NDLI: Only when the boat has started sinking: a maternal death in rural north India.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Jeffery, Patricia Jeffery, Roger
Spatial Coverage	India
Description	Country affiliation: United kingdom Author Affiliation: Jeffery P ( School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, Edinburgh EH8 9LD, United Kingdom. pjeffery@staffmail.ed.ac.uk)
Abstract	This paper uses a close reading of villagers' responses to the death in childbirth of a Muslim woman to raise questions about India's current policy emphasis on institutional delivery as a means of reducing maternal mortality. After introducing the context and methods of our research, we describe recent policy interventions related to maternal health, including the National Rural Health Mission established in 2005. We then outline villagers' commentaries on the specific maternal death, focusing on the costs to women's health (and sometimes life) of high fertility; the lack of care available from rural government facilities and staff and the preference for delivering at home with the aid of local practitioners; the financial constraints that make people hesitate to seek medical treatment; and the high costs of private treatment and the poor treatment experienced in government facilities. Our core argument is that government health care provision in rural Uttar Pradesh is embedded in a moral universe characterised by widespread and long-term mistrust of state services and that encouraging institutional deliveries without addressing the perceptions of potential service users is a seriously flawed approach to reducing maternal mortality. The paper draws primarily on ethnographic research funded by the Wellcome Trust during 2002-2005, in a Muslim village in rural Bijnor district (in north-western Uttar Pradesh).
File Format	HTM / HTML
ISSN	02779536
e-ISSN	18735347
DOI	10.1016/j.socscimed.2010.05.002
Journal	Social Science & Medicine
Issue Number	10
Volume Number	71
Language	English
Publisher	Elsevier
Publisher Date	2010-11-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Medicine Health Policy Hospitals, Public Organization & Administration Maternal Health Services Obstetric Labor Complications Mortality Rural Health Services Attitude To Health Maternal Mortality Prevention & Control Pregnancy Professional-patient Relations
Content Type	Text
Resource Type	Article
Subject	Medicine Health (social science) History and Philosophy of Science

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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