the relationship between maternal mortality and...

Geo-Analyst , Vol.2, No.2., ISSN 2249-2909 2012

132

THE RELATIONSHIP BETWEEN MATERNAL MORTALITY AND FEMALE EDUCATION : A

CASE STUDY OF UTTAR DINAJPUR DISTRICT IN INDIA

Beauty Das*

ABSTRACT

Now-a-days, in a sustainable community, everyone has the right to the fulfilment of basic

human needs including safe shelter, dignified work, sufficient food, education and basic

health care that meet their needs and skills. But, it is evident that life in India both in rural

and urban areas is full of tension. Health is one of the important indicators of human

development and rural female health care has been one of the neglected areas in India. It is

well known that the growth and development of women have direct impact on the general well-being in a society. The power of mothers is God’s greatest gift against of all that ails

the world. The present study is an attempt at assessing the variations in the levels of rural

women health care during pregnancy period. It is observed that many thousands of rural

women do not receive the antenatal and postnatal check-ups during pregnancy period that

they need. Sex ratio is the most credible pointer towards the status of women of village

areas in the country. The present paper is an attempt to focus on the rural maternal

mortality, infant mortality in specific study area. The main objective of this paper is to

make improvement the nutritional and health standard of mothers and children in the study

area as well as to make people conscious about the importance of basic health of

motherhood.

KEY WORDS: Maternal Mortality, Antenatal, Postnatal caring, Sex-Ratio, Post-partum

complication, NRHM.

INTRODUCTION

Health is one of the important fundamental human rights and it is the responsibility of the

government to provide health care to all people of rural and urban areas in equal

proportion. India is the 2nd

largest populous country which shares 18 percent of the world’s

total population. According to 2011, census rural population of India is about 742490639.

The health status of rural areas is a matter of great tension in recent days in India. It is very

unfortunate fact that despite impressive economic growth in the rural areas, female health

indicators have not yet changed noticeably.

The present paper is an attempt to focus on health status of rural mothers which has been

ever changing in India in the 21st century. There have been infinite variations in the status

of folk women over the different corners of the country. In general, it is stated significantly

that maternal health status is measured in terms of indicators of maternal mortality, crude

birth rate, infant mortality rate, neo-natal mortality rate, post natal mortality rate and birth

rate.

The stories of women who die in rural India during pregnancy, delivery or from post-

partum complications have largely remained untold tragedy in the 21st century of

globalisation. The National Rural Health Mission goals for 2012 call for the reduction of

maternal mortality to 100 women per 100,000 live births.

Despite of substantial improvements in life expectancy, the maternal mortality ratio

continues to be unacceptably high in the state West Bengal in India. This state is still far behind the better performing Indian state like Kerala. There have been intra-rural

variations in health status between districts in the state West Bengal. Female literacy and

*Beauty Das, Assistant Professor in Geography, Balurghat College, West Bengal


133

education are crucial determinants of mother and child survival. So, health status and hygiene of rural women may vary with the variations between per capita income and

female literacy rate in West Bengal. The female literacy rate of West Bengal is about

60percent where is even more striking rate at 49.77 percent in the district Uttar Dinajpur.

The present study is an attempt to focus on hypothesis which may conclude relationship

between rural education and rural health in the study area.

STUDY AREA

The district Uttar Dinajpur is a part of Jalpaiguri Division in West Bengal and it is located

entirely within the catchment of the Mahananda River. It covers an area of 3180 sq. km.

with high compound population growth during 1901 to 2001. The district remains pre-

dominantly rural, and has an aggregate of population 3000849 among which male and

female are 1550219 and 1450630 respectively according to census 2011.

Uttar Dinajpur district extends form 250 17

/10

// N to 26

0 35

/ 15

// N latitude and from 87

048

/

37// E to 88

0 20

/ 10

// E longitudes respectively. To the East is Darjeeling district, to the

West is Bihar to its South are Malda and Dakshin Dinajpur districts. Average literacy rate

of this district is 60.13 in 2011. The total rural population is about 87.93 percent and total

literate population is about 57.15percent in rural areas.

OBJECTIVES

It is true that rural development is directly related to the rural maternal status of any

region. Female health status is one of the important indicators of human development. The

growth and development of women have direct impact on the general wellbeing of a

society. In the era of globalisation, Kerala in India has a unique position in regard of

female literacy (87.9 percent) sex ratio (1058 Females par 1000 Males) institutional

delivery (more than 90 percent) and notable achievements of women health. The present paper is aimed to make an assessment on the maternal health status in Uttar Dinajpur

district.

