Editorial 1: Apathy of family and high costs hinder maternal healthcare
Context
- According to a report by the United Nations global progress on improving maternal and newborn health has halted since 2015.
India related findings:
- The report said that India was among the 10 countries that together accounted for 60% of global maternal deaths, stillbirths and newborn deaths.
- India accounted for over 17% of such deaths in 2020, followed by Nigeria (12%) and Pakistan (10%).
- It is also reported that India had the second-highest number of maternal deaths (24,000) after Nigeria.
Key findings
1. Less than four visits (recommended by WHO) to antenatal care visits or ANC visits :
- During antenatal care, health workers educate women about complications during pregnancy and labour, and after childbirth.
- The visits also help women get access to micronutrient supplementation (iron and folic acid supplements) to prevent anaemia, which can lead to maternal and perinatal mortality.
- It also helps them seek treatment for hypertension to prevent eclampsia, and to get immunisation against tetanus and other endemic diseases.
2. The urban-rural divide: More importantly, only 39.9% of mothers who had no school education completed four ANC visits compared to the 68.6% of those who completed 12 years of schooling.
3. Postnatal health check-up: Postnatal care within the first two days after birth is recommended because mothers are in their most vulnerable state in the postpartum period (42 days after childbirth).
- As per data most women didn’t have at-least one postnatal checkup while others had a delayed check-up two days after the childbirth.
4. Financial issue: Money is also an important factor with 27.7% citing lack of finance for refusing such visits.
5. Tetanus shots: It is also important to point out that 8% of Indian women did not receive tetanus shots which helps prevent infections during and after surgery.
6. Complications: More worryingly half of the husbands were informed by a health worker at any time during the pregnancy of the specific signs of pregnancy-related complications. And only about 64% of them knew what to do if the woman had a complication.
Common causes of maternal and newborn deaths
- Haemorrhage: Excessive bleeding during or after childbirth, which can lead to shock and death.
- Infection: Bacterial or viral infections that affect the mother or the baby, such as sepsis, tetanus, pneumonia, meningitis, etc.
- Pre-eclampsia and eclampsia: A condition characterized by high blood pressure and protein in the urine during pregnancy, which can cause seizures and stroke in severe cases.
- Obstructed labour: A condition where the baby cannot pass through the birth canal due to its size, position, or shape, or due to a problem with the mother’s pelvis or uterus.
- Complications of unsafe abortion: Injuries or infections caused by unsafe methods or untrained providers of induced abortion.
- Birth asphyxia: A condition where the baby does not breathe adequately at birth, leading to brain damage or death.
- Prematurity: A condition where the baby is born before 37 weeks of gestation, which increases the risk of infections, breathing problems, bleeding in the brain, etc.
- Congenital anomalies: Birth defects that affect the structure or function of the baby’s organs or body parts.
Recommendations:
- Scale-up access to quality sexual and reproductive health services as part of universal health coverage and primary health care
- Use of technology: E.g., using a simple, low-cost collection device called a ‘drape’ to reduce blood loss during delivery
- Addressing harmful gender norms, biases and inequalities
- Investment and political commitment
- Strengthening service delivery for quality and respectful care
- Community engagement
- Data and information systems
- Access to quality emergency obstetric care (EmOC)
Conclusion
- The UN report on maternal and newborn health is a wake-up call for the world to take action now to save the lives of millions of women and babies who are dying unnecessarily every year. It is also a reminder that improving maternal and newborn health is not only a moral obligation but also a smart investment that can yield multiple benefits for individuals, families, communities, and societies.
Editorial 2: Tripping trade
Context
- Indian goods exports slumped to $34.6 billion in April, the lowest since last October and Imports shrank by a sharper 14% to trip to a 15-month low of under $50 billion thereby witnessing a trade deficit.
Implications
- Deepening of Contraction: Both exports and imports have seen a deepening of the pace of contraction. Merchandise exports fell by 8.8% in February, while imports declined by 8.2% in the same month. These figures follow a decline of 6.6% and 3.6% in exports and imports respectively in January.
- Narrowing Trade Deficit: The contraction has led to a further narrowing of the trade deficit to $17.4 billion in February.
- Impact on Export Destinations: The report by Nomura reveals that the sharpest declines have been observed in India’s exports to the US, China, Japan, and the rest of Asia.
- Overall Growth: The higher export growth in the first half of the financial year has pushed overall growth for the year so far (April-February) to 7.55%.
Sectors Affected
1. Exports side:
- The disaggregated data reveals that core exports, which exclude exports of oil, gold, and gems and jewellery, have continued to contract.
- 16 out of the 30 main export segments have fallen in February, including labour-intensive segments such as leather and textiles.
- Non-oil non-gems and jewellery exports are almost at the same level as last year.
2. On the imports side:
- Core imports, which exclude oil, gold, and gems and jewellery, have also continued to contract.
- This points out towards a softening of imports of consumer and investment goods, indicative of weakening domestic demand.
Trade deficit:
- A trade deficit is an amount by which the cost of a country's imports exceeds its exports. It's one way of measuring international trade, and it's also called a negative balance of trade.
- A trade deficit can be calculated by subtracting the total value of a country's exports from the total value of its imports.
Potential Effects of a Trade Deficit:
- Lower prices: A country may have a trade deficit because it is cheaper to purchase goods internationally than to produce them at home. This means that prices of consumer goods and services may decrease.
- Weakening currency: A trade deficit has the potential to weaken a country’s currency.
- Deflation: A country that has a trade deficit is sending a portion of its currency overseas. This can cause deflation, a state in which reduced demand leads to lower prices.
- Changes in employment: If a country imports more than it exports, unemployment may increase. For example, if a country shifts from manufacturing cars to importing cars from international car manufacturers, the job market for car manufacturing will be negatively impacted.
- Decrease in GDP: Trade deficit is one factor used to calculate a country’s Gross Domestic Product (GDP), a measure of the size of the economy. If the trade deficit increases, the GDP decreases.
Conclusion
- A small trade deficit is necessary for the development of the country as it increases demand, consumption and in turn, causes economic growth. However, an unchecked trade deficit can lead to overdependence of the economy on imports, and any small disturbances in the geopolitical scenario and supply chain will create a ripple effect and causes widespread inflation which is unsustainable.