{"id":360330,"date":"2026-04-08T17:44:38","date_gmt":"2026-04-08T12:14:38","guid":{"rendered":"https:\/\/forumias.com\/blog\/?page_id=360330"},"modified":"2026-04-08T17:44:38","modified_gmt":"2026-04-08T12:14:38","slug":"answered-examine-the-significance-of-the-one-health-approach-in-the-context-of-indias-public-health-system-and-how-it-can-be-incorporated-effectively-to-address-the-risk-of-pandemics","status":"publish","type":"page","link":"https:\/\/forumias.com\/blog\/answered-examine-the-significance-of-the-one-health-approach-in-the-context-of-indias-public-health-system-and-how-it-can-be-incorporated-effectively-to-address-the-risk-of-pandemics\/","title":{"rendered":"[Answered] Examine the significance of the One Health approach in the context of India\u2019s public health system and how it can be incorporated effectively to address the risk of Pandemics."},"content":{"rendered":"

Introduction<\/strong><\/h2>\n

The professional midwife has transitioned from a supporting role to a central pillar of India’s maternal health reform. This shift addresses the birthing paradox: a scenario where the urban elite faces over-medicalization (with C-section rates exceeding 27% to 50% in some states), while rural and tribal populations struggle with under-resourcing and a lack of skilled attendance.<\/p>\n

Historical and Policy Context of Midwifery Reform<\/strong><\/h2>\n
    \n
  1. Shift from Doctor-Centric Model: <\/strong>India\u2019s maternal healthcare has historically been doctor-centric, leading to over-medicalisation. The 2018 Guidelines on Midwifery Services marked a shift toward midwifery-led care. The Midwifery Services Initiative (2018) aims to create NPMs trained to global standards.<\/li>\n
  2. Institutional Policy Support: <\/strong>The reform aligns with recommendations of the NITI Aayog and global agencies such as United Nations Population Fund promoting Midwife-Led Care Units (MLCUs).<\/li>\n<\/ol>\n

    The Natural Pillar and Countering the Scalpel Culture<\/strong><\/h2>\n

    The professionalization of midwifery, specifically through the Nurse Practitioner in Midwifery (NPM) cadre, is the primary tool to restore physiological birth as the norm.<\/p>\n

      \n
    1. Clinical Gatekeeping:<\/strong> They support continuous labour care, lowering C-section rates (currently 21.5% nationally, higher in private sectors). This aligns with the WHO target of 10\u201315% for C-sections, which India has significantly overshot in recent years.<\/li>\n
    2. Respectful Maternity Care (RMC):<\/strong> Unlike the episodic and often impersonal nature of high-volume obstetric wards, midwifery enhances maternal dignity, emotional support, and breastfeeding initiation. This woman-centric model counters the scalpel culture prevalent in high-volume obstetric wards.<\/li>\n
    3. Restoring Agency:<\/strong> Midwifery shifts the narrative from delivering a patient to supporting a mother, providing her with the autonomy to choose birthing positions and avoid unnecessary episiotomies.<\/li>\n<\/ol>\n

      Ensuring Equitable Access<\/strong><\/h2>\n

      Midwifery acts as a social leveler by democratizing access to high-quality care across India’s diverse geography.<\/p>\n

        \n
      1. The Last Mile Reach:<\/strong> In dark zones (rural, tribal, and low-income areas) where obstetricians are scarce, the NPM cadre provides Skilled Birth Attendance (SBA). They are trained to handle common emergencies like Post-Partum Hemorrhage (PPH) while knowing exactly when to refer a case to a specialist.<\/li>\n
      2. Integration with SUMAN:<\/strong> They manage 90% of low-risk pregnancies, freeing specialists for high-risk cases and reducing tertiary hospital burden. This democratises access, aligning with SDG-3 (maternal health) and SUMAN (Surakshat Matritva Ashwasan) scheme goals.<\/li>\n
      3. Economic Viability: <\/strong>Offers a high Return on Investment (ROI). Scaling midwifery can avert up to 83% of maternal and neonatal deaths, saving the healthcare system billions in long-term complication costs and neonatal intensive care.<\/li>\n<\/ol>\n

        Regulatory Backbone the NNMC Act, 2023<\/strong><\/h2>\n

        The success is anchored by the National Nursing and Midwifery Commission (NNMC) Act 2023, which replaced the archaic Indian Nursing Council.<\/p>\n

          \n
        1. Standardization:<\/strong> It ensures that every NPM undergoes a rigorous, 18-month competency-based program aligned with International Confederation of Midwives (ICM) standards.<\/li>\n
        2. Professional Identity:<\/strong> By creating a separate register for midwives, the Act has helped decouple midwifery from general nursing, granting these professionals the legal and administrative autonomy required to run MLCUs.<\/li>\n<\/ol>\n

          Pilot projects in Maharashtra and Telangana demonstrate improved outcomes. UNFPA data indicates professional midwifery can avert up to 83% of maternal and neonatal deaths. Yet, challenges persist: hierarchical resistance from obstetricians, scaling training, and rural retention.<\/p>\n

          Way Forward<\/strong><\/h2>\n
            \n
          1. Scale NPM training with ICM standards and establish more Midwifery Training Institutes.<\/li>\n
          2. Integrate midwifery fully into public health systems with dedicated MLCUs in every district hospital.<\/li>\n
          3. Strengthen regulatory autonomy under NNMC and address inter-professional hierarchy through collaborative protocols.<\/li>\n
          4. Leverage Ayushman Bharat and digital platforms for community-level midwifery outreach.<\/li>\n
          5. Conduct periodic outcome audits and incentivise rural postings.<\/li>\n<\/ol>\n

            Conclusion<\/strong><\/h2>\n

            National development begins with healthy mothers and children. Professional midwifery can humanise childbirth while ensuring equitable maternal healthcare across India.<\/p>\n","protected":false},"excerpt":{"rendered":"

            Introduction The professional midwife has transitioned from a supporting role to a central pillar of India’s maternal health reform. This shift addresses the birthing paradox: a scenario where the urban elite faces over-medicalization (with C-section rates exceeding 27% to 50% in some states), while rural and tribal populations struggle with under-resourcing and a lack of… Continue reading [Answered] Examine the significance of the One Health approach in the context of India\u2019s public health system and how it can be incorporated effectively to address the risk of Pandemics.<\/span><\/a><\/p>\n","protected":false},"author":10320,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"class_list":["post-360330","page","type-page","status-publish","hentry","entry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/pages\/360330","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/10320"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=360330"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/pages\/360330\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=360330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}