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Wednesday, November 17, 2010

‘Death By Birth’: Reality of Maternal Deaths in India

The study, ‘Maternal Mortality for 181 countries, 1980-2008: A systematic analysis of progress toward millennium development Goal 5’ says India is one of the few countries — others being Egypt, Romania, Bangladesh and China — that have recorded “substantial decline” in MMR. In 1980, India reported about 677 maternal deaths (the death of women during pregnancy, childbirth or in the 42 days after delivery) per 1,00,000 live births but in 2008, this was down to 254 deaths. Indian maternal mortality ratio (MMR) fell from 570 per 1,00,000 births in 1990 to 230 in 2008. This is a 59% decline.

Acknowledging this success should not encourage complacency. Regardless of the magnitude of the decline, MMR of 230 is hardly a cause for celebration. While India has lower MMR than Pakistan, Bangladesh and Nepal and considerably lower than over 600 in most sub-Saharan African countries, comparison with MMR of 38 in China and 39 in Sri Lanka gives enough sense of the task ahead.

According to a recent report in Lancet medical journal, more than half all maternal deaths in 2008 were reported from just six countries: India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of Congo. In India, every year, about 78,000 women die during pregnancy, childbirth or within 48 hours of delivery. And what is perhaps most unfortunate is that 75% of these deaths are preventable.

In order to ensure that India meets the United Nations Millennium Development Goal of bringing down its MMR to 109 by 2015, an integrated and stepwise approach focusing on increased family planning and safe abortion combined with consecutively increased skilled birth attendants, improved care before and after birth, reduced home-birth and increased institutional delivery with improved emergency obstetric care could eventually prevent nearly 80% of maternal deaths.

Apart from the above health care services, there has to be mechanisms to ensure accountability in health system for the substantial deaths occurring during child birth. Mandatory maternal death audits should be enforced and rural health care system should be made more responsive and responsible towards the preventable deaths taking place in the absence of any state accountability.

Saturday, October 23, 2010


The great city of Delhi has witnessed amazing shows of human spirit and endeavour through its historic past. Now this spirit is evoked through the Airtel Marathon on 21st Nov, 10 -a massive unifying sporting event which cuts across all barriers.

On a personal level, it helps you get closer to your dreams, by making you aware of your abilities. Many run for the pure joy of running while others do it to keep fit and healthy. This season why not run only for your own health but also invest in the health of other less privileged by running for Sukarya.

Sukarya is a non-governmental development organization working on issues affecting the health status of rural and urban communities in Haryana since 1999. Registered in 2001, the focus of our work is primarily to improve the health status of urban and rural poor by making primary health care services at both preventive and curative levels accessible to underserved and marginalized communities. For more information about Sukarya and its activities please visit us at

If you are passionate about the cause of health for the underprivileged and want to contribute towards the effort of making Sukarya’s vision of making right to health a reality, come and join us during the Airtel Marathon. We expect to continue to focus and deliver in the area of public health and women empowerment through your support.

There are several ways in which you can contribute. ‘I Pledge’ category is for everyone who would like to contribute their bit and run for a cause of their choice by raising pledges for the same. The funds can be of any amount. One can register by paying Rs. 700 ( Rs. 600 + Rs. 100 for the charity kit) for the Half Marathon ( a run of 21.097 km) and by paying Rs. 400 ( Rs. 300 + Rs. 100 for the charity kit) for the Great Delhi Run of 6 km

You can also participate as a Dream maker. A Dream maker is an individual with a good social network and believes that his contribution can bring some difference at an individual level. To sign as a Dream Maker, an individual has to make an upfront, non-refundable contribution of Rs.10,000. This contribution will be considered as part of the minimum Rs.1 lakh to be raised by him/her.

Dream Challenger is an individual with a spirit of doing good for a cause with full enthusiasm and positive spirit. To sign up as a Dream Challenger, the individual has to make an upfront, non-refundable contribution of Rs.20,000. This contribution will be considered as part of the minimum 3 lakhs to be raised by him/her.

