HC notice to Centre, Delhi govt on maternal health schemes

New Delhi: Taking strong note of the failure of the maternal health schemes, the Delhi High Court has sought to know from the central and Delhi governments the measures they have taken in this regard.

Justice Rajiv Shakdher issued notice to the central and Delhi governments asking them to indicate the measures they have taken on working such schemes and gaps in them, and to highlight the reasons for not properly implementing them.

Issuing notice to Delhi`s Deen Dayal Upadhyay (DDU) Hospital and Guru Gobind Singh Hospital (GGSH), the court also asked them to file responses on the measures that require compliance. 

"The hospitals have to indicate the measures that require compliance as per the provisions of Janani Suraksha Yojana (JSY), Integrated Child Development Scheme (ICDS), National Maternity Benefit Scheme (NMBS), Antyodaya Anna Yojana (AAY), National Family Benefit Scheme (NFBS)," said the court.

The government designed these schemes to reduce maternal and neo-natal mortality by encouraging institutional delivery for poor pregnant women and providing necessary health and medical care during the term.

The court`s direction came on a plea of mother-in-law of Tabassum, a 25-year-old woman who died along with her new-born baby in February in the DDU Hospital, after she was not given necessary health and medical care by the authorities.

Tabassum, who belonged to poor strata of society, and her baby died as a result of "poor implementation of government maternal health schemes, absence of ante-natal care, a broken referral system, and substandard medical treatment during delivery", alleged the plea. 

The woman who left behind a five year-old kid had registered her second pregnancy at the MCD dispensary in Jwala Puri, Delhi. Tabassum`s labour pains began on February 6, 2015, in early morning, after which she was taken to the dispensary but there was no doctor on duty to attend her and her condition started worsening.

From the dispensary she was taken to the Guru Gobind Singh Hospital and the ambulance took one hour to reach the hospital. The hospital staff referred Tabassum to the Deen Dayal Upadhyay Hospital, saying they did not have adequate equipment required for the surgery. It took another 30 minutes for her to reach the DDU Hospital.

"Tabassum`s mother-in-law paid Rs.5,000 for medicines and her son paid additional sums in clear violation of the Janani Shishu Suraksha Karyakaram (JSSK) which guarantees totally free delivery services for all women at all government facilities," the plea filed through the Human Rights Law Network claimed.

After the delivery of child, the Deen Dayal Upadhhyay Hospital staff did not provide Tabassum`s family any information about the health condition of the baby or about Tabassum. Next morning, the baby died and the doctors did not inform the family of the cause of death. A day later, Tabassum`s condition started deteriorating, and the doctors did not inform the family about it either. She died on February 15. 

The plea said from 4 a.m. till 3 p.m. of February 6, Tabassum was "either travelling from one health facility to another or waiting for her treatment", which had complicated her case.

"Delay in seeking delivery care, a delay in reaching facilities, and a delay in receiving adequate care at facilities led to the death of Tabassum," said the plea.

It said the latest data shows that 50,000 women in India died from pregnancy related causes in 2013, or 137 women every day and six women every hour. 

"The World Health Organization reports that the 90 percent of maternal deaths are preventable if women have access to antenatal services, skilled delivery assistance, and post-natal care," the plea stated. 

The plea sought Rs.12 lakh compensation in a fixed deposit account in the name of Tabassum`s son for violations of his mother`s fundamental rights and to ensure his education and health.

The plea also sought direction to governments to ensure that no woman succumbs to a preventable maternal death in Delhi and the entitlements under the JSY be provided to women post-delivery.

"NMBS be provided to all needful citizens 8-12 weeks prior to delivery, government fully implement the guarantees in Janani-Shishu Surakasha Karyakram (JSSK), all patients and their families are treated with respect and dignity, and appropriate compensation be provided to the victim and family when preventable maternal deaths happen due to callousness caused by government aide d or private hospitals," it added.