Meeting with Additional Secy H&FW
- Dear All,Mr Nanda and I met Ms Jalaja on the 29th. A brief resume of what we discussed in given below.Best,Abhijit
Issues and Concerns Raised
1. Millenium Development Goals
A concern was shared that while the MDGs raise the issue of maternal health they do not address reproductive health and rights. The review of MDGs in September inNew York provides an opportunity for incorporating these concerns into the MDGs if the Government delegation would do so. India has already taken steps to include RHR within the RCH 2 and NRHM and is in a position to take this forward. A speech by the Minister of Development Cooperation of The Netherlands which makes this point was also shared with her.
Response Ms Jalaja agreed that this should be done. She informed us that a National Conclave is going to be held in Delhi sometime in August which is going to discuss MDG related issues and a Delhi Declaration would be adopted. This issue could be incorporated into the Delhi Declaration and then would form part of the official representation at New York . She said that she would try to get us / groups like ours invited to this conclave
2. Coercive Population Policies, Two Child norm, Informed Choice and Quality of Care
We raised the concern that in many states Coercive population policies and two child norm were still being enforced and local level targets were being used for punitive action against health workers. We shared that the National Human Rights Commission ( with which Ms Jalaja was associated earlier) had clearly mentioned that coercive population policies were a violation of human rights. The National Population Policy did not mention any norms and norm setting had many detrimental effects, however many states and officials felt that target setting was the most effective. We also explained the nature of Population Momentum and the need for increasing services for spacing.
Response Ms Jalaja was in full agreement to most of our points. However she mentioned that the current advice that had been given to the Minister was that sterilization was the only way of ensuring that a TFR of 2.1 was quickly achieved. Ms Jalaja mentioned that the PM had clearly spoken against coercive measures in the population programme. She agreed that the Minister could write a letter to the states emphasing that coercion was not part of the government approach. She agreed that the emphasis should be on Informed Choice and Quality Services. Ms Jalaja also raised the issue of the PIL in Supreme Court filed by A.K.Haritash and said that groups should file intervention petitions. She also mentioned that a meeting of the National Population Commission has been scheduled for the 23rd of July and will be chaired by the Prime Minister.
3. Maternal Mortality and National Rural Health Mission
We congratulated the Government for conceiving and launching out the National Rural Health Mission and the RCH 2 programme. However these excellently designed programmes could become very ineffective at the operational level because of the lack of accountability. We shared that maternal mortality remains a very important issue of concern and it will be necessary to ensure that the 24 hours FRUs are actually providing the referral services that they are supposed to provide. The Community Monitoring mechanism that has been envisaged within the NRHM will provide an excellent opportunity for doing so. Maternal death audit should be institutionalized and should include social and system aspects as well. We asked her to look into the issue of ensuring safe and legal MTP services because abortion related deaths were a major contribution to maternal death. We shared an advocacy note prepared for this purpose with Ms Jalaja.
Response Ms Jalaja agreed with the concept of Community Monitoring and said that she would look forward to mechanism for doing so. She agreed that maternal death audit could be started in states like Bihar , Rajasthan, MP, Orissa and UP where maternal death rates are very high.
4. Quality of Care of RH services
We raised the concern the Quality of Care is a very important area which needs to looked into carefully. Medical interventions and negligence have a great potential to cause harm. We asked her to institutionalize a forum for reviewing Quality of Care at all levels and include community within it,
Response Ms Jalaja mentioned that the Government was now following the Supreme Court instructions about sterilsation camps. She has been associated with NHRC and is keen that Quality of Care be a very important concern.
We asked Ms Jalaja to increase the attention on youth reproductive health services and to incorporate it into larger outreach based programmes like NYK.
- Dear Frineds
A renown journalist from the press is interested in
featuring a story on Maternal Mortality. He wants to
talk with a family with a loss.
I know this is a very sensitive area and want all your
advice in terms of how we handle journalists who are
interested in the story - but unwilling to get out of
the big cities!!!
Please write back about your experiences and what is
most effective for such advocacy
Leila Caleb Varkey
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