Role of Social Health insurance in reducing maternal mortality burden in rural India

According to World health organization (WHO) report, 45,000 of the pregnant women die due to a preventable complication during the period of pregnancy. The maternal mortality ratio (MMR) has decreased from 212 in 2011 (SRS 2011) to 167 in 2017 (*NFHS 4) per 1, 00,000 live birth. The most vulnerable population are pregnant women from the rural area. The severe shortage of qualified and trained human resources, lack of infrastructure, hard to reach area, literacy level are the primary reason behind the preventable complication death. In response to these challenges the government has launched many schemes and initiated many programs to encourage women to have full ANC check-up, immunization, safe delivery at the medical centre, easy transportation to and fro from the hospital. The government initiative to reduce MMR has worked very well, but still, challenges persist. 30 % of the pregnant women are at high risk during their pregnancy period. The major burden of the MMR comes from the rural area where the pregnant women cannot visit the point of care centre for check-up or delivery if identified in a risk group. The major reason behind not visiting a healthcare centre is poverty, high out of pocket expenditure, wages lost. The government of India has launched many schemes for monetary compensation for the pregnant women delivering in the facility.

The government of India and many state governments are running social insurance scheme for the marginalized population which covers major surgeries and treatment for people who are among the marginalized population. The social insurance scheme has been a real success in term of providing healthcare to the marginalized population especially from rural areas. Social insurance scheme basically focuses on reducing out of pocket expenditures, providing quality care from qualified medical professionals and better infrastructure. This social scheme has benefited major of the population suffering from renal diseases, heart diseases various other major diseases.

The government should think of including pregnant women under this scheme to increase the reach and thus reducing MMR in the country. The pregnant women from marginalized population should be enrolled under this scheme. The initiative will provide them better healthcare service from skilled and qualified human resources with the availability of better infrastructure and medical facility to manage the complication. The scheme will also help to overcome the fear of out of pocket expenditure among the marginalized population.

The inclusion of the maternal care in the social insurance scheme will help in lowering the MMR to a great extent in rural marginalized population and thus helping to reduce the overall burden of MMR of the country.