Indian women's reproductive health -- challenges and remedies.

The state of Indian women's health is appalling. At least 50% of women of all age groups suffer from anaemia. The pregnant woman in India faces a risk of death due to pregnancy that is 50 times higher than for women in industrialized countries. According to the recently released provisional figures of the 1991 census, India's population has reached 844 million, showing an increase of 23.5% during the previous decade. The all-India growth rate of 2.11% annually is only marginally less from 2.23% of the earlier decade. Another disheartening feature of the 1991 census is the declining sex ratio. The number of females in India was 929 per 1000 males compared to 934 in 1981. Only 39.42% of females are literate, compared to 63.86% of males. A trial of the reproductive health care approach for population control and women's health could be a remedial measure. The existing programs such as family welfare, child survival, maternal and child health, safe motherhood initiative, and all-India hospital postpartum programs could serve as useful building blocks for broad-based reproductive health care. It is estimated that out of all pregnancies 50% are high risk pregnancies and require referral to an apex hospital, but so far only 6.2% of cases have access to such a facility. Thus, speedy transportation of such cases is urgently needed. The emphasis also has to be shifted from curative medicine to preventive medicine. The primary health care concept combining traditional and modern medicine is still needed. It is estimated that fewer than 30% of deliveries are in institutions, and the rest are conducted by traditional birth attendants (TBAs). TBAs should be trained in the techniques of asepsis and how to recognize high-risk pregnancy cases.