Mothers require better healthcare, not just access

A study published in The Lancet Obstetrics, Gynaecology & Women’s Health last week has underscored the successes of the country’s maternal health programme. But it has also flagged a worrying slowdown in progress since 2015. Maternal mortality in 2023 was nearly a fifth of what it was in 1990. The steepest decline occurred in the first decade and a half of this century, driven largely by more effective government interventions, a rise in institutional deliveries, and greater public awareness. Yet, India still accounts for one in 10 maternal deaths globally, and the report highlights persistent systemic challenges that stand in the way of meeting the Sustainable Development Goal of reducing maternal mortality to 70 deaths per lakh births by 2030. Pregnant women continue to die due to haemorrhages, infections, and blood pressure-related disorders.

The Covid pandemic exposed the fragility of India’s maternal health programme. Frontline workers were diverted to meet the crisis, institutional deliveries were delayed and antenatal visits fell. The government has shown awareness of the challenge. It has strengthened programmes like LaQshya to improve the quality of care in labour rooms. The Pradhan Mantri Surakshit Matritva Abhiyan has emphasised the use of online portals and a greater role for anganwadi workers in tracking the health of pregnant women. However, implementation remains uneven. Health is a state subject, and the efficacy of the government’s programmes depends on local administrative capacity and political will. While Gujarat, Maharashtra, and the states in South India are on track to meet the SDG goal, government reports and the Lancet study highlight gaps in the healthcare systems of Uttar Pradesh, Madhya Pradesh, Bihar, Rajasthan, Chhattisgarh, Odisha, Jharkhand, and Assam.

Overall Analysis

This editorial focuses on India’s maternal healthcare system, arguing that mere access to healthcare services is not enough; quality and effective implementation are equally important. It begins with a balanced tone, acknowledging progress made over decades—especially the sharp decline in maternal mortality since 1990. The language here is factual and data-driven, using statistics to establish credibility and highlight success. However, the phrase “worrying slowdown” signals a shift from appreciation to concern.

The author then points out that despite improvements, India still contributes significantly to global maternal deaths. This contrast between achievement and remaining challenges is a key linguistic strategy—showing that progress is incomplete. The mention of causes like haemorrhage and infections brings a sense of urgency, grounding the issue in real-life consequences rather than abstract policy discussion.

In the second paragraph, the editorial becomes more critical and analytical. It uses the example of the COVID-19 pandemic to expose structural weaknesses in the healthcare system. The disruption of services such as antenatal care highlights how fragile the system is under pressure. The tone here subtly shifts to one of concern and caution.

The author acknowledges government initiatives like LaQshya and Pradhan Mantri Surakshit Matritva Abhiyan, which shows an attempt to maintain objectivity. However, this is followed by a strong critique of uneven implementation, emphasizing that policies alone are insufficient without strong execution. The editorial uses federal structure (health being a state subject) to explain regional disparities, contrasting better-performing states with lagging ones. This comparative language strengthens the argument by showing inequality within the system.

Overall, the editorial combines data, contrast, and policy critique to argue that improving maternal health outcomes requires systemic strengthening, not just expanded access. The language remains formal, precise, and policy-oriented, making it suitable for academic and exam contexts.

Important Vocabulary (5)

1. Underscored – emphasized or highlighted something important.
2. Fragility – weakness or lack of strength; easily breakable system.
3. Antenatal – relating to care before childbirth.
4. Efficacy – the ability to produce desired results.
5. Disparities – differences or inequalities between groups.

Conclusion & Tone

The editorial concludes that India must move beyond increasing healthcare access and focus on quality, consistency, and strong implementation to reduce maternal mortality effectively. It stresses that without addressing systemic gaps, progress may stall further.

Tone: Balanced yet critical — starting with recognition of progress but ultimately emphasizing concern, urgency, and the need for policy improvement.