A review of  maternal deaths in India’s Koppal district reveals that pervasive community gender bias contributes to avoidable deaths. Researchers are developing assessment tools for frontline healthcare workers to improve care for women.

Image: Eric Parker/flickr

Because of their low social status, girls and women in India’s state of Karnataka are less likely to receive medical attention when they are sick or expecting a child, and receive inferior care when they do seek help. With support from Canada’s International Development Research Centre, the Indian Institute of Management in Bangalore is exploring how patterns of neglect and abuse within households and communities affect women’s health.

A review of verbal autopsies — interviews conducted following a death — suggests that oversights and bias may be masking the true causes of women’s deaths. For example, common underlying conditions such as nutrition-related anaemia, which affects nearly two-thirds of pregnant women in Karnataka, are not recorded. Anaemia increases risk during pregnancy. And because verbal autopsies are normally conducted by a single medical officer, often one involved in treating the deceased, mistakes by health workers are under-reported.

The team is using data on maternal deaths to identify the prevalence of abuse and its consequences in Karnataka’s Koppal district. Researchers are finding that the health system reflects community norms that contribute to avoidable deaths. For example, because anaemia and pregnancy are considered routine, doctors and health workers often neglect to point out obvious signs of risk to pregnant patients, such as the risks posed by poor nutrition and iron deficiency.

The project is taking steps to improve care for women at the village level and to inform district and state policies. Given the area’s high rates of undernourishment, teen pregnancy, anaemia and domestic abuse, researchers are testing measures to help health workers address these factors earlier than usual. A pregnancy risk assessment tool for frontline health workers was developed and applied in 15 villages. Village-level support groups and district-level advocacy are promoting safe motherhood and building awareness of maternal rights and safety.

Lessons are also being shared at the community, state, national and international levels through channels such as the Fostering Knowledge-Implementation Links Project. Commissioned by the Karnataka state government, this initiative aims to strengthen the links between researchers and policy makers so that research findings can be better translated into sound public health policy.

 

 

For further information contact:

Isabelle Bourgeault-Tassé
International Development Research Centre, Canada
Email: ibourgeault-tasse@idrc.ca