Even as India battles Covid-19, data from two states, Chhattisgarh and Jharkhand, shows that the number of institutional deliveries of children has begun to drop.
Senior officials in Jharkhand said that while the state had listed 52,000 women for scheduled deliveries in May, only 5.9 per cent of these were conducted in medical institutions by May 21. Meanwhile, data compiled by the Chhattisgarh government shows that deliveries dropped 15.39 per cent in April from the numbers recorded in March.
Over the past two decades, India has made progress in increasing the number of institutional deliveries. According to NFHS 4, institutional deliveries went up to 79 per cent in 2015-16 from 39 per cent in 2005-06. Institutional births in public institutions went up from 18 per cent to 52 per cent in the same time period.
In Chhattisgarh, the percentage of institutional deliveries went up to 70.2 from 44.9 between NFHS 3 (2005-06) and NFHS 4, while in Jharkhand the corresponding increase was from 40.1 per cent to 61.9 per cent.
Government data accessed by The Indian Express shows that in February 2020, before the lockdown was imposed, Chhattisgarh recorded 37,984 institutional deliveries, which rose to 38,449 in March. Following the lockdