Four years and governments in UP of Rajnath Singh to Mayawati and then of Mulayam Singh, the health care scenario for pregnant women in villages remains unchanged leading to high infant mortality rates. Despite a US funded health program in place, rural women in the Samajwadi party stronghold Ferozabad district witnesses unattended childbirths, have no access to immunization or prenatal care and records high rate of infant mortality.

In Nirbhay Ghadi village, despite Yadav having relatives in the family of the Panchayat president, it has made no difference to the lives of pregnant women who still do not get medical attention. Take the case of 17-year-old Sharda, whose both sons died of Jaundice soon after birth. She is now under immense pressure to have another child. During both the pregnancies, she never had tetanus shots or iron tablets, most essential for young mother like her. She also very candidly informs that no one would allow her any injections if offered.

In neighboring hamlet Ramnagar, the 19-year-old Kanti is pregnant for the third time. She has lost her first two newborns. She and her husband, 22 year Joginder, decided to consult a doctor for the first time when Kanti was five months pregnant. They arrive at health center in Usayani block on a bicycle and are told by the clerical staff to come on Saturday when an ANM will be there. The doctor in charge M.L.Mishra is although present but the couple was not directed to him. When informed about the incidence, Dr.Mishra grudgingly calls Kantis husband, Joginder and advises him to meet the lady doctor in district hospital. The doctor expresses shock that Kanti has never received tetanus injections but feels relieved when learns that their village does not fall under his primary health center. He refers them to Tundla Primary Health Centre. The couples visit there was again a wasted journey. In the doctors absence, the pharmacist saw the patients. Kanti also said that no ANM has ever visited her house.

An ANM in the area admits that it is humanly not possible for her to visit every home as she has 10 villages under her says Usha an ANM (name changed). Besides these women do not agree to take any medicine or injection, she says. ANM Sushila Chauhan of the Usayini PHC says I sit in my village once a week and whoever wants anything comes to me. I dont beg of them for any thing, because they think we have some ulterior motive in offering them pills or injections. One can just feel the real need of awareness camps in reproductive health care in the area, where information about the importance of iron tablets and tetanus injections for healthy pregnancy should be provided in local languages.

However, in health camps organized by the government and SIFPSA (State Initiative in Family Planning Services) are full of women brought by ANMs for sterilization. SIFPSA is a reproductive child health care program currently on in the state funded by USAID, but there are hardly any pregnant women in the SIFPSA camps. A doctor in the district hospital Anjali Gule says, We have to concentrate on sterilizations in the health camps and we cannot be doing other things at the same time. Randy Kolstad, the SIFPSA official in New Delhi says, In a large state like UP exceptions could be there. But SIFPSA has been emphasizing on holistic care of women rather than population control.

There has been very little improvement in infant and child mortality rate and we are yet to achieve the National Health Policy target to reduce IMR to less than 60 per 1000 live births. The infant mortality rate in UP is the highest in the country at 86.7% per 1000 births. The national average is 67 per 1000 births.

With governments changing every two years, the new government does not own up any responsibility for the high infant mortality rate in UP. UP Health Minister Rajvir Singh says, What are you talking have happened under another government. Come to our state now and you will see the difference. However he does not explain what steps he has taken to make health care accessible to pregnant women.