by Suhani Dewra
Strengthening Comprehensive Abortion Care (CAC) services, especially for poor women, helps to reduce the Maternal Mortality Ratio (MMR).
Indian state Madhya Pradesh is one of the six states that records higher Maternal Mortality Ratio (MMR) than the national average (22) in comparison to 167 deaths for every 1,00,000 births. To reduce this number, the Government of Madhya Pradesh in 2006 initiated an effort to allow access to Comprehensive Abortion Care (CAC) services. This was done in collaboration with the technical support from Ipas Development Foundation (IDF). The aim was to strengthen CAC to reduce the maternal death rate.
Ipas Development Foundation (IDF) is a not-for- profit organization that aims to prevent and manage unwanted pregnancies, and end deaths and disabilities from unsafe abortion. The IDF collaboration means working closely with the State Government to train the doctors, orient nursing staff, cooperation with state and district officials for facilitating availability of essential equipment and drugs, and establishing site signage (poster or wall sign) on availability of CAC services. The services are fee of cost, especially for poor women.
In the same regard, a study undertaken by IDF that was published in The BMC Health Services Research (BioMed Central) journal, highlighted the socio-economic profile of women accessing CAC services at different levels of public health facilities in rural and urban Madhya Pradesh.
1036 women presenting to 19 facilities for induced abortion and post-abortion care, provided informed consent, were interviewed between May and December 2014. Seventy-two percent of them were interviewed at selected primary level health facilities and twenty eight percent were interviewed at secondary level hospitals. Dr Sushanta Banerjee, Senior Director, Research and Evaluation, IDF says, “Results highlight that overall 57% of women who received CAC services at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for post-abortion complications (67%) than induced abortion”
Dr Archana Mishra, Deputy Director, Maternal Health Services, Government of Madhya Pradesh explained, “It is encouraging to note the findings of the study suggest that poor women are predominantly visiting public health facilities for availing CAC services.”
Although conducted in Madhya Pradesh, the findings of this study have a national implication on the role the public health system plays in serving poor women. Vinoj Manning, Executive Director, IDF, said, “The study reaffirms the importance of our work in the country on strengthening access to CAC services in the public sector as it is the only way to ensure access to safe abortion services for poor women. It also underlines the need for increasing access to CAC services across the country.”
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