Mother India

This past March I traveled to India to join Dr. Julio Frenk, the Dean of Faculty at the Harvard School of Public Health, along with some faculty from the school and fellow members of the Board of Dean’s Advisors. I met up with everyone in New Delhi, having arrived in the middle of the night after about 20 hours combined flight time from New York. I pretty much hit the ground running as one must do when trying to squeeze in as much of an experience as possible in such a short period of time.

With Dean Frenk March 2012. Photo by Kuku Photography

I was excited to return with such a learned group, many of whom are already so deeply committed to this country that is equal parts challenging and hopeful. I had traveled to India a handful of times over the years as a yogi, as a model and as a guest correspondent for the Today Show but this was a first as a mother and maternal health advocate.

Vogue Paris 2001 cover, shot in Rajhastan, India by Inez and Vinoodh

Here’s the challenge, India is made up of 28 states which collectively inhabit 1.22 billion of the country’s people or roughly 17% of world’s population. With a growth rate of 1.58% it is estimated that the population will grow to 1.53 billion by 2030.  With this many people come countless health challenges, particularly amongst the poor. According to a 2005 World Bank estimate, 41.6% of the total Indian population falls below the international poverty line of U.S. $1.25 per day. 

India is also a major source of the world’s maternal deaths. Combined with Nigeria, these two countries make up one-third of the world’s total maternal deaths each year. In 1980, the maternal mortality ratio was 677 deaths out of 100,000 live births. The latest estimates have those rates dropping down to 200 deaths per 100,000 live births. And this progress is significant. One of the ways they have been able to bring these deaths down is through ASHAS (Accredited Social Health Activists), an effort instituted by the Government of India’s Ministry of Health and Family Welfare as part of the National Rural Health Mission in 2005. They expect this program to achieve full implementation this year.

Another effective tool that is beginning to have an impact is the Safe Childbirth Checklist developed for the World Health Organization. This tool was designed to assist health workers who support mothers and newborns through deliveries. We visited the AIIMS teaching Hospital in New Delhi and met nurses who are using this tool already.

Maternity Ward nurses at AIIMS Teaching hospital in Delhi who use the Safe Childbirth Checklist. March 2012

If we can continue to train more health workers and equip them with the tools they need to support women during childbirth we will see these numbers continue to come down but we have a long way to go to reach EVERY mother. If we really want to prevent maternal deaths in India more needs to be done to protect girls because there are far too many child brides which put these young women at even greater risk of dying in childbirth.

Adolescent girl at Mobile Crèches Delhi. March 2012