Assam continues to top maternal deaths in India

 Assam has recorded the highest maternal death in India for the tenth successive year, portraying the dismal condition of healthcare system in the northeastern state.

The findings are part of the National Family Health Survey-4 released recently.

According to the Sample Registration System during 2011-1013, the Maternal Mortality Rates (MMR) of Assam is 300 for every 100,000 live births, way above the national average of 167.

In the same survey, Assam has recorded a high domestic abuse rate, with 25 percent of married women reporting domestic violence. The figure though is lower than the average national rate, which stands at 50 percent.

The fourth national family survey conducted field work in Assam from November 6, 2015 to March 31, 2016 through Nielsen (India) Private Limited and gathered information from 24,542 households – 28,447 women, and 3,860 men.

Its findings show that 32.6 percent of Assam women, between 20-24 years, were married before the age of 18, which could be an indication of the high number of maternal deaths. The survey also found that Assam also has a high anemic rate. According to the report, 46 percent girls and women between age 15 and 49 are anemic, reports northeasttoday.in.

Analysing the reports, Centre for Catalysing Change executive director Dr Aparajita Gogoi said that the Janani Suraksha Yojana has led to more than 70 percent institutional deliveries.

The health expert, however, said that gender differentiation and female feticide could be the causes but there are also a number of medical reasons for the high mortality rate.

The high MMR in certain pockets, like the tea belts and char areas in Assam, is another aspect of the problem, Gogoi said. The tea communities in Assam are socially isolated and often have high rates of malnutrition, worm infestation and alcohol consumption and low rates of education. She also said that it needs to be researched as to why Assamese girls and women are anemic given the protein rich diet the people in the State eat.

In a telling comment on the Assam Government’s health care records, the State has for the tenth successive year recorded the highest maternal deaths in the country. With the Maternal Mortality Rates (MMR) of 300, the State has surpassed the national average of 167.

According to the Sample Registration System (SRS) (July, 2011-13), the MMR in Assam of 300 per 1 lakh live births is the highest in the country, the corresponding national number being 167.

Further, what should come as an eye-opener, Assam has recorded a high domestic abuse rate, with 25 per cent of married women reporting domestic violence. The figure though is lower than the average national rate, which stands at 50 per cent.

These findings are part of the National Family Health Survey-4 (NFHS-4) (2015-2016) released recently.

The NFHS-4, which will be the benchmark for future survey, conducted field work in Assam from November 6, 2015 to March 31, 2016 through Nielsen (India) Private Limited and gathered information from 24,542 households – 28,447 women, and 3,860 men.

Analysing the reports, Centre for Catalysing Change executive director Dr Aparajita Gogoi told this newspaper that the progress in institutional deliveries, especially under the Janani Suraksha Yojana, has led to over 70 per cent institutional deliveries.

There are many reasons for the high mortality rate in Assam. The State is grappling with challenges like difficult terrain and inaccessibility to health services as a percentage of the population live on islands in the Brahmaputra, which can be aggressive and harsh in the rainy season.

The NFHS-4 states that 32.6 per cent of women in Assam, aged 20-24 years, were married before age 18. Early marriages of such huge numbers could lead to maternal deaths.

The health expert, however, said that gender differentiation and female foeticide could be the causes but there are also a number of medical reasons for the high mortality rate.

One can understand the situation in a conservative State like Rajasthan, where girls are married off early but why an Assamese girl is married off before attaining the age of 18,” wondered Dr Gogoi.

Further, there are socio-economic reasons. The high MMR in certain pockets, like the tea belts and char areas in Assam, is another aspect of the problem, she said. The tea communities in Assam are socially isolated and often have high rates of malnutrition, worm infestation and alcohol consumption and low rates of education.

Assam also has a high anaemic rate and according to the survey report, 46 per cent girls and women between age 15 and 49 are anaemic. She said that it needs to be researched as to why Assamese girls and women are anaemic given the protein rich diet the people in the State eat. Genetically the Ahom community in Assam have low haemoglobin, which could be one of the reasons for anae

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