Division Bench at Patna Underscores Importance of Maternal Mortality and Orders State of Bihar to Account for Every NRHM Rupee Spent

20 March 2012

PATNA- The Division Bench of Patna’s recent order in Centre for Health and Resource Management (CHARM) v. The State of Bihar and Others (W.P. 7650/2011) asks the State Health Secretary to account for NRHM spending and unequivocally holds the State responsible for failures to protect, respect, and fulfill the rights of pregnant women under the National Rural Health Mission (NRHM).

At about 300 maternal deaths per 1 lakh births, Bihar has the fourth-highest Maternal Mortality Rate (MMR) in India and one of the highest MMRs in the world. Almost all of these deaths are completely preventable where the government provides adequate antenatal, delivery, and post-natal care. Despite significant financial support under the NRHM, sub centres and hospitals in Bihar do not have adequate supplies of iron, folic acid, blood, or basic equipment for checking blood pressure or hemoglobin levels. The state does not have adequate staff or infrastructure and reports an institutional birth rate of just 27%.

The Fifth Common Review Mission of the National Rural Health Mission found that state mismanagement of NRHM funds and inadequate implementation “prevented women from receiving these crucial benefits and services and contributed to the high incidence of preventable maternal deaths.” (p.203). In light of these facts, this Public Interest Litigation (PIL) was filed by CHARM through its executive director, Dr. Shakeelue Rahman and the Humlog Trust through its Secretary Parveen Amanullah as a part of Human Rights Law Network’s strategy to use litigation to address India’s high maternal mortality and morbidity rates. Advocate Ms. Anubha Rastogi argued the case.

On 6th February a Division Bench of the Patna Court led by Justice (Smt) T Meena Kumari expanded the scope of the PIL to cover NRHM implementation in all districts of Bihar. The Health Secretary, Bihar was expected to file a district-by-district status report by 19th March 2012. In an unusual move, the State filed its report, but through a private advocate and not through government counsel. The case came up for hearing again on 20th March where the Division Bench of Justice T Meena Kumari and Justice Jyoti Saran took objection to the fact that a government official filed an affidavit through a private lawyer. The Division Bench has since ruled that this status report is unsatisfactory.

On 20 March, the Division Bench also ordered the Health Secretary to account for each and every Rupee released by the Central Government under NRHM and spent by the State Government for the implementation of NRHM. The total sum amounts to nearly Rs. 3500 crores. The State Government must file their response in an affidavit and should produce the bills for every Rupee spent. The report will highlight key gaps between Central Government disbursement and state level implementation. The State must submit its expense report by 9 April 2012.

The High Court of Madhya Pradesh recently held that the state has a duty to ensure that every woman survives pregnancy and childbirth. Today, the Patna Court underscored the state’s obligation to effectively implement the NRHM and to protect pregnant women.and Orders State of Bihar to Account for Every NRHM Rupee Spent

March 22
PATNA- The Division Bench of Patna’s recent order in Centre for Health and Resource Management (CHARM) v. The State of Bihar and Others (W.P. 7650/2011) asks the State Health Secretary to account for NRHM spending and unequivocally holds the State responsible for failures to protect, respect, and fulfill the rights of pregnant women under the National Rural Health Mission (NRHM).

At about 300 maternal deaths per 1 lakh births, Bihar has the fourth-highest Maternal Mortality Rate (MMR) in India and one of the highest MMRs in the world. Almost all of these deaths are completely preventable where the government provides adequate antenatal, delivery, and post-natal care. Despite significant financial support under the NRHM, sub centres and hospitals in Bihar do not have adequate supplies of iron, folic acid, blood, or basic equipment for checking blood pressure or hemoglobin levels. The state does not have adequate staff or infrastructure and reports an institutional birth rate of just 27%.

The Fifth Common Review Mission of the National Rural Health Mission found that state mismanagement of NRHM funds and inadequate implementation “prevented women from receiving these crucial benefits and services and contributed to the high incidence of preventable maternal deaths.” (p.203). In light of these facts, this Public Interest Litigation (PIL) was filed by CHARM through its executive director, Dr. Shakeelue Rahman and the Humlog Trust through its Secretary Parveen Amanullah as a part of Human Rights Law Network’s strategy to use litigation to address India’s high maternal mortality and morbidity rates. Advocate Ms. Anubha Rastogi argued the case.

On 6th February a Division Bench of the Patna Court led by Justice (Smt) T Meena Kumari expanded the scope of the PIL to cover NRHM implementation in all districts of Bihar. The Health Secretary, Bihar was expected to file a district-by-district status report by 19th March 2012. In an unusual move, the State filed its report, but through a private advocate and not through government counsel. The case came up for hearing again on 20th March where the Division Bench of Justice T Meena Kumari and Justice Jyoti Saran took objection to the fact that a government official filed an affidavit through a private lawyer. The Division Bench has since ruled that this status report is unsatisfactory.

On 20 March, the Division Bench also ordered the Health Secretary to account for each and every Rupee released by the Central Government under NRHM and spent by the State Government for the implementation of NRHM. The total sum amounts to nearly Rs. 3500 crores. The State Government must file their response in an affidavit and should produce the bills for every Rupee spent. The report will highlight key gaps between Central Government disbursement and state level implementation. The State must submit its expense report by 9 April 2012.

The High Court of Madhya Pradesh recently held that the state has a duty to ensure that every woman survives pregnancy and childbirth. Today, the Patna Court underscored the state’s obligation to effectively implement the NRHM and to protect pregnant women.