Dead Women Talking A civil society report on maternal deaths in India B Subha Sri, Renu Khanna Jan Swasthya Abhiyan People's Health Movement - India Suggested citation: Subha Sri, B., & Khanna, R. (2014). Dead Women Talking : A civil society report on maternal deaths in India. CommonHealth and Jan Swasthya Abhiyan, 2014. Cover Design: Thanks to Priya John for the cover photograph of Devi Paharin with her 6 month old daughter from Bada Palma village (Sundarpahari block, Godda). Published by: CommonHealth - Coalition for Maternal- Neonatal Health and Safe Abortion Published in: July 2014 Authors' email ids: Subha Sri B subhasri <[email protected]> Renu Khanna [email protected] This report may be freely adapted, reproduced or translated in part or in whole purely on a non-profit basis. Kindly acknowledge the original source when doing so. Copies can be downloaded from www.commonhealth.in Dead Women Talking A civil society report on maternal deaths in India B Subha Sri, Renu Khanna CommonHealth, Jan Swasthya Abhiyan July 2014 Credits and acknowledgements This report is an outcome of a larger civil society initiative led by CommonHealth to which several civil society and community based organizations and networks have contributed. Given below is a brief introduction to each of these organizations (in alphabetical order). 1. Amhi Amchya Aarogyasathi: 'We for our Health' is an integrated rural development organization working in Gadchiroli District of Maharashtra since 1980. Founder members of the organization were active member in 'Chhatra Yuva Sangharsha Vahini'(CYSV), a youth organization established by Jay Prakash Narayan to struggle for fulfilling the dream of Entirety or Total Revolution. The founder members began by addressing landholding and land encroachment rights issue and implementation of employment guarantee scheme (EGS) in northern Gadchiroli district. Further the group of founder members decided to concentrate in constructive work in the field of their individual interest. They adopted 'registered society' form in 1984. Dr. Gogulwar, one of the founder members, is inspired by Vinoba's perspective on addressing health problems in its 'wholeness of life' and not merely administering medicines. He was interested in constructive work for 'health revolution' by addressing livelihood, water, etc. comprising wholeness of life. Methodology chosen was 'let's find our own way.' Hence the name 'Amhi Amchya Arogya Saathi.' 2. ANANDI: Area Networking and Development Initiatives has been working in four districts of Gujarat with over 7000 poor rural women from low income groups such as the tribals, migrant families, salt pan workers, marginal farmers, farm and construction labour and the fishing community. ANANDI organizes these women in collectives to become active agents of change to improve their living conditions and develop sustainable livelihoods and work towards changing the nature and direction of systemic forces which marginalize women. The impact of the organization's work can be seen in terms of increased participation of women in leadership roles as well as in the overall improvement in the living conditions of their communities. ANANDI has also been working on promoting social accountability for maternal health. 3. ARTH: Action Research and Training for Health is a private, non-profit, research and training organization that was established by a group of professionals in 1997 with the intent to contribute to the improvement of the health status of underprivileged communities in India. ARTH focuses on the health needs of marginalized rural and urban slum inhabitants, as well as on those of vulnerable groups like adolescents, women, migrants and unorganized labour. ARTH's mission is to help communities access and manage health care according to their needs and capacity, by using research and training initiatives. The programme areas that ARTH works on are: sexual and reproductive health, neonatal and child health and health systems and policy. 4. ASHA, West Bengal: Association for Social and Health Advancement (ASHA) is a non-profit, non- political, non-governmental organization which has been working to improve the socio-economic and health status of disadvantaged rural and urban communities since 1998. ASHA implements development initiatives in socio-economic and health sectors and also acts as a technical support agency for other organizations and institutions and collaborates with both Government and Non Governmental agencies. Support provided includes training, action research and evaluation exercises as well as advocacy and networking. ASHA primarily works with women, adolescents and i children belonging to vulnerable and marginalized populations like minorities, scheduled tribes and scheduled castes and has been implementing development initiatives directly in the underserved and hard-to reach areas of Murshidabad, Bankura, Purulia and Malda districts in West Bengal and urban slums of Kolkata. ASHA recognizes that the empowerment of women is a precondition to social development, and pledges action to achieve equality between men and women. ASHA in principle has adopted the primary health care approach, which puts people at the centre of health care delivery. ASHA works in close co-operation with Central and State government agencies as well as UN agencies, INGOs and national NGOs. ASHA is also a founding member and currently steering committee member of NAMHHR. 5. CEHAT: Centre for Enquiry into Health and Allied Themes is the research centre of Anusandhan Trust. The organization is involved in research, training, service and advocacy on health and allied themes. CEHAT's aim is to do socially relevant and rigorous academic health research and health action for the well-being of the disadvantaged masses, for strengthening people's health movements and for realizing right to health and health care. CEHAT acts as an interface between progressive people's movements and academia. The strategies are: to undertake socially relevant research and advocacy projects on various socio-political aspects of health, establish direct services and programmes to demonstrate how health services can be made accessible, equitably and ethically, and disseminate information through databases and relevant publications. CEHAT has been working on a range of maternal health issues, including safe abortion for a number of years. 6. CHETNA: Centre for Health Education, Training and Nutrition Awareness, is a non-government support organization based in Ahmedabad, Gujarat. Established in 1980, CHETNA addresses issues of women's health and development in different stages of their lives from a 'rights' perspective. CHETNA supports government and Non-Government Organizations through building the management capacities of educationists/health practitioners/supervisors/ managers enabling them to implement their programmes related to children, young people and women from a holistic and gender perspective and advocate for people centred policies. CHETNA's core activities are capacity building, forging partnership at local, regional and national level. CHETNA also does advocacy, development and dissemination of materials. CHETNA works primarily in Gujarat and Rajasthan states. 7. CommonHealth: Coalition for Maternal-Neonatal Health and Safe Abortion is a multi-state coalition of organizations and individuals in India committed to drawing attention to the unacceptably high levels of maternal and neonatal mortality, poor access to safe abortion services and less-than-optimal quality and lack of affordability of maternal-neonatal health and safe abortion services. CommonHealth seeks to bring voices from diverse constituencies to influence discourse at the national level. These constituencies are diverse not only geographically but also in terms of different areas of expertise and focus such as health care providers, public health researchers, non- governmental organizations, research and service delivery organizations, human rights lawyers, grassroots activists, public sector programme managers etc. Formed in 2006, the Coalition is steered by a Steering Committee of individuals with considerable expertise in one or more of the three thematic areas: maternal health, safe abortion and neonatal health. ii 8. Gramin Punarniran Sansthan (GPS) was founded on 10th December 1992 on World Human Rights Day by eleven socially committed youth in Atraulia block of Azamgarh district, Uttar Pradesh. GPS has focused its work on rural women and helped them form Self Help Groups/CBO. The groups have taken up several local issues and the activities have enabled the women to improve their livelihoods. GPS has a strong presence in the community and works on the issue of women's right to food, right to work, right to health and Gram Sabha awareness, and initiative on local issue like dalit rights. GPS has been promoting social accountability for maternal health rights. 9. Jan Swasthya Sahayog: Jan Swasthya Sahyog (JSS) is a voluntary, non-profit, registered society of health professionals running a low-cost, effective, health programme providing both preventive and curative services for the past 14 years to people from the tribal and rural areas of Bilaspur, Chhattisgarh through a community health programme and a rural health centre, which includes a hospital. The community health programme has provided extremely low cost care to patients drawn from more than 2500 villages (approximate population 10 lacs)/towns of Chhattisgarh as well as adjoining districts of eastern