Maternal and child health: is South Asia ready for change?

Bhutta and colleagues (2204) commentary on Maternal and child health:
is South Asia ready for change? is a comprehensive review of the
situation. However, the authors are rehashing the existing knowledge base
on this issue. The authors have not contributed anything new to the on-
going debate on maternal and child health in South Asia. This debate has
been going on for far too long now, without any signs of noticeable
improvement in the health of the mother or the child in the South Asian
context, with the exception of Kerala in India and Sri Lanka.

Undoubtedly South Asia has to go a long way before any change can be
detected in its maternal and child health. However, for this to happen we
need to move forward and look at ways to improve the overall health and
well-being of the South Asian women and children. Several research and
studies have shown that if the health and well-being of women are
improved, it automatically reflects in the children’s health as well
(Bandyopadhyahy and Mcpherson 1998; Caldwell, 1989; Cleland, 1989; Belsey
and Royston, 1987).

Currently, we need additional resources and political will to improve
the overall health and well-being of women and children in South Asia. We
need to develop policies and programs based on evidence. The right way to
move forward to improve the situation of women and children in South Asia
instead of reinventing the wheel is of prime importance in this new
millennium.

We need more debates on policies and strategies for enhancing women’s
right in South Asia and in translating these to impact on their health and
well-being. Also more debates centring on the structural issues and
impediments of resource allocation is required to bring about change and
to enhance women’s and children’s health in the Sub-continent. We need to
get dialogues started on the issue of a rights based approach to gender
and how it affects women’s health in particular, and what kind and types
of gender sensitive policies and programs are necessary to enhance the
overall health situation.

It would have been interesting to read and learn more about the
authors’ views and ideas on concrete solutions to bring about change in
the lives, health and well being of South Asian women and children, rather
than revisit the long-standing view and feelings of doom. It appears that
the authors have taken a safe route of not offending powerful
international institutions whose policies have direct bearing on the lives
of women and children in South Asia.

References:

Bandyopadhyay, M., and MacPherson, S., 1998. Women and health:
Tradition and culture in rural India, Ashgate Publishing Ltd., Aldershot,
UK.

Belsey, M. A., and Royston, E., 1987. Overview of the health of women
and children. Population Council, New York.

Bhutta, Z. A., Gupta, I., de'Silva, H., Manandhar, D., et al., 2004.
Maternal and child health: is South Asia ready for change? British Medical
Journal, 328:816-819

Caldwell, J. C., 1989. Mass education as a determinant of mortality
decline, in Cultural, social and behavioural determinants of health, John
C. Caldwell and Gigi Santow (ed), The Australian National University,
Health Transition Centre, Canberra.

Cleland, J., 1989. Maternal education and child survival: Further
evidence and explanations, in What we know about health transition: The
proceedings of an international workshop, John C. Caldwell et al (ed), The
Australian National University, Health Transition Centre, Canberra.

Competing interests:
None declared