preceding six months, only 31% said that they had eaten more nutritious food than usual during their pregnancy. 
  • Less weight gain – Their average weight gain during pregnancy was just seven kg on average, compared with a norm of 13 kg to 18 kg for women with a low body-mass index. In Uttar Pradesh, 39% of the respondents had no clue whether they had gained weight during pregnancy, and 36% had gone through it without a health check-up.
  • Performance of PMMVY
    • Reduced coverage – The coverage and benefits were reduced compared with NFSA norms. Had the benefits been higher and universal, the scheme would have been a hit.
    • Tedious procedure – The application process is tedious. From filling a long-form for each instalment, women have to submit a series of documents, including their ‘mother-and-child protection’ card, bank passbook, Aadhaar card and husband’s Aadhaar card. Essential details in different documents have to match, and the bank account needs to be linked with Aadhaar.
    • Technical limitations – There are frequent technical glitches in the online application and payment process. When an application is rejected or returned with queries, the applicant may or may not get to know about it.
  • Aadhaar
    • Rejected payments due to mismatch between a person’s Aadhaar card and bank account. 
    • More than 20% of the respondents mentioned that they had faced difficulties because the address on their Aadhaar card was that of their maika, not of their Sasural.

Way forward

  • Expand on existing national health plans, and update them where appropriate to ensure that women’s and children’s health budgets and services are prioritized.
  • Increase governments’ portion of the budget allocated to health and build on existing regional commitments to increase access to sexual and reproductive health services (Maputo).
  • Fully integrate the following into all primary health-care facilities: family planning, HIV/ AIDS services, abortion-related care (where legal), and maternal, newborn and child care.
  • Ensure that services exist in more marginalized geographic and poverty-stricken areas. • Strengthen health systems, prioritizing the health of women, girls and children by means of targeted policies, programs, and budgeting.
  • Engage the private sector in promoting innovative financing initiatives focused on improving health outcomes for women, girls and children.
  • Establish systems to measure progress, accessibility and service quality, and to ensure accountability and data quality.
  • Promote health education and awareness programs; adopt community participatory approaches, innovative communications, and behavioural change approaches to increasing demand for and removing barriers to accessing health services.
  • Address gender inequality through new initiatives or investments.
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