A recent report prepared by Jan Swasthya Abhiyan, involving several NGOs working on health issues in Gujarat, and high-profile CommonHealth, has found that 41 per cent of the maternal deaths in Gujarat occur in very young women, below the age of 25 years. Basing its analysis of 46 maternal deaths, it said, seven of them took place when the mother was between 16 and 20 years, and 12 deaths were of women between 20 and 25 years.
Finalised in December 2014, and titled “Social Autopsies of Maternal Deaths in Select Areas of Gujarat”, the report states, “For many of the women, this was either the first (14/46) or the second pregnancy (13/46).” It added, “Eleven of the 46 women had between four and eight pregnancies.”
The report says, “More than half – 59%, i.e. 27 of the 46 deaths -- were of scheduled caste (SC) and scheduled tribe (ST) women. This is a higher proportion than the state’s SC-ST population of around 22% (2011 Census).”
Pointing towards social indicators of these women, the report says, “Almost half of the women, who died – 46% -- were illiterate in comparison to 37% female illiteracy in Gujarat, and majority of the rest, almost one third of the total, were educated only up to primary level. Only 8 of the 46 women who died had secondary, graduate and vocational education.”
Most of the women who died had multiple occupations/responsibilities, the report says, “In addition to domestic work, 25 of them were involved in either agricultural work or/and wage labour. Nine of the women who died migrated for longer than 2-3 months without safety of home and other basic amenities or any social security.”
What the report particularly found shocking was, three of the women who died were extension workers of the Gujarat government – a teacher, a midday meal in charge, and an Asha health worker. One was Life Insurance Corporation agent.
Profiling death, the report says, “14 women (30%) died in the ante natal period, four (8.7%) during the childbirth and 28 (60.8%) after delivery. Amongst the post natal deaths, eight occurred within 24 hours, three within a week of the delivery and the rest (17) between 8 to 42 days of delivery.”
Lack of health facilities appeared to a major reason, indicates the report. “Fourteen maternal deaths – (30 %) - took place at home, 24 (52%) in institutions (10 in private and 14 in public institutions); eight deaths (17%) took place in transit”, it says.
“Among the indirect causes unrelated to pregnancy, anaemia in 4 (8.6%%) was the commonest followed by 2 deaths each due to jaundice, sickle cell disease and cardiovascular disease and one each due to malaria, tuberculosis, rabies, renal failure and dengue”, the report says.
The report says that the very fact that eight deaths happened during transit “points to the fact that although 108 has helped to increase access to health services for many women, many especially vulnerable women in remote areas continue to be plagued by lack of physical access and transport facilities.”
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