How can access, equity, equality, and technology shape maternal health in India and South Africa?
“Women and children are not dying because of diseases; they are dying because society is still deciding whether their lives are worth saving,” proclaimed by Ms Sweety Pathak, Associate Programme Director of the Society for Nutrition, Education and Health Action (SNEHA). This statement was made during a panel discussion on maternal health issues in a globalising world. The event was jointly organised by ORF Mumbai and the South African consulate on 31 July 2019 to commemorate the Mandela Day. The panelists engaged in a meaningful discussion on the current challenges in maternal health by introducing their unique perspectives from different sectors of the healthcare system.
This annual event is held in honour of Dr Nelson Mandela’s legacy of social justice and peace. The event began with a screening of a short film on Mandela’s views on public health, which also compared maternal health indicators in South Africa and India.
The screening of the film was followed by opening remarks from the moderator, Dr Kamakshi Bhate, who is Member Secretary of MCGM’s Savitribai Phule’s Gender Resource Center and the former professor and head of Preventive and Social Medicine at KEM Hospital. Dr Bhate explained the miraculous progress India has made in maternal health while recognising that India is still lagging behind in some respects. She urged listeners to understand that maternal and child health is not just a problem for the health sector alone, but a major societal challenge affecting all sectors of the economy.
The panel discussion was commenced by the South African Consulate General Ms Maropene Ramokgapa, who gave a global perspective on the issue, especially highlighting the progress in South Africa. She spoke of the need for improved menstrual hygiene and access to sanitary products around the world. South Africa, in particular, has been devoted to improving health education and the interface between the health system and patients.
Ms Sweety Pathak introduced the impactful work of SNEHA, an NGO that works to strengthen public health infrastructure, empower communities, and advance public health research in Mumbai. She explained how even with the knowledge and research, an intervention cannot easily be translated into action. In response, SNEHA has been active in ensuring accessible and quality care through optimising location, improving staff and equipment, and standardising protocols.
Dr Sangeeta Pikale, Director of the Maharashtra Healthcare Sector Skill Council, who juxtaposed the role of the private and public health sectors of India. In particular, she critiqued the inequities of healthcare: “When the private sector gets involved in health and education, the problem is that they have to look at return on investment. This is not ideal.” She emphasised the engagement of all sectors from small nursing homes to ASHA community health workers, to large private hospitals. Dr Pikale also explained the importance of incentivising skilled clinicians to serve in villages and undeserved areas in order to provide equitable healthcare.
Dr Sanjida Arora, from the Center for Enquiry into Health and Allied Themes (CEHAT), spoke on quality of care, specifically about gender-based violence and traumas, such as the abuse women face during childbirth. She stressed, “There is a lot of neglect of women giving birth. There is a lot of focus on the child but not the mother.” The quality of care for pregnant women is inadequate. There are barriers to receiving abortions and medical services that ultimately push women to go to expensive private hospitals or make uninformed choices about their health. She also advocated for the appropriate integration of gender issues into the medical curriculum.
Dr Aparna Hegde shared how technology is changing the landscape of maternal health. She founded mMitra, a mobile application that sends pregnant women and new mothers voice calls that provide preventive care information directly to their phones. This use of technology to enhance medical care has proven to be cost effective and impactful. As she put it: “Data is extremely important; if you don’t have data you can’t improve services.” By tailoring the information to the woman’s needs and partnering with local NGOs, hospitals, and health workers, maternal health has drastically improved for users.
Dr Bhate, concluded the discussion by urging that women’s healthcare should not be overlooked, but be a topic of conversation until equal, reliable, and quality access is guaranteed for all. In the words of Nelson Mandela, “Health cannot be a question of income; it is a fundamental right.”
Jessie Huang and Sophia Ashebir are Research Interns at ORF in Mumbai.
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