175)
"Mother’s Health is Child’s Health" was the theme of a five rupee coin issued by
the Reserve Bank of India/India Govt. Mints in 1996:
World
Population Day:
In 1968, World
leaders met and resolved that “individuals had a basic human right to determine
freely and responsibly the number and timing of having their children”.
Despite having asserted
their commitment towards creating awareness towards this right, modern
contraceptives have remained out of reach for millions of women, men and young
people world-wide.
On 11.07.1987, when
the World population was recorded at Five Billion, the World Population Day was
first observed in 1989, as an awareness initiative. This initiative was started
to build awareness on population related issues and the impact that a rapidly
rising human population has on development, quality of life as well as the
environment. As a corollary, of vital concern was the health of a mother, as
well as, her newly born child particularly in large families, where not only
the mother’s health was under severe strain but the quality of life of the
family also underwent a severe setback in a majority of cases.
The driving point behind
every one of these UNO initiatives was “Make
every Mother and Child count”.
Therafter, World
Population Day is observed by the United Nations on July 11 every year to
reassert the human right to plan for a family, at the same time, to refocus on
the problems arising out of a rising population.
The UNO encourages
activities, events and information to help make this right a reality across the
World. It aims at increasing people’s
awareness on various population issues such as the importance of family
planning, gender equality, poverty, maternal health and human rights. The
Day is celebrated world-wide with several activities including seminar
discussions, educational information sessions and essay competitions. World
Population Day is a global observance and not a public holiday.
Focal
points which go into creating an Environment for taking care of the health of
Mothers and new born and young children:
- There
is a need for World Nations to set in place Public health programmes which
should focus on all families having continuous care which extends from even
before pregnancy through childbirth and on into childhood, instead of piecemeal
health related services as are available at present. Mothers, the new born and
children represent the well-being of a society and its potential for the
future. Their health needs cannot be left unmet without harming the whole
society. In many countries several
mothers and children are excluded from even the most basic health care benefits
– those that are important for their mere survival. Nevertheless, even
today, in many countries, the situation is improving too slowly or not
improving at all, while in some it is getting worse.
- Universal
access and financial protection is required for all mothers and children. This
is required, so as to ensure that every
mother, new born baby and child in need of care obtains it and no one is driven
into poverty by the cost of that care.
- There
is an urgent requirement to build up a health workforce based on better funding
and better organisation to respond to health needs of mothers and new born and young children, on extremely affordable or no cost basis.
- The
Millenium Development Goals (MDGs)
which have a target of being achieved by December 2015 have also emphasised the
importance of improving health of mothers and children as an integral part of
poverty reduction. The redefined
buzz-word for this purpose not “MCH” (Maternal and Child Health) but “MNCH”
(Maternal, Newborn and Child Health).
- Every year more than 3.5 to 4.0
million babies are still-born, more than 5.0 million die with a month of their
birth and around 7.0 to 8.0 million young children die before they reach the
age of five. Maternal deaths at over half a million every year too are rather
alarming – during pregnancy, during child-birth or after the
child is born – often leaving behind families driven to poverty because of meeting
the health care costs.
- During
the 1990s, several countries with the highest burdens of mortality and
ill-health made little progress towards reducing this human cost. Even today a worrisome situation regarding
reversal of newborn, child and maternal mortality exists in these countries.
- Ante-natal
care needs to be integrated with other health programmes such as HIV/AIDS/HINI,
prevention and cure of sexually transmitted infections, tuberculosis and
malaria etc. as well as, Family Planning through awareness created by dedicated
teams of health workers.
- There
is an urgent need to reform the thinking
in every society, political and legal environment, through Education and
focussed programmes, in a way that violence against women, discrimination in
the workplace or at school or even marginalisation is done away with. Usage and
wider availability of contraceptives would go a long way too in Family
Planning. These initiatives would do away with several millions of unwanted,
unintended and mistimed pregnancies, as the women would have an equal say in
the matter. This would help focus resources towards mothers who have planned to
have a family.
