ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Reproductive HealthSubscribe to Reproductive Health

Delivering Nutrition to Pregnant Women

To reduce the burden of maternal undernutrition in India, select nutrition interventions are delivered to pregnant women at scale through the National Health Mission. But in Purnea, a district in Bihar, delivery is constrained by poor planning and budgeting, delayed fund flow, and shortage of infrastructure and human resources; and funds are underutilised.

Utilisation of Health Facilities for Childbirth and Out-of-pocket Expenditure

Using data from the household surveys on health conducted by the National Sample Survey Office between 2004 and 2014, the utilisation patterns of health facilities for childbirth and the associated out-of-pocket expenditure are analysed. The findings reveal that the utilisation of public facilities for childbirth increased three times in rural areas and almost one and a half times in urban areas between 2004 and 2014, but that most deliveries took place in district hospitals. Also, the average medical expenditure on childbirth in government health facilities declined by 36% in rural areas and by 5% in urban areas. Considerable interstate variations in regard to oop expenditure on drugs, diagnostics and transportation were also witnessed. Though government policies to promote institutional births have improved the utilisation of public facilities and reduced the overall oop expenditure, more needs to be done for the benefits to reach the vulnerable sections, especially in urban areas.

Rising Caesarean Births

India’s rising rate of caesarean births is a cause for concern and signals the need for strategies to deal with it. Adverse outcomes of caesarean births include high risk of maternal and neonatal death, various maternal morbidities including infections, need for blood transfusion, neonatal morbidities related to iatrogenic prematurity, and potential complications in subsequent pregnancies.

In Search of Non-tangential Premises

The Surrogacy (Regulation) Bill, 2016 marks a significant shift in the discourse on commercialisation of surrogacy. This article explores issues of altruism, repugnance, paternalism, marketability, exploitation, and assumptions of the moral inviolability of motherhood, with respect to surrogacy in India. It offers close perspectives on the ramifications of altruism in assisted reproduction based on field research and interviews conducted in the cities of Kolkata, Mumbai, Pune, Anand, and Howrah.

mHealth Solutions for Family Planning Services

There is limited experience in India of using mobile phones for sexual and reproductive health services, including family planning, in rural areas where service coverage is still insufficient and accurate information is lacking. Information and integral support can be provided by leveraging mobile health (mHealth) services, but issues of privacy and gender sensitivity are crucial for its success.

Where Is the Husband?

Despite global efforts towards creating awareness and involving men in maternal and reproductive health of women, their participation remains low, particularly among the tribal population.

Right to Safe Abortion

The case of the 10-year-old victim of rape who is pregnant and awaiting delivery after being denied permission to abort by the courts is an urgent indication that all stakeholders must come together and find a solution for unwanted pregnancies of more than 20 weeks.

International Rhetoric, Domestic Evidence

Civil society reports on sexual and reproductive health provide a contrast to the claims and assurances made by the government’s report to an international human rights mechanism on its public health commitments and achievements, with information that is at gross variance to the official report. This discordance questions the credibility and accountability of the government to these international human rights processes and more so, its citizens.

Surrogacy and the Laws on Maternity Benefits

Five high courts across India have uniformly held that women employees who have children through surrogacy would be entitled to maternity benefits in accordance with the rules. How they have arrived at this conclusion is quite different in each case, and each judgment presents different approaches to address this legal question. Beyond the legal question, the approaches must also be closely examined for class biases and paternalistic assumptions about motherhood.

Realising Universal Maternity Entitlements

In India, most of the work women do is invisible and unrecognised because it is done outside the boundaries of the formal economy. As a result, the laws pertaining to maternity entitlements reach a very limited number of women. The National Food Security Act, 2013 was the first national-level legislation to recognise the right of all women to maternity entitlements and wage compensation. Since the passage of the act, India has been using an existing conditional cash transfer scheme, the Indira Gandhi Matritva Sahyog Yojana, to implement this entitlement. An examination of the implementation of defined maternity entitlements under the act via a conditional cash transfer, highlights the failure of such a programme to uphold the spirit of the act. Amendments to the act are necessary to ensure that the most vulnerable women are able to realise their right to maternity entitlements, wage compensation, health and nutrition.

Politics of the Womb

Solid: Liquid: A (Trans)national Reproductive Formation by Kumkum Sangari, Tulika, 2015; pp xii + 264, ₹695.

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