In August 2015, Call to Action Summit- ending preventable maternal and child deaths”- was co-hosted by the Ministry of Health and Family Welfare, Government of India and the Health Ministry of Ethiopia, in partnership with USAID, WHO and Bill and Melinda Gates Foundation, the Tata Trusts and UNICEF where the Indian Prime Minister announced that mothers and newborns were now free from tetanus at the time of birth in India. The source of this announcement was a report by World Health Organization(WHO) which has now placed India on the list of countries who have successfully implemented Maternal and neonatal tetanus elimination (MNTE).
But as we recall the announcement it is equally essential to realize that tetanus cannot be eradicated as the spores of the germs are still present in the environment unlike other diseases like Polio etc. With the upcoming week of immunisation in the month of April, it’s time we revisit how government and development sector have time and again emphasised the need for complete vaccination and immunization of the mother and child.
Specifically catering to the immunization needs of the children who are either partially vaccinated or unvaccinated government of India initiated ‘Mission Indradhanush’ to provide full immunization coverage to 90% by 2020. There are also other programmes like Reproductive, Maternal, Newborn, Child and Adolescent Health initiative, Janani-Shishu Suraksha Karyakram, India Newborn Action Plan but are these catering to the goals? Inspite of these programmes India had missed its targets for Millennium Development Goal 5, to reduce its MMR by 75 % between 1990 and 2015.
The new SDG Goal 3, good health and well-being which ensures healthy lives and promotes well-being, also mentions the need to improve maternal health. The specific target mentions that ‘by 2030 reduce the global maternal mortality ratio to less than 70 per 100,000 live births specific maternal health indicator.’ How much can India contribute in achieving this target? The sheer size of the population means that progress made by India to a large extent also determines the global success of this particular SDG.
The overall progress in improving the maternal healthcare has been uneven, a major reason being lack of a robust immunization cycle for the mother and the child. In India some researchers have also noted gender discrimination in vaccination where families in rural areas often neglect and discriminate female child. There is also a relationship between mother’s academic and education background and her child’s immunization coverage. In a diverse country like India one can also not forget other factors like caste /tribe which also affect full immunization.
It remains to be seen how well the government and the development sector aims to handle such factors.