The recent data released by the Brihanmumbai Municipal Corporation showing a drop in maternal deaths in Mumbai is good news. According to the report, maternal deaths in the city fell to 311 in 2015-16. This is welcome given that the figures on this front have seen a steady rise over the last few decades, except for 2013-14.
One of the main factors is that anaemia, which has been the single largest contributor to the high maternal deaths, has seen a major fall. According to the report, anaemia is behind less than 2% of the maternal deaths in 2015-16. Until a few years ago the figure was as high as 25%. This shows that interventions by the BMC alongwith various organizations like SNEHA in slums have paid off. There is greater awareness about the importance of taking folic acid tablets, calcium and iron from the early stages of pregnancy.
As women I spoke to in Dharavi point out, they would rarely remember to take these supplements during pregnancy. And even when they did, they had no idea how to. They would simply club them together.
“Now I am aware that I have to space them out through the day so they are effective,” says Vandana, who is pregnant with her second child. “These are things that I learned from counselors who visit the area”.
Another positive is that the fight against tuberculosis is showing results. It contributed to 6% of maternal deaths in 2015-16 compared to 11% in 2015-16. Proof that DOT centres in the slums and awareness campaigns by the BMC is paying off.
However, what is worrying is the threat posed by poor sanitation and hygiene. The BMC data shows that a majority of maternal deaths are due to hepatitis – both A and E. Both strains are directly attributed to poor hygiene and the lack of clean water. Around 14% of the deaths in 2015-16 were due to hepatitis.
Experts say the figures highlights the lack of clean water in the slums, Most of the slums, especially in the tertiary areas like Govandi, rely on water from tankers. Lack of safe water is a major risk factor during and post pregnancy.
Apart from ensuring clean water supply, there is also a need to strongly promote better hygiene and sanitation practices like boiling water, washing hands and using public toilets to reduce infections. The solutions are many and entirely in our hands. Like the fight against anaemia, this too is a battle that can be won.