BACKGROUND

Motherhood is a cherished dream of every woman. However, this dream is being shattered too often due to an unholy alliance between poverty, ill health and lack of access to existing health delivery services. The maternal mortality ratio in India is unexceptionally high with 407 women dying each year per 1 lakh live birth each year. According to WHO estimate 5, 15000 maternal deaths occur due to pregnancy-related causes each year in the World. In every minute more than one woman dies from pregnancy-related causes worldwide.

Every five minutes a woman dies somewhere in India due to pregnancy associated causes. The annual toll of over, 100,000 maternal death constitutes over 20 percent of the global burden which is perhaps the highest for any single country.

Nowhere in India is this unholy alliance between poverty and ill-health more stark than in Orissa. With per capita income less than Rs. 13000 and vast gap between rich and poor which is further gnawing, and poor access to health services and the State has the highest maternal mortality ratio (407 against the national average of 367- SRS, 1998) and highest infant mortality rate (101/reduced to 85 against the national average of 63).

Most of the maternal mortality deaths, which occur due to obstetric complication, can be preventable. While more common reason for direct causes of obstetric complication are post-partum hemorrhage, unsafe abortion, eclampsia, obstructed labour and infection, Pre-existing causes, particularly caused by HIV/STD and RTI (Reproductive Tract Infection) pose a great threat given the pandemic nature of such an epidemic. Other communicable diseases like malaria and other water-borne diseases also significantly contribute to maternal deaths.

However, almost three- fourth of the maternal death is preventable provided the mother is having access to a quality health care and she is well informed of the utilization of these quality healthcares.

It is here in accessing these health are and availability of quality healthcare that the unholy between ill health and poverty stands as a great obstacle. Lack of access to basic entitlements as result of absence of economic opportunity force many pregnant women to undergo labour in unhygienic conditions. Moreover, lack of nutritional food during pregnancy turns many to anemic. Reinforced further by cultural taboos in many communities, which leaves hemorrhage untreated, use cow-dung plastered houses for undergoing labour.

However, there are many good practices among many communities to treat obstetrics complications. One study has found out very low maternal mortality ratio among the tribal communities of Koraput district in Orissa.

The keys to effective treatment of obstetrics complication and corresponding death are to provide access to health services including ready availability of human resources and anti-biotic, utilization of these health services and availability of quality healthcare. Effective training of paramedical staff like ANM, dais, augmentation of health delivery infrastructure in communities, community doctor, participation of NGOs in raising awareness of the communities as well as diffusion of good indigenous practices of prevent maternal death are some of steps required to prevent untimely maternal death, which is slur on nay democratic progressive state.

OBJECTIVES

The present study will try to capture this unholy alliance between poverty and ill health by documenting the lack of access to quality healthcare, and other basic entitlement.

It will also document good practices in indigenous communities to deal with obstetrics complication during and after pregnancy.

It will also document gender biases in food consumption with household and its ill effect on anemic pregnant woman.

Attitude of women folk to common obstetrics problems like hemorrhage.