It is believed that, save a mother and together we can save a millions of mothers. So the

main objectives of the study work are –

i) To improve the nutritional and health standard of mother and children

suffering from malnutrition in the study area.

ii) To strengthen the rural female literacy and education for the reduction of

the incidences like maternal mortality during pregnancy period within

the study area.

iii) To improve the both antenatal and post natal care at least 70 percent of

the rural women within next five years in the study area.

iv) To observe the monitoring and planning process regarding rural health

mission within the study area.

METHODOLOGY AND DATABASE

In this study, methodology is based on primary and secondary data. To focus on the

hypothesis of the study, intensive library work, field work, collection of data, sampling

study etc. are collected for the intensive information.

Although the present paper is an attempt to make an assessment on the rural maternal

health status in the district Uttar Dinajpur in West Bengal, but there is a major constraint

which could affect the accuracy of the findings and conclusion of this report. This is a sort

time frame work for such type of study having complex project covering a vast field of

significance. DISCUSSION

The number of pregnancy-related deaths every year is estimated to be 166,000 or 450 per

day. The survival of a pregnant mother hinges on several factors, right from mother’s

health, education, and nutrition, access to health care and protection of the child from

diseases.


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Female literacy and education may determine progress in terms of demographic and health indicators. These include specially the expectancy of life at birth, the birth rate and death

rate, infant mortality etc. In Kerala, both access to utilization of health care particularly

among women are quite high compared to the women in rest of the country.

BAR-GRAPH SHOWING THE MATERNAL MORTALITY RATIO IN INDIA, KERALA AND

WEST BENGAL (SINCE 1999 TO 2006).

Figure – 1

Source : Special bulletin on M.M.R Registrar of Gen. of India.

From the diagram, it is evident that the state of Kerala leads the other states and Indian

average in maternal mortality since very early two decades. Kerala has experienced with

the favourable sex ratio (1058 Female per 1000 Males), high rate of female literacy (87-86

percent), more than 95 percent of institutional delivery etc. which may play vital role in

decreasing of maternal death. Thus, Kerala having highest H.D.I. and sex related

development index stands against other parts of the country.

Figure-2

Source: Census 2001.

Uttar Dinajpur district is one of the socio-economically backward regions in West Bengal.

It occupies lower ranks in terms of Human Development Index. Although health status of

rural women and children assume a special importance in Uttar Dinajpur district, but there

has been a huge rural – urban gap in the percentage of underweight women, prevalence of

anaemic and indeed is significant. Due to health services, maternal death and infant death

rates are decreasing gradually in towns of Uttar Dinajpur. But, the situation is opposite in

0

100

200

300

400

INDIA KERALA WEST BENGAL

1999-01

2001-03

2004-06


135

case of block areas due to low literacy, differential income levels, socio-economic conditions and age-old beliefs. It is observed from the Survey of Health Management

Information System that the maternal death is 118 women per 100,000 live births in the

year 2010-2011 in this district.

Several factors are thought to be associated with maternal mortality, these are followings:

• Socio-economic status of rural women.

• Haemorrhage or critical anaemic situations.

• Sepsis or infections after deliveries.

• Hypertensive disorders associated obstructed labours.

• Obstructed labour.

• Complications of abortions.

• Other disorders such as maternal malnutrition, non-availability of

skilled birth attendants, low proportion of institutional deliveries, poor

maternity care including antenatal and post-natal check-up of female

mothers in rural areas over the country.

Figure-3

Source: Millennium Development Goals India, Country Report.

There is evidence of relationship between lower level of maternal education and higher

maternal mortality. The study examines the relationship between maternal education and

mortality among women giving birth in health care institutions. World -wide Research

shows that socio-economic benefits from women’s education calculated as the return of

education are comparable to those from men’s education. The gender gap in education is

undesirable. Female education has powerful effects on changing the plight of motherhood.


136

MAP SHOWING DISTRICT WISE LITERACY IN WEST BENGAL

Figure-4

Source: Census 2011.

So it has proved that the differential mortality in India is the most dramatic manifestation

of social economic discrimination against female education. There are so many factors

which have direct impacts on general status of women in a society. Socio-political

participation of women to forefront, importance to life expectancy for female, proportion

of maximum female workers, large number of women movements, self- help group etc. all

these factors play vital role in reduction of maternal death in rural areas.

