THE ECONOMY-Away from Production

countries suggest that effective and efficient institutional support at birth has a spectacular effect on maternal mortality rate. This support, however, must be in consonance with other facilities, such as knowledge about when a woman in labour has to be moved to a medical centre, availability of and access to transport, the existence of roads (which cannot be taken for granted), etc In fact, recent SRS data show that states with a low MMR have a higher proportion of institutional births. Given this, there is certainly a case for establishing and strengthening maternity facilities. However, there is the danger that the health bureaucracy with its cockeyed approach may in consequence further de-emphasise the preventive and promotive aspects of the programme and unnecessarily medicalise child-birth with high investment drawn from the other part of the programme.