- Skilled
mid-wifery professionals can help in providing first-level maternal care, as
back-up care is necessary for only a minority of mothers and newborn children who
may need the intensive care provided at well-equipped hospitals.
- Even
after child-birth, the days following the birth can be dangerous for mothers
and their babies. There exists an urgent need to develop effective ways of organising continuous care during the
first few weeks after birth. Health programmes to tackle vaccine
preventable diseases, malnutrition, diarrhoea or respiratory infections still
have a huge unattended/unfinished agenda.
- The
Integrated Management of childhood
Illness (IMCI) programme has a three-fold initiative: improving the
skills of health workers to treat diseases and to counsel families,
strengthening the health system’s support and helping households and
communities to bring up their children in a healthy manner and to deal with
ill-health if and when it occurs. The
emphasis is on health care closer to the mother and child’s home. The
magnitude and scaling up of services towards universal access is, nevertheless,
a very tall order.
- Seventy million mothers and their
new-born babies, as well as countless children are excluded from the health
care to which they are entitled. Even more numerous are those mothers and
children who remain without protection against the poverty that ill-health can
cause.
- Channelling
increased funding flows through National
Health Insurance Schemes, which may be tax-based, social health
insurance or mixed systems offers an
avenue to meet the finances required for building up the supply of services
towards universal access, building up financial protection systems after the
supply of services is put into place as well as having a dedicated and
motivated work-force.
- Above
all, there is to be an overriding focus which places the mother, newborn and
child health as the overriding concern for all these efforts and providing
universal access to the entire target group. This will ensure that no mother, newborn or child’s health needs remain
unattended and that “every Mother and Child counts”.
Millenium
Development Goals (MDGs):
In September 2000, World
leaders met at the UN Headquarters in New York where they adopted the United
Nations Millennium Declaration, committing their nations to a new global
partnership to set out a series of time-bound targets, with a deadline of
December 2015.
The Millennium campaign aimed at eradicating extreme poverty
which continues to be one of the main challenges today and is a major concern
of the international community. The MDGs
also targeted reducing hunger, disease, lack of adequate shelter and exclusion,
while promoting gender equality, health, education and environmental
sustainability which embody the basic human rights for every person on Earth.
The following eight
initiatives are encompassed in the MDGs:
- To
eradicate extreme poverty and hunger
- To
achieve universal primary education
- To
promote gender equality and empower women
- To
reduce child mortality
- To
improve maternal health
- To
combat HIV/AIDS, Malaria and other diseases
- To
ensure environmental sustainability
- To
develop a global partnership for development
Each
goal has specific targets and dates for achieving those targets. Till date, the
progress in attaining the set goals has been unsatisfactory. Some countries
have achieved many goals while been alarmingly slow.
Millenium
Development Goals (MDG) Programme initiative – Improving the health of mothers
and children:
These goals underline the importance of improving health, particularly
of mothers and children as an integral part of poverty reduction around the Globe.
The health of mothers and
children is a priority which had emerged long before the 1990s – it builds upon
a century of programmes, activities and experience.
The nature of the priority
status of maternal and child health (MCH) has now over the years also undergone
a sea-change – previously, mothers and children were thought of as targets for
focussed programmes, but now they are increasingly asserting their right to
access of quality care as an entitlement to be guaranteed by the State. Today,
maternal and child health issues have gradually transformed from a perceived
concern into a moral and political imperative.
Nevertheless, universal
access to the care provided to mothers and children which they are entitled to
is still far from realisation. It is therefore necessary to refocus/ revisit
strategies within maternal and child health programmes and give importance to
the often overlooked health problems of newborn children. In other words, the term MCH (Maternal and Child Health) has now been
recoined as MNCH (Maternal, Newborn and Child Health).
The proper strategies to
improve MNCH can be put in place effectively only if they are implemented
across programmes and service providers, throughout pregnancy and childbirth
through to childhood. Placing MNCH at the core of this refocused initiative
will provide a platform for building sustainable health systems where existing
systems have hitherto failed to deliver satisfactorily.
Even in countries where
MDGs are not fully achieved by 2015, moving towards universal access will be a
positive step.
