In the fifth round of National Family Health Survey (NFHS), a drop in marriages taking place before girls turn 18 has been recorded with only 21 per cent of the surveyed women reporting such marriages as compared to 26.3 per cent in 2015-16. The latest NHFS-5 has also indicated a small drop in teenage pregnancy from 8.3 per cent to 7.6 per cent between 2015-16 and 2019-20 in Maharashtra.
Data shows there is vast disparity in teenage pregnancy in rural and urban areas with 10.6 per cent teenagers in rural areas found to be pregnant or with a baby, as compared to 3.9 per cent in urban areas.
A shift in family planning methods was also noted with men getting more involved in using contraception. Condom use rose from 7.1 per cent to 10.2 per cent, more so in urban areas in the last four years while use of contraceptive pills by women dropped from 2.4 per cent to 1.8 per cent. Overall female sterilisation methods have also noted a drop from 50.7 per cent to 49.1 per cent.
Although out-of-pocket expenditure on delivery in government hospitals in Maharashtra is higher than Kerala or Tamil Nadu, within the state there is a drop from Rs 3,578 to Rs 2,966 in the last four years. Spending is higher in cities for delivery in a government set-up at Rs 3,390 as compared to Rs 2,675 in rural areas.
Other indicators like owning a bank account, mobile phone and employment have also improved for women. At least 34.7 per cent women reported they had worked and earned in the last 12 months, a jump from 28.9 per cent from 2015-16.
The government’s push for direct bank transfer for a number of schemes recorded an uptake in the creation of bank accounts — 72.8 per cent women now have a bank account in contrast to 45.3 per cent until four years back, and 54.8 per cent women own a personal mobile phone as compared to 45.6 per cent as per NFHS-4.
A state health official said the government focused on maternal, child health and family planning that drove these changes.
However, while most health indicators have improved, anaemia rates have worsened in children as well as women over the past four years. Iron deficiency can cause weakness and premature deliveries. The NFHS-5 data shows 57.2 per cent women in the age group of 15 to 49 years are anaemic, a rise from 49.7 per cent in NFHS-4. In urban areas, anaemia rates are slightly lower than rural areas.
For children aged between six months and five years, 68.9 per cent were found to be anaemic as compared to 53.8 per cent as per the previous survey.
“The fall in nutritional status of children and women is of concern. It may be indirectly linked with demonetisation and rising rates of unemployment, affecting the family’s overall nutrition,” said public health expert Ravi Duggal.
Duggal added that Covid-19 has impacted several health programmes this year. The impact is not visible in the latest report. “From 2019 to 2020, there will be a huge drop in access to basic services,” he said.
State data shows 8.2 lakh in-patient admissions were noted from April 2019 to June 2020 across government hospitals, a drop from 14.4 lakh admissions in the same period the year before. Duggal said the drop was significant, especially in the months during lockdown this year.
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