National Workshop on `Human Rights and Health’ with special reference to Maternal Anaemia

Recognising that the persistence of maternal anaemia, infant mortality, maternal mortality and morbidity is the anti-thesis of any notion of human development, the Commission in collaboration with UNICEF and the Department of Women and Child Development, decided to address itself to these issues in a two-day workshop which involved experts from various fields, disciplines and professions.

Chairperson, Justice J.S. Verma, inaugurated the workshop on 26 April 2000. Shri Arun Jaitley, Minister of State for Information and Broadcasting, Shri N.T. Shanmugam, Minister of State for Health and Family Welfare and Smt. Sumitra Mahajan, Minister of State for Women & Child Development participated in the function. Eminent scientists, policy makers, civil servants, legal luminaries and social activists including Justice K. Ramaswamy, Dr. Ramalingaswamy, Dr. Kochupillai, Dr. Madhava Menon, Dr. Mrinalini Devi Puwar, Dr. Shanti Ghosh, Dr. Rajammal Devadas, Dr. B.S. Narsimharao, Dr. S.K. Sood, Mr. Alan Court, Dr. V. Prakash, Dr. Vijayaraghavan were among those who attended the workshop.

Delivering the keynote address at the inaugural function, Justice Verma said that positive recommendations are necessary for formulating a proper health policy and implementing it as early as possible in order to improve the status of health in the nation. Explaining why the National Human Rights Commission is involved in the prevention of maternal anaemia, Justice Verma said that health is a very significant human right. The Right to Life, which is guaranteed in Article 21 of the Indian Constitution, is to be read as a Right to Life with Dignity. This makes every aspect of human dignity equally sacrosanct and each one of them a human right. Quoting Amartya Sen on the "three unfreedoms" that afflict our society, the Chairperson said that improved care is imperative to the achievement of a better society. Lamenting the existing deficiencies in this area, he said that every section of society should come together to provide an answer to the problem. The Commission’s role in this sphere is to bring together all policy makers, decision takers and implementers. The Right to good health is embodied in the Constitution and it is a duty of every citizen to ensure it. He called upon the media to create more awareness about this problem. Safe motherhood and healthy children, he stressed, would ensure a better future for the country.

The Minister of State for Health and Family Welfare, Shri T.N. Shanmugam spoke about the National Nutritional Anaemia Control Programme – its current status and future plans. He said that malnutrition and micronutrient deficiencies like anaemia, iron deficiency disorders and Vitamin-A deficiency are serious public health problems today. About 780 million people in developing countries still do not have access to essential nutritional requirements, he said.

The Minister of State for Women and Child Development, Smt. Sumitra Mahajan said that 60 per cent of all maternal deaths in India can be directly or indirectly attributed to maternal anaemia, which also is the cause of 50 per cent of infant mortality. Only 30 per cent of infants in India get complementary food between the age of 6 to 9 months. The figure is as low as 9 per cent in Rajasthan. According to the Second National Family Health Survey completed recently, 40 to 55 per cent of children below the age of three years are moderately or severely anaemic in most States of the country. Smt. Mahajan said that the Department of Women and Child Welfare would soon launch a National Nutrition Mission, which will aim to control and prevent anaemia in women and children by adopting the life-cycle approach. The Minister of State for Information and Broadcasting, Shri Arun Jaitley, spoke of the role and relevance of the media in helping to eradicate maternal anaemia. He said that the problem of health care has to be addressed to all sections of society, a large part which does not have access to print media. This puts a greater responsibility upon the electronic media The representative of UNICEF in India, Mr. Alan Court, appreciated the role of this Commission as well as the Government of India in focussing on this aspect of the Rights of the Child. He said that freedom from anaemia is a human right, as is freedom from iron deficiency. Promoting the right to health will promote equality in society for children and women. Polices and programmes should be focussed to reach the unreached, there should be no diluting of the pressure needed in this regard.

For two days the workshop deliberated on various relevant issues in three groups – Group I: Legal, Political and Administrative Issues; Group II: Scientific and Technical Issues; Group III: Programmatic Issues. Far-reaching recommendations were made in its report.

The unanimous view of the workshop was that every citizen is entitled to a right to life with dignity. Right to health and right to development should be recognised as essential components of human rights. Every citizen is entitled to humane governance, which is good governance centered on the goal of securing human development for all citizens. The workshop noted that maternal anaemia is a major contributing factor to maternal mortality and maternal morbidity and this is a grave threat to the future well being of the nation. It was also noted that low birth weight children who happen to survive suffer serious physical disorders and behavioral difficulties and that maternal anaemia is known to lead to the birth of children with poor mental and physical development, emotional disabilities, speech disorders, poor verbal skills etc. The workshop also noted that despite three decades of existence of the National Anaemia Control Programme and the National Nutrition Programme there have not been significant changes in Maternal Mortality and Morbidity. In some of the Northern States of India, MMR is still unacceptably high.

Taking note of the deliberations of the workshop and the conclusions thereof, the Commission, after considering them in a meeting held on 1 May 2000, decided to make appropriate recommendations to the Government based on the Report. The following are the salient features of the Commission’s recommendations:

In the light of the materials and statistics shared at the workshop, the Commission urged that strong and emergency measures be taken to deal with the problem. It was unanimously felt that the nation owes to itself to have the right to health made a fundamental human right and to have a comprehensive legislation. The legislation should cover all facets of health with emphasis on rights of women, especially pregnant women and children, especially adolescent girl children. It should delineate the duties of the state for the provision of relevant services to enable the citizen especially the women and girls to access the services. The legislation should also specify the standards for the health care to be offered by the state. Minimal health standards and measures to realise them should also be formulated.

It was emphasised that the National Anaemia Control Programme needs to be reviewed and restructured to have it effectively implemented, with elements of accountability for implementation, spread of health education in the context of maternal anaemia and with the participation of various state and non-state agencies. This should be done immediately in collaboration with NHRC.

The existing programme (NNACP) should be further strengthened, by higher budgetary allocation, to facilitate eradication of the ill on a war footing – like pulse polio.

All agencies concerned with education – formal and non-formal – should be involved in the formulation of the curriculum at all levels, to spread health and human rights education.

The Ministry of Information and Broadcasting should take up the job of disseminating information and educating the target groups to make people aware of their rights and entitlements, etc. to facilitate effective implementation of the programme.

Literacy being fundamental to implementation of all public welfare programmes, the right to education should be incorporated as a fundamental right and, to effectively deal with the problem, the girl child should be given free and compulsory education up to graduation. It is equally important that human rights education should be made part of formal, non-formal and adult education.

The Ministry of Human Resources Development should be involved along with various agencies such as UGC, NCERT, AICTE, MCI etc. for development of educative programmes and curricula on these issues.

All concerned institutions, including Panchayats, local bodies and NGOs should be involved in this process.

A Special Committee of Members of Parliament should be set up to oversee the entire effort to rid the country of the scourge of Maternal Anaemia.

The office of NHRC is to be utilised for monitoring the effective implementation of the NNACP.