This paper looks at the so far undocumented maternal health needs and practices among women of semi-nomadic shepherd pastoral communities called Dhangars that migrate across the western Indian state of Maharashtra. The constant migration of these communities through remote areas where health services are scarce, poses particular challenges for women during pregnancy and childbirth.
Semi-nomadic pastoral populations travel with their livestock in search of grazing pastures and their livelihood is derived from the sale, or exchange of, livestock for cash or other commodities. Exclusive pastoralists grow no crops of their own and depend on the exchange of livestock for food and grains or offer fertilisation of the farmer’s fields with manure in exchange for food and essential household items (Hatfield & Davies 2006). While practitioners of pastoralism are often viewed as being socially, economically and politically marginalised, they have also been known to make significant contributions to national economies and to the maintenance of ecosystems, especially those which are unsuitable for agricultural production.
The profession of pastoralism involves the whole family and is usually hereditary; therefore herding is strongly rooted to their ethnic and cultural identity.
An estimated 20 to 100 million people worldwide make their living as pastoralists (Blench 2000, Downie 2011).
No official figures exist for the population of pastoral communities in India but they are estimated to make up 7–11% of the population (8.7 to 13 million people).
Almost all the small ruminant meat consumed in India and a large part of the milk consumed originates from pastoral sources. Although hidden from public discourse with no official figures, their contribution to the Indian economy is considered to be substantial (Sharma et al 2003).
Maternal health in Maharashtra
India accounts for 20% of the world’s maternal death burden (Goldie et al 2010), but there are large interstate variations well-documented within the country. Maternal deaths in India tend to occur during the intrapartum and postpartum period with obstetric haemorrhage being the leading medical cause of death (Montgomery et al 2014). The western Indian state of Maharashtra is one of only five Indian states that have already achieved Millennium Development Goal (MDG) 4 — reduce child mortality (by two-thirds) and MDG 5 — improve maternal health (by reducing maternal mortality by three-quarters and improving universal access to reproductive health care by 2015) (United Nations 2014).
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Ganesh G, Ghotge N. MIDIRS Midwifery Digest, vol 27, no 4, December 2017, pp 527-532.
Original article © MIDIRS 2017
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