G. Rama Padma: Perception on Safe Motherhood: An Analysis of Results From Rural Andhra Pradesh

Safe motherhood means ensuring that all women receive the care they need to be safe and healthy through pregnancy and childbirth. India's maternal and child health programmes have expanded vastly over the years. After analysing the levels of safe motherhood in rural areas of Andhra Pradesh, this paper tries to understand the knowledge levels and practices of rural women, perceptions of rural men and the awareness levels of health care providers on issues relating to safe motherhood. This has been done on the data from the National Family Health Survey (NFHS-2) conducted during 1998-99, focus group discussions and in-depth interviews conducted in twenty-three villages of a backward district (Mahabubnagar) and a developed district (Guntur).

At a glance, this NFHS-2 data suggests that the women in rural Andhra Pradesh are experiencing safe motherhood. However, a further analysis reveals that many women are exposed to unsafe motherhood. Apart from the lack of awareness about the need for maternal heal care, quite often the unfriendly attitude of the governmental health staff also discourage rural women to utilize antenatal care facilities at public health centers. Financial compulsions are determining the choice in favour of home deliveries. The decision-makers in this regard are invariably the elderly males. The informal health care providers viz., RMPs, dais, traditional healers etc. are still playing an important role in maternal health care in the backward areas. It is necessary to utilize their services by imparting adequate training to improve their knowledge levels. Attitude of the governmental health staff, the uncontrolled levels of fee charged by private health centres, and fears of unnecessary caesarian sections imposed by the private hospitals are forcing the economically weaker sections to opt for home deliveries especially in backward areas. Health care after delivery is highly neglected by both women and local health care providers. The health workers in rural areas appear to be burdened with multiple tasks. Because of which, they are diverting their efforts more toward immunization programmes and meeting the sterilization targets rather than on postpartum care.