India’s progress in
achieving the MDGs:
The
Ministry of Statistics and Programme
Implementation (MoSPI) is of the view that while India has made
remarkable progress in several sectors, achieving all the MDGs is unlikely.
On
the issue of reducing poverty by half, India has achieved the target well ahead
of time n 29.9 percent of the population living below the poverty line in 2011
(Of course, India’s systems of collecting data are still quite “primitive”, so
this figure may at best be an educated “approximation”). The Ministry has
further stated that India has achieved this target ahead of time.
The
Ministry has further stated that India has successfully eliminated gender
disparity in primary and secondary education.
Also, that India has successfully managed to
control the spread of deadly diseases such as AIDs, malaria and tuberculosis
etc.
(What
is alarming is that) the country is
unlikely to meet the target of reducing the proportion of underweight children
by half.
India
has also increased the forest cover and has halved the proportion of population
without access to clean drinking water.
Nevertheless, India lags behind on
targets of empowering women through wage employment and political
participation. Also, on the issue of maternal mortality India is unlikely to
reduce mortality by 75% and under-five mortality by two-thirds, both of which
issues are highlighted on this coin as early as 1996.
Issuing
a coin with a social message by the Government of India/India Givernment Mints
to highlight the issue of Mother and Child Health:
For the purpose of
reducing mother/infant mortality rate in India, the Government of India brought
out this slogan/coin which emphasises that a healthy mother’s health has a
direct bearing on her child’s health.
This coin was released on
World Population Day on 11.07.1996 to raise awareness among the citizens of
India.
On the Reverse of the Coin there is a
triangle, representing the symbol of Family Planning, within which is shown a
mother holding her baby/child. On the upper periphery is mentioned “Swastha Maa se Swasth Shishu” in Hindi
and on the lower Periphery is mentioned “Mother’s Health is Child’s Health”.
The Year of issue is mentioned as “1996” on top of the Family Planning
Triangle, below which is the “Diamond” mint mark of the Mumbai Mint.
On the Obverse of the Coin
on the upper – centre is the Lion Capitol of Emperor Asoka with the legend “Satyameva Jayate” in Hindi meaning
“Truth always Prevails” which is the emblem of the Government of India. On the
left periphery is mentioned “Bharat” (in Hindi) and on the right periphery is
mentioned “India” (in English). The denomination of the coin “Rs.5” is at the
extreme bottom.
The specifications of this coin are as under:
Year of issue: 1996; Metal
Composition: Copper-Nickel; Weight: 8.97 gms. Diameter: 23 mm; Thickness: 2.85
mm; Edge: Security; Shape: Round.
As
a matter of interest – a Mother’s and Newborn’s Health Insurance Plan enacted
in 1996 in the USA:
In 1996, the USA brought out
“The Newborn’s and Mother’s Health Protection Act of 1996, which was a piece of
legislation relating to the coverage of maternity by health insurance plans in
the USA which was enacted on 26.09.1996.
This act requires a health
plan or an employee health benefit plan that provides maternity (including
childbirth) benefits to provide coverage
for a minimum in-patient length of stay for a mother and her newborn following
delivery. The Act mandates timely post-delivery care when mother and newborn
are discharged prior to those lengths of stay.
The Act prohibits the Plan
from using certain types of penalties or inducements regarding participants,
beneficiaries, policy-holders or providers.
This Act also encompasses
plans that offer maternity coverage to
pay for at least a 48-hour stay following childbirth or a 96 hour hospital stay
following a caesarean section except under certain clauses i.e. where the
attending medical physician or midwife decides in consultation with the mother
to discharge the mother or new-born child earlier and that health plans and
insurance issuers may not restrict a mother’s or newborn’s benefits for a
hospital length of stay as prescribed.
Also, a mother cannot be
encouraged to accept less than the minimum protections available to her under
the Act and an attending provider cannot be induced to discharge a mother or
newborn earlier than 48 or 96 hours after delivery.
(This
coin has been contributed for my collection by Rohit Tingre and his mother
Manda Tingre.)
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