The Indian economy is growing at eight-plus percent but all is not well for most people making up the economy. In this country, 1.83 million children die every year before reaching the age of five and close to 70,000 women lose their lives due to pregnancy or childbirth complications. These are the findings of the State of the World’s Mothers report prepared by the childrights organisation Save the Children. The report, released on Monday, places India on 73rd rank out of 77 middle-income countries in terms of the “Best Place to be a Mother".

Forty percent of the child deaths in India occur within the first few weeks of life and despite progress, the country is still number one on the index of maternal mortality, says the report titled "Women on the Front Lines of Health Care: State of the World's Mothers 2010".

The report focuses on the critical role of female health workers in the fight to reduce maternal, newborn and child mortality. It says that in most developing countries including India, the majority of women give birth at home and not in an institution or hospital. Also, social or cultural barriers often prevent women from visiting male health providers. In rural areas, husbands or elder family members decide whether a woman should go outside the home for health care or not. So female health workers have a critical role to play in saving the lives of women, newborns and young children.

But the country has a huge shortfall of health workers. The shortfall of ASHA (Accreditated Social Health Activists) workers is estimated at a 74,000 and that of Auxillary Nurses and Midwives (ANMs) at 21,066. As per the government norms, there should be one ASHA for a population of 1,000 and one ANM for 5,000 population in plain areas and 3,000 for rural areas.

The report suggests that to reduce the interconnected problems of maternal and newborn mortality, it is important to provide skilled care to mothers and newborns. It also says that how investing in training and deploying female health workers has paid off in terms of lives saved and illnesses averted. It has used examples from around the world including Indonesia, Nepal and Bangladesh to show how these countries have invested in training and deploying female community health workers to bring down maternal and newborn mortality.