Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens
Background: Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in matern...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2015-04-01
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| Series: | Global Health Action |
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| Online Access: | http://www.globalhealthaction.net/index.php/gha/article/view/24976/pdf_67 |
| _version_ | 1828882392798986240 |
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| author | Tej Ram Jat Prakash R. Deo Isabel Goicolea Anna-Karin Hurtig Miguel San Sebastian |
| author_facet | Tej Ram Jat Prakash R. Deo Isabel Goicolea Anna-Karin Hurtig Miguel San Sebastian |
| author_sort | Tej Ram Jat |
| collection | DOAJ |
| description | Background: Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery–related dimensions of maternal deaths in rural central India using a human rights lens. Design: Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using the matic analysis. The factors associated with maternal deaths were classified by using the ‘three delays’ framework and were examined by using a human rights lens. Results: All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. Conclusions: The study highlighted various socio-cultural and service delivery–related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their entitlements and that the duty bearers were not successful in meeting their obligations. Based on the findings of our study, we conclude that to prevent maternal deaths, further concentrated efforts are required for better community education, women's empowerment, and health systems strengthening to provide appropriate and timely services, including emergency obstetric care, with good quality. |
| first_indexed | 2024-12-13T10:27:32Z |
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| id | doaj.art-f9214f5dc8a3439b90144489a45f9a65 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-12-13T10:27:32Z |
| publishDate | 2015-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-f9214f5dc8a3439b90144489a45f9a652022-12-21T23:50:58ZengTaylor & Francis GroupGlobal Health Action1654-98802015-04-018011510.3402/gha.v8.2497624976Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lensTej Ram Jat0Prakash R. Deo1Isabel Goicolea2Anna-Karin Hurtig3Miguel San Sebastian4 United Nations Population Fund, Bhopal, India United Nations Population Fund, Bhopal, India Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, SwedenBackground: Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery–related dimensions of maternal deaths in rural central India using a human rights lens. Design: Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using the matic analysis. The factors associated with maternal deaths were classified by using the ‘three delays’ framework and were examined by using a human rights lens. Results: All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. Conclusions: The study highlighted various socio-cultural and service delivery–related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their entitlements and that the duty bearers were not successful in meeting their obligations. Based on the findings of our study, we conclude that to prevent maternal deaths, further concentrated efforts are required for better community education, women's empowerment, and health systems strengthening to provide appropriate and timely services, including emergency obstetric care, with good quality.http://www.globalhealthaction.net/index.php/gha/article/view/24976/pdf_67maternal healthmaternal deathright to healthrights-based approachIndia |
| spellingShingle | Tej Ram Jat Prakash R. Deo Isabel Goicolea Anna-Karin Hurtig Miguel San Sebastian Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens Global Health Action maternal health maternal death right to health rights-based approach India |
| title | Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens |
| title_full | Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens |
| title_fullStr | Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens |
| title_full_unstemmed | Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens |
| title_short | Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens |
| title_sort | socio cultural and service delivery dimensions of maternal mortality in rural central india a qualitative exploration using a human rights lens |
| topic | maternal health maternal death right to health rights-based approach India |
| url | http://www.globalhealthaction.net/index.php/gha/article/view/24976/pdf_67 |
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