Figure-5


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PIE-CHART SHOWING THE PERCENTAGE OF FEMALE LITERACY IN NINE BLOCKS OF THE

STUDY AREA

Source- Uttar Dinajpur district-profile. Figure-6

DIAGRAM SHOWING THE ANTENATAL AND POSTNATAL CHECK-UP

Source: Field’s investigation in Block Public Health Centre. Figure - 7

BLOCK WISE INSTITUTIONAL DELIVERY IN UTTAR DINAJPUR DISTRICT (APRIL-JULY

2012)

Source- Field’s investigation in Block Public Health Centre.

Figure- 8

29.7

19.8

23.5

45.7

25.736.5

25.5

29.7

39.1

FEMALE LITERACYCHOPRA (29.7)

GOLPODHOR-1(19.8)

GOLPODHOR-2(23.5)

HEMTABAD(45.7)

ISLAMPUR(25.7)

ITAHAR(36.5)

KARANDIGHI(25.5)

KALIAGANJ(29.7)

RAIGANJ(39.1)

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1000

2000

3000

4000

5000

Ch

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Go

alp

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kh

or ii

Go

alp

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kh

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He

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ba

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Islam

p

ur

Itah

ar

Ka

liag

a

nj

Ka

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dig

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A.N.C

P.N.C

0

500

1000

1500

2000

2500

I.D


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Institutional Delivery information has been collected from health management information

system of the period of April-2012 to July-2012.

From the Figure – 7, it is observed that there is great difference in number of health check

– up of antenatal and post natal to young mothers and institutional delivery in the district

health centres. The several schemes for mother health improvement, has been accepted by

NRHM, but the stories of real picture of young mother lie in tragedy. To promote

institutional delivery, women from rural areas are given monetary incentives by Janani

Suraksha Yojna. ASHAs provide antenatal and postnatal care such as vaccination and

nutrition supplement in rural young mothers.

Suggestive steps are to be taken to improve the present situation of rural motherhood, which are given below.

• A powerful new tool is required to analyse medical or social reasons

behind maternal death.

• The role of MAPEDIR (Maternal and Prenatal Death Inquiry

Responses) in empowering communities to wipe out the root causes

behind these deaths are very much becoming significant now-a-days.

• “UNICEF” is committed to continue working with the National Rural

health Mission to promote surveillance as a key strategy to lower

maternal and child mortality.

• One of the most significant steps is formed that a team is made up of state Government health and nutrition officials and NGO members,

headed by member of the local village Council or Panchayeti Raj

Institution which will conduct interviews with surviving family

members at community level.

• Community awareness on rights and public participation in women’s

health care issues will save women’s lives and ultimately their new

born.

• One of the most important innovations is to improve local health

services such as a referral transport scheme practised in rural corners of

west Bengal.

• Janani Shishu Surakhsha Karyakram has been accepted for rural areas for free transport, delivery, medicines and food.

• It is time for rural healthcare course as health workers can bring down

MMR only to a certain level, but for further improvement, better

qualified health workers, better infrastructure and better nutrition are

needed in rural areas.

CONCLUSION

So, from the above discussion, it is concluded that MMR is one important indicator of

development of a community. Preventing deaths to mothers associated with pregnancy and

child birth is one of the greatest challenges before the nation in 21stcountry. Perhaps this is

the reason for developing several schemes and interventions to improve maternal and child

health. Several schemes for health under National Rural Health Mission as Janani

Suraksha Yojna, ASHA, Nutritional Rehabilitation Centres, Universal Immunization

Programme, Facility based new born care, Janani Shishu Sulaksha Karyakaram etc. are

taken on improving women health care to reduce maternal mortality in the rural areas of

the study area. Though it is difficult to assess how are all these health care programmes


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(introduced by Union Health Ministry) working even in those remote pockets of the country but the responsibility of lower IMR and MMP largely rests on the shoulder of

health professionals as well as female awareness in a society.

BIBLIOGRAPHY

1. HMIS- Govt. in India.

2. Bureau of Applied Economics and Statistics –“District Statistical Handbook”-

Uttar Dinajpur.

3. Census of India 2011.

4. Planning Commission (2010), “West Bengal Development Report”, New Delhi.

5. Govt. of India (2009), “National Health Profile”, New Delhi.

6. www.Uttar Dinajpur Dist.profile. 7. Moldal. K.C (2009), “Geography”, Oriental Book Company pvt.ltd.

8. Down to Earth, March 1-15-2012,Pp. 29-38.

9. Singh. Kumar Amit,(2010),”Patterns and Process of Urban Development”

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