From Mexico City: In India, Lower Castes and Tribals Lag Furthest Behind in Maternal Health

By: Sandeep Bathala, Senior Program Associate, Maternal Health Initiative, Wilson Center

A mother holds her child near the Indian-Pakistan border

Maternal mortality causes 56,000 deaths every year in India, accounting for 20 percent of maternal deaths around the world. Women who are born into the lower castes or are tribals – India’s indigenous groups – are especially likely to lack access to quality health care. Over 40 percent of these women also belong to the lowest wealth quintile.

An investigation of 29 birth-related deaths in one hospital in the Barwani district of Madhya Pradesh revealed that 26 of the women were tribals, explained Poonam Muttreja, executive director of the Population Foundation of India, at a Wilson Center event.

Abhishek Kumar of the India Health Action Trust and International Institute for Population Sciences said that scheduled tribes and castes make up 25 percent of India’s population and disparities within such a large social group should be expected. However, progress on improving antenatal care and medical assistance at delivery has been slowest for lower caste and tribal women, especially those living in the northern, central, and eastern regions of the country.

Only the richest of the rich scheduled castes/tribes are benefiting from caste-based government programs, economic development, and expanding maternal and reproductive health care services, said Kumar. He suggested further investigation is needed into individual factors such as economic and educational status to determine why the most egregious disparities continue.

More research is required to understand factors associated with the lack of access to health services between and among social groups in what will soon be the world’s most populous country.

I have heard successful stories of scaling up quality and equitable maternal and newborn health programs across the world over the past few days. 1,000 of us from over 75 countries are poised to apply the lessons we learned to catalyze commitment and accelerate maternal and newborn health within the post-2015 development framework.

I hope to learn more about how to reach the most vulnerable women and newborns before the next Global Maternal Newborn Health Conference. Effective approaches to improve equitable care must continue to be given priority. To hear about programs described at the conference that have increased adolescent’s access to quality care that is affordable and accessible; addressed supply side issues; provided incentives for providers and users; partnered with the private sector; or entailed innovative community-based solutions, check out Crowd 360 digital hub. This week has been so enlightening.

Sandeep Bathala is reporting from 2015 Global Maternal and Newborn Health Conference in Mexico City for the Wilson Center, Maternal Health Task Force, and UN Population Fund.