deaths per 100,000 live births in 1991-92 to 540 maternal deaths per 100,000 live births in 1997-98. This is inexcusable. Female to male ratio is also declining at various ages, despite enhanced prosperity and improved medical care. Punjab & Haryana are telling examples of prosperity coupled with poor healthcare, due to bad management and lop-sided planning. Empower the mother with knowledge and awareness on better parenting techniques and let her be the doctor of her ‘baby’ under ordinary circumstances. Her attitudes and knowledge can save many lives, including her own.

The Kumars assert that the commonly stated reason for doing so poorly in promoting, protecting and restoring the health of the millions — in particular lower-middle and poorer sections — are: (1) dwindling government expenditure on health from 1.3 percent of GDP in the mid-Nineties to 0.9 percent (WHO recommends 5 percent), (2) Health Ministries at the Centre and in the States not attracting political leaders of high calibre, (3) though health is a state subject, too many health programmes are of vertical nature, sponsored and funded by the Centre, (4) frequent transfers of administrative secretaries with national average period of stay on one post for only seven months, and (5) not enough, adequately trained public health professionals at the Centre, states and district levels.

One stumbling block with our policy-makers and planners has been their failure to appreciate that the determinants of health also include education, adequate income and nutrition, adequate housing, water, sanitation, empowerment of women, etc. Thus, it would need cross-sectoral approaches and quality community planning – Kumars conclude.

<< 1 2