Sociological Analysis of Maternal Mortality and Effectiveness of Maternal Newborn and Child Health (MNCH) Program in Rural Areas of Hyderabad

Abstract

Maternal Mortality Ratio (MMR) was one of priority goal among Millennium Development Goals (MDGs) of United Nations till 2015. Following to MDGs it is again considered as a priority goal in Sustainable Development Goals (SGDs) set by United Nations, which are supposed to be achieved by 2030. As per SGDs, MMR should be reduced at the level of 71 deaths at per 100,000 live births during a specific time period. Though, Sindh Government couldn’t achieve its specific target for 2015, instead of running Maternal Newborn and Child Health (MNCH) program at gross root level. This study aims to find out the sociological barriers such as, issue of availability of health workers and access to these health workers by poor people to reduce MMR in rural areas. An exploratory study was conducted using mix methods (qualitative and quantitative) in-depth interviews with mothers and key informant interviews with local maternal health workers including lady health visitors/workers, lady doctors and traditional birth attendants were conducted. A total of 60 mothers and 45 health care professionals were interviewed from different rural areas of Hyderabad division. Semi-structured interview guide was developed having quantitative and qualitative questions. During interviews with key informants, 53.3% respondents said that there has been maternal mortality under their supervision due to different types of complexities. Whereas, access to health workers is not major issue, 4.4% of people approach to health by foot, 35.6% use public transport and rest avail services at home. But the actual problem is availability of professional health workers those could handle deliveries. Only 11.2% interviewed health workers were professional in gynecology. High frequency of poor people (13) is covered by LHVs and second majority (12) is covered by LHWs. Only (5) gynecologists said that they have treated poor families (having income <2 USD per day) as per defined by World Health Organization (WHO). During interviews with community, 60.9% respondents said that health facility is not available nearby their village. These respondents (60.9%) said that there had been maternal deaths due to unavailability of professional maternal health workers near to their village. According to community 73.4% people experiences problems in accessing health workers or facilities. Whereas, 26.6% respondents did not have had any problem to access health workers or facilities. 73.4% respondents said that there had some maternal deaths in their village due to difficulty in accessing professional maternal health facilities or workers on right time.