Even as increasing number of women are able to access ante-natal care during the first three months of pregnancy, institutional deliveries (births at health facilities) in most states are low resulting in maternal and child deaths.
Only six states and UTs – Telangana, Gujarat, Kerala, Mizoram, Puducherry and Chandigarh – had more than 90% deliveries conducted in private or public health facilities. Whereas, in Uttar Pradesh, Nagaland, and Daman and Diu only around 50% of total deliveries were in health facilities, according to the latest health index of Niti Aayog.
However, a significant number of pregnant women are reaching health facilities during the first trimester. Among the 21 larger states, 13 have more than 70% of antenatal care registered in the first trimester. Almost all states except Uttar Pradesh, Telangana, Uttarakhand, and Madhya Pradesh have shown incremental progress in registration of pregnant women in the first trimester, the index shows.
“Antenatal care is essential not only to tackle maternal and neonatal complications but it is also an important intervention to increase proportion of births in healthcare facilities. Both antenatal care and institutional delivery have a strong additive effect on maternal mortality reduction,” said Dr Niti Kautish, senior gynecologist at Fortis.
The fourth round of the National Family Health Survey (NFHS) conducted by the health ministry during 2015-16 showed a significant rise of over 34% in institutional births in public health facilities as compared to a decade ago in 2005-06.
However, the latest index shows, from 2015-16 to 2017-18, the percentage of institutional deliveries hovered or slightly changed in most states, and significantly changed in only a few states and UTs.
In Chhattisgarh and Jharkhand, institutional deliveries increased by more than 10 percentage points. However, institutional deliveries declined by 20.4 percentage points in Lakshadweep and 24.6 points in Daman and Diu. Among larger states, institutional deliveries declined in UP, Bihar, Madhya Pradesh, Kerala, Gujarat, Andhra Pradesh, Tamil Nadu, Assam and Odhisa during the period.
“In developing countries, home delivery is a strong predictor of infant and maternal deaths. The percentage of deliveries in public or private healthcare facilities reflects the level of access to basic healthcare services,” the report said. – TOI