Many enthusiasts and individuals with a high sense of social commitment have supported the cause of health by running on behalf of Sukarya in the last few years. The fund generated through their active participation has been used to serve the health needs of impoverished, unserved communities. The amount is utilized to run diagnostic health camps for the underprivileged. For more information visit our web-site or call us at +91-9910248487, +91-9999918517.

We look forward to your enthusiastic participation by running in the Marathon on behalf of Sukarya. Together we can make a difference. If the idea of contributing to the health of underserved communities appeals to you, please run for Sukarya during the Marathon.

Monday, October 4, 2010


A sound social health is a cornerstone of sustainable social development leading towards well being of every citizen in any State or Country. The sex ratio is an indicator which describes the number of women per 1000 men for a given population. The child sex ratio describes the ratio of girls to boys in the age group of 0-6 years.

The sex ratio of a given population is also used as a strong indicator to ascertain social health. In the developed societies where female and male enjoy equal status the women usually out number men. The adverse sex ratios (where female are lesser than male) not only indicate poor social health, but also a barrier in attaining sustainable social development.

In a “normal world,” the female population equals or slightly surpasses the number of males. Except in India, that is, where the situation is just the opposite, where the gender ratio — or the number of females to males — is known to be among the most imbalanced in the world.

Although China has the most severe shortage of girls compared to boys of any country in the world today, in India, the 2001 census revealed disturbing news: the proportion of girls aged 0-6 years dropped from 945:1000 to 927:1000 since the previous census done 10 years earlier.
This means that 35 million fewer females than males were registered in India over this particular decade.

The census also revealed that the phenomenon has reached high proportions in states which had no prior history or practice of female infanticide, or where forms of discrimination against girls were not strongly evident earlier.

The declining child sex ratio in India is so alarming that if the present trend continues it is going to result in a demographic and social disaster. Hence, hidden though it is often, this is an issue which ought to be of concern to every citizen.

This is so because India’s already abysmal sex ratio figures are getting worse by the day, with 80% of its districts recording declining sex ratios since 1991, as thousands of girl-children are killed before or at birth; according to a report by UNICEF on the global status of children.

In another indication of just how serious the problem of missing girl-children in India really is, a new report by UNICEF finds that child sex ratios have declined in all but three Indian states and union territories. Kerala, Pondicherry and the Lakshadweep islands are the only exceptions to this rule.

Unsurprisingly, the state of Punjab is cited as the worst offender -- the ratio has dropped from 875 in 1991 to 798 girls for every 1,000 boys in 2001, says ‘State of the World’s Children 2007’ the UN children’s agency annual report. Haryana, which records a sharp 60-point drop, from 879 girls in 1991 to 819 in 2001, is a close second. Chandigarh, Himachal Pradesh and Uttaranchal, all in north India, are other states where girl-children are largely unwanted.

The all-India sex ratio is 927 girls for 1,000 boys, which puts the country right at the bottom of the global charts, worse off than countries like Nigeria (965) and neighbour Pakistan (958).

Although there have been attempts to address the problem through legislative provisions with the enactment of PNDT (Pre-natal Diagnostic Test) Act in 1994 which was later amended to PC-PNDT Act (Pre—conception and Pre natal Diagnostic Techniques Act) in 2003 to check the misuse of technology cited as a major reason responsible for distorting child sex ratios.

In order to regulate use and prohibit misuse of technology, the Pre-Conception and Prenatal Diagnostic Techniques (PC and PNDT) Act is considered an important tool for addressing sex selective eliminations and in addressing the declining child sex ratios.

However, the law has not been effective in controlling the declining numbers of girls and the reasons behind this mistreatment of girls crosses the spectrum of Indian regions, economic classes, and castes and are due to a complex mix of economic, social, and cultural factors.

Saturday, August 14, 2010


As we all know, poverty and health are connected. The accessibility of health among other social resources is conditioned by several other economic, social and cultural determinants. One of the important learnings of our first hand experience of working on health and reproductive rights issue in communities of Mewat and Gurgaon districts of Haryana was the criticality of viewing efforts at improving women’s health as closely entwined with larger issues of social and economic backwardness of women in traditionally male-dominated societies. Women in the rural areas of Haryana have little control over their lives. They have little power to take part in decision making in family matters. Dependency on male members of the family can be observed in almost every sphere of their lives including their health. In part women’s low status in the family and lack of decision-making power can be ascribed to her almost complete economic and social dependency on men.

