Despite all the paeans to glorious motherhood, India still has one of the highest maternal mortality rates in the world — 167 per 100,000 live births, as per the latest official statistics. Compare this to 27 in China, 23 in Iran, 29 in Sri Lanka, 31 in Maldives and 120 in Bhutan.
Nearly five women die every hour in India from complications developed during childbirth, with heavy blood loss caused by haemorrhage being a major factor. This comes to nearly 45,000 deaths, or about 17 per cent of the global total of deaths linked to childbirth.
But do you see nationwide hand-wringing or hear high-decibel outrage about this? The answer, of course, is an emphatic no.
The figures, however, offer a useful context to the outrage that the death of cows has begun to generate in this country. What are our priorities?
Last week, Gujarat chief minister Vijay Rupani was in the news for proclaiming that “protection of cows is the single-most important principle towards saving the whole world from both moral and spiritual degradation”. The state government has just made cow slaughter punishable with life imprisonment. Mr Rupani also wants Gujarat to become totally vegetarian.
Interestingly, Gujarat’s latest salvo in the battle to protect the holy cow comes just when the Comptroller and Auditor-General of India has criticised the state over a spurt in maternal deaths.
A CAG report tabled in the Gujarat Assembly last Friday noted maternal mortality in the state had risen in the past three years, from 72 in 2013-14 to 80 in 2014-15 and to 85 in 2015-16.
In an affluent state, why is this so? One key reason is the stark disparities between different regions. In three districts, the maternal mortality rate was even higher than the state’s abysmal average —Valsad (94), Dahod (93) and Surat (89).
Health experts will analyse this spurt in Gujarat’s maternal deaths in greater detail in the coming days. But clearly, one contributing factor is the reduction in the state’s social sector budget.
The CAG report notes that the Gujarat government’s expenditure on social services — notably education, health and family welfare — has gone down by around 11 per cent in 2015-16 compared to the previous year.
The findings of the CAG are revealing. The report draws attention to the many factors that could and would put pregnant women’s lives at greater risk. One telling example is how women are taken home after delivery. The usual method in rural areas is to use rickshaws designed to carry goods. The effect of the jolting — specially on women who have just undergone a caesarean operation — can be easily imagined. The CAG report catalogues several other lapses pointing to poor healthcare systems in parts of the state.
Gujarat has done a better job in reducing infant deaths and newborn deaths. But when it comes to maternal deaths, its record is worse than that of many neighbouring states, including Maharashtra.
The CAG had drawn the Gujarat government’s attention to gaps and deficiencies in the healthcare sector earlier too.
But Gujarat is not the only state which needs to take far better care of our human “matas”.
As the latest compilation of data by the Niti Aayog shows, many states are doing worse. Assam’s record is the worst — at 300 maternal deaths per 100,000 live births between 2011 and 2013.
Uttar Pradesh and Uttarakhand come next at 285, followed by Rajasthan at 244, Odisha at 222, Madhya Pradesh and Chhattisgarh at 221, Bihar and Jharkhand at 208 maternal deaths, and so on.
In Chhattisgarh, too, chief minister Raman Singh declared anyone found killing cows in the state will be hanged.
Uttar Pradesh has a new chief minister, Yogi Adityanath, who has made the crackdown on illegal slaughterhouses and cattle smuggling the flagship priorities of his administration.
Everyone knows that the cow is sacred to Hindus, who make up the vast majority of our population. But what should our priorities be? Is the continuous hullabaloo about “gau mata” distracting us from the protection of human “matas”? Though things have improved, clearly the progress is not commensurate with India’s economic status.
Indeed, as is evident from the statewise data on maternal mortality, affluent states are not necessarily the best performers when it comes to many health indicators, including our mothers’ survival.
The southern states have typically done far better on education and health indicators than the rest. This holds good for maternal health as well. Most southern states have reduced their maternal mortality ratio to double digits — Kerala to 61 deaths per 100,000 live births, Tamil Nadu to 79 and Andhra Pradesh-Telangana to 92. Only Karnataka trails behind, at 133.
Even West Bengal, which has many other problems, has a better record of saving our mothers. Its maternal mortality ratio of 113 is significantly better than that of Gujarat, Punjab or Haryana — all far more affluent states.
So economic growth, while necessary, is not sufficient to deliver good health. We all know this. Signalling matters.
Let’s face it. Whether it is old India, or Narendra Modi’s New India, a maternal death does not spark public outrage or provoke protest rallies, demonstrations or even candlelight vigils. We have grown accustomed to it.
We have normalised the staggering number of such deaths, even when other countries we consider our peers have done far better than us on maternal health. We are not outraged enough by maternal deaths unless our score on this or any other health indicator is worse than that of Pakistan. Then hell breaks loose.
Bharat Mata and Gau Mata are centrestage. What about turning the spotlight too on the ordinary “mata”?
If chief ministers got as excited about the alarming number of Indian women who become anaemic during pregnancy, about the delays and deficiencies in public healthcare, about the entrenched neglect that leads to a woman dying during or after childbirth as they evidently are about cow slaughter, change would begin.
But will they?
