By Karthik Shankar:
Despite all the hoopla about India’s rise as a world power, the country’s social indicators are at par with countries that have far lower GDPs or per capita incomes. The statistics with regards to maternal mortality in particular are alarming. India has the highest rates of maternal deaths and accounts for 17% of all maternal mortality rates worldwide according to a UNICEF report released last year.
In order to tackle this, several organisations are seriously taking up this cause, but only few have made so many inroads as fast as the White Ribbon Alliance. The White Ribbon Alliance (WRA) is a global coalition of individuals and organizations formed to promote increased public awareness of the need to make pregnancy and childbirth safe for all women and newborns in the developing, as well as, developed countries. White Ribbon Alliance unites citizens to demand the right to a safe birth for every woman, everywhere.
In a span of fifteen years, the White Ribbon Alliance in India (WRAI) has evolved to engage over 1800 organizational and individual members, five state chapters and one regional chapter. Members include NGOs, UN agencies, bilateral, donor organizations, foundations, academic and professional bodies such as the Trained Nurses Association of India (TNAI) and the Federation of Obstetrics and Gynaecologist Society of India (FOGSI). Centre for Catalyzing Change (formerly CEDPA India) has been the secretariat of the WRA India since its inception in 1999.
Dr. Aparajita Gogoi, the Executive Director of Centre for Catalyzing Change is the person who coordinates a coalition of 1800 organizations under the White Ribbon Alliance for Safe Motherhood in India. She has been a vociferous advocate for maternal health. Due to the intense lobbying of WRAI, in 2003, the Indian Government declared 11 April the anniversary of Kasturba Gandhi’s birth, as National Safe Motherhood Day.
Every year WRAI members select a nationwide advocacy theme for Safe Motherhood Day, and WRAI members carry out activities and full-scale campaigns throughout the country. The goal of these annual campaigns, launched on National Safe Motherhood Day, is to increase awareness that every woman has a right to live and survive pregnancy and childbirth. In addition to campaigning together, NGOs, members, and state chapters come together on National Safe Motherhood Day to share technical expertise and resources. The theme this year is on engaging citizens for improving women’s and children’s health under the campaign titled ‘Nothing about Us without Us’.
2015 is a watershed year, since the Sustainable Development Goals (SDGs) will replace the Millennium Development Goals. The National Meeting, part of a global commitment to raise the cauldron on maternal deaths and appropriate recognition on the issue, will feed into the recommendations for the Global Citizens Hearing, which is to be held during the World Health Assembly in May 2015.
Safe Motherhood Day however is not the only achievement of WRAI. WRAI was twice awarded the Global Safe Motherhood Award in 2000 & 2003 by the Global Health Council in recognition of its contribution to the cause of safe motherhood. In 2001, WRAI received world-wide media attention for its march to the Taj Mahal. The connection between a memorial built for a beloved wife lost in childbirth and maternal health was unmissable. Several thousand people, including a leading parliamentarian and ministers, participated in the march.
The organisation also mobilised public figures and spokesperson to bring attention to the issue. The champions include Shabana Azmi, Raveena Tandon, Pooja Bedi, Shivani Wazir Pasrich, Poonam Bhagat, Rali Nanda, Padamshree Shovana Narayan, and many others who had tirelessly contributed towards advocating for safe motherhood issues. Veteran singer Shubha Mudgal composed a special single for WRAI.
One of the most important achievements of the WRAI is using social accountability efforts as a catalyst for system change to address the high volume of maternal deaths. The social accountability work centres around the performance of maternal death audits via verbal autopsies, utilisation of health facility checklists, use of community scorecards to jointly discuss the actions needed and use of Interactive Voice Response by women and community to directly link them in the process on improving quality of service. Finally, public hearings and rallies bring women together with government officials and service providers to allow them to address grievances related to maternal health service delivery.
All these efforts are commendable. Despite this, 44,000 women die every year due to pregnancy related causes. 80% of those deaths are due to preventable causes. Dr. Gogoi says that most of the women who die due to pregnancy related causes in India are poor women, who have little political power, are frequently illiterate, and have very low status in their societies. “Their voices are not really heard and therefore it is so very important for people like us to add our voices, speak with and speak for these women. The underlying causes for maternal mortality include low quality of health systems, socio economic causes that obstruct and underplay the importance of healthcare for women.”
Despite the hurdles WRAI continues to face, the umbrella of organisations continues to espouse maternal health initiatives. Their next goal is to push forward citizen engagement as a core aspect of the Post 2015 agenda through the Sustainable Development Goals (SDGs).
“Through this campaign, we want to send out the message that every woman has a right to live and survive pregnancy and childbirth, and that citizen’s engagement can go a long way to help achieve the goals,” says Dr. Aparajita Gogoi, National Coordinator, White Ribbon Alliance India.