It was therefore clear that the impact of any stand alone women ‘health’ program devoid of interventions that address the other associated socio-cultural and economic determinants impacting accessibility would be largely circumscribed.

Thus, over the years the focus of Sukarya’s efforts has shifted from exclusive ‘health’ programs to programs focusing on social and economic determinants impacting health outcomes. With the intention of dovetailing economic and social empowerment intervention with ‘direct’ health programs; Sukarya has enlarged its programmatic area to include income enhancing livelihood supporting initiatives for women.

Empowerment of women has thus emerged as a strategic thrust area in Sukarya’s work on women’s health issues. The idea is economically empower women through micro-credit and entrepreneurship development income enhancement programs which will in turn make women socially mobile and aware and help them overcome some of the social, economic and cultural impediments to leverage their enhanced social and economic standing to access better health care for themselves and their families.

Sunday, August 8, 2010

Sukarya and The Airtel Delhi Half marathon 2010

Check out this SlideShare Presentation:


Health is the fundamental inalienable right of citizens of any nation. Though India since its liberalization in 90’s has made strident economic growth the quality of development especially in the health sector is an area of concern. Just to give you a glimpse of the prevailing health status,

 India accounts for more than 20% of global maternal and child deaths, and the highest maternal death toll in the world estimated at 138,000.1
 United Nations calculations show that India’s spending on public health provision, as a share of GDP is the 18th lowest in the world.
 Nearly 67% of the population in India do not have access to essential medicines.
 Infant Mortality Rate (IMR) in India was 57 in 2005-06.
 79% of the children between the age of 6-35 months, and more than 50% of women, are anaemic, and 40% of the maternal deaths during pregnancy and child-birth relate to anaemia and under-nutrition.
 There are 585 rural hospitals compared to 985 urban hospitals in the country.
 The ratio of hospital beds to population in rural areas is almost fifteen times lower than that for urban areas.
A villager needs to travel over 2 km to reach the first health post for getting a tablet of paracetamol; over 6 km for a blood test and nearly 20 km for hospital care.
A study conducted by the World Bank showed absenteeism ranging from 40% to 45% among doctors working in primary health centres.

It is obvious from the above statistics that the distribution of health resources are skewed in favour of the urban, privileged masses in the cities and the remote, rural areas and the under privileged sections of society including the urban poor are left without any access to basic health care services.

It is important to understand that health and poverty are closely related and a nation with good health tends to be more productive and that productivity tends to uplift economic and societal development. Therefore any nation –building exercise should first focus on ensuring basic health to its people and improving health should be the fundamental goal of economic development.

The challenges facing the nations’ health are eliminating infectious diseases, nutritional deficiencies, unsafe pregnancies and the challenge of escalating epidemics of non-communicable diseases. This requires a concerted public health response that can ensure delivery of cost-effective interventions for health promotion, disease prevention and affordable diagnostic and the therapeutic health care.

The health programs of Sukarya, a non-profit development organisation has been guided by its motto “behtar swasthya, behtar samaj’ since its inception in 2001. Sukarya’s work in the health sector focuses on making primary health care accessible to the underprivileged and underserved communities with the ultimate aim of contributing to the nations’ health and in turn to its growth and development.

In all its effort, the aim of Sukarya has been to reach the un-reached, marginalized and most vulnerable sections of society. In a society characterized by inequitable distribution of development, there exists a disparity in access to resources. Sukarya has therefore been particularly focusing on concerns of women and children who remain disadvantaged and to whom ‘heath’ remains elusive because of broader socio-cultural and economic factors. The high infant and maternal morbidity and mortality rate is a clear development indicator that proves the low health status of women and children in our country despite some strident development in other areas.

Sukarya has therefore specially been focusing on the health needs of the most vulnerable sections including women and children. The health concerns of women and children therefore find a greater programmatic space in our work. The critical areas of work in Sukarya’s health intervention therefore include efforts at ensuring safe motherhood, reproductive health, nutrition, sanitation, immunization and child care.