Academic journal article Journal of Health Population and Nutrition

Maternal Mortality-Reduction Programme in Andhra Pradesh

Academic journal article Journal of Health Population and Nutrition

Maternal Mortality-Reduction Programme in Andhra Pradesh

Article excerpt


Profile of Andhra Pradesh

Andhra Pradesh, one of the 28 states of India, is located in the southeastern part of the country with Karnataka in the West, Tamil Nadu in the South, Maharashtra, Chattisgarh, and Orissa in the North, and the Bay of Bengal in the East. Its total land area is 275,045 sq km with a long coastline of about 1,000 km. The state is ranked fifth in the country in terms of its area and population size.

According to the Census 2001, the total population of Andhra Pradesh was 75,727,541. The density of population is 277 per sq km compared to 312 in the country. The state has 23 districts, including the capital district Hyderabad. It is divided into three sociocultural and geographic regions-Coastal Andhra, Telangana, and Rayalaseema-with 10 districts, including Hyderabad in the Telangana region, nine districts in the Coastal region, and four districts in the Rayalaseema region. Andhra Pradesh is predominantly rural and agricultural, with 73% of the total population living in 28,123 villages and hamlets, according to the Census 2001 (1).

Andhra Pradesh fares better than other states on key demographic indicators (Table 1). Its population is growing at a slower decadal growth rate at 14.59% compared to 21.54% in the rest of India. The contraceptive prevalence rate (CPR) is 68% according to the National Family Health Survey (NFHS) 3 compared to the national average of 56.3% (2). The total fertility rate (TFR) in Andhra Pradesh is 1.8 compared to 2.9 in the country. Overall, the demographic profile indicates that the state has moved into the next phase of demographic transition.

Over the last six decades, Andhra Pradesh has made great leaps in areas, such as information technology and population stabilization. In other areas, trends do not show much improvement, especially in terms of health of infants and status of women. Sex ratio in the state is slightly better than the national average with 978 females to 1,000 males compared to 933 in the rest of India. Infant mortality is nearly the same as the rest of India. In the area of maternal health, Sample Registration System (SRS) data show that the state has a lower maternal mortality ratio (195 per 100,000 childbirths) compared to the national estimate of 301 (3). The percentage of population below the poverty-line is lower in the state (15.77%) compared to the country as a whole (26.1%). However, the human development index and the human poverty index of the state are not encouraging and are similar to the national average according to the National Human Development Report (NHOR) 2001 (4). In some critical areas of social development of women, the state falls below the national average. Female literacy and age at marriage are two examples where Andhra Pradesh lags behind the country as a whole. Only half of the females aged seven years and above are literate in the state. The mean age at effective marriage for females in Andhra Pradesh according to the 1999 SRS is 18.1 years-about one and a half years lower than the national figure of 19.6 years.

This case study was carried out with the following three objectives: (a) analyze the slow reduction of maternal mortality in Andhra Pradesh in contrast to achievement of demographic goals and in comparison with the neighbouring states-Tamil Nadu and Kerala; (b) contextualize the high maternal mortality ratio (MMR) within the sociodemographic and programmatic scenario of the state and assess the factors contributing to unsatisfactory achievements in the area of maternal health compared to huge successes in the area of population stabilization in terms of strategies chosen and opportunities missed; and (c) design and implement sustained advocacy for cost-effective and comprehensive strategies for achieving safe motherhood, including pilot interventions to showcase the best practices.


The background work for this case study included analysis of qualitative and quantitative data, opinions of stakeholders, and advocacy meetings over a three-year period from 2005 to 2007. …

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