The recent data from the states of Chhattisgarh and Jharkhand has indicated a decrease in institutional deliveries. Such deliveries refer to births taking place in a medical institution under the supervision of trained health personnel, representing a vital factor in reducing maternal and infant mortality. However, since the nationwide lockdown was imposed due to the ongoing Covid-19 pandemic, both states have reported sizeable drops in their numbers.
The Current Scenario in Chattisgarh
Data from Chattisgarh shows a reduction by 15.39% in April compared to March. The state had recorded 37,984 institutional deliveries in February 2020 before the lockdown. This number fell to 32,529 following the lockdown. Nevertheless, the state did record an increase in institutional deliveries from 44.9% to 70.2% between NFHS 3 (2005-06) and NFHS 4 (2015-16).
State of Affairs in Jharkhand
In Jharkhand, out of the 52,000 women scheduled for deliveries in May, only 5.9 % of these took place in medical institutions by May 21. Similar to Chattisgarh, Jharkhand reported an increase in institutional deliveries from 40.1 % to 61.9 % between NFHS 3 (2005-06) and NFHS 4 (2015-16).
Reasons Behind the Decrease in Institutional Deliveries
Several factors have been attributed to this decline in institutional deliveries. Public transport restrictions dramatically impacted accessibility to hospitals, particularly for villagers. Fear of infection led people to avoid named Covid-19 hospitals, with many opting for delivery at small private nursing homes instead to avoid potential exposure to the virus. Additionally, the strain of tackling Covid-19 has resulted in a decrease in available medical staff for non-Covid related health services.
A National Overview of Institutional Deliveries in India
Despite the recent downturn, India’s progress in increasing institutional deliveries has been noteworthy over the last two decades. According to the National Family Health Survey (NFHS-4), institutional deliveries rose from 39% in 2005-06 to 79% in 2015-16. Furthermore, births in public institutions climbed from 18% to 52% within the same period.
Steps Taken to Boost Institutional Deliveries
Several initiatives have been launched to promote institutional deliveries among pregnant women with the aim of reducing maternal and infant mortality. These include Janani Suraksha Yojana (JSY), a centrally sponsored scheme, and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), which focuses on conducting special AnteNatal Check-ups (ANC). The Pradhan Mantri Matru Vandana Yojana (PMMVY) is a maternity benefit programme implemented across all districts in the country since January 1, 2017. Finally, the LaQshya Programme aims to improve care quality in labour rooms and maternity operation theatres in public health facilities.
A Balanced Way Forward
Amid the Covid-19 battle, it is essential not to compromise on non-Covid health services, which form the bedrock of the country’s health infrastructure. Hence, the government should ensure sufficient medical staff and emergency medical services like ambulances, vaccinations, and maternity care, are available in both urban and rural areas. Balancing Covid and non-Covid medical services is crucial, and the government must ensure its effective implementation in the future.
