We generally know how to measure performance in the telecom sector: increased connectivity in voice and data; lower prices; improved quality of service experience; and greater choice. Similar in electricity. In each of these cases we can also identify the factors that led to improvements in performance.
Recently I was thinking about the healthcare sector. This sector has commonly accepted, internationally comparable indicators such as the infant mortality and maternal mortality rates. I was engaged in the television debate on the trade agreement with India when the representative of the government doctors’ trade union claimed credit for improvements in the above indicators in Sri Lanka. Was this true, I wondered.
In 1955, less than a decade after Sri Lanka celebrated its independence, some 405 women died for every 100,000 live births. In 2013, Sri Lanka’s MMR was 32. Compare this with the island’s closest neighbours: in India, 189 women died for every 100,000 live births in 2013, in Nepal, it was 291 that same year, while in Bangladesh it was 201.
The answer came in a fascinating Al Jazeera report. It seems the true heroes are those who toil on the preventive side, not the high-profile doctors on the curative aside.
According to their official schedule Ari and Kumudini are on track – midwives are expected to pay four postpartum visits; two in the first 10 days, and another two within the first two months. In 2013, according to data collected by Sri Lanka’s Family Health Bureau, 92.2 percent of new mothers who were identified and registered were visited at least once by a midwife in that critical postpartum period.
Each visit involves a thorough check-up of mother and child. As the boy grows, he and his parents will also visit the nearby clinic. The midwives will watch him closely until he is five years old, checking his growth and development and ensuring that he is up to date on critical vaccine shots. The attention and support provided by the midwives feels deeply personal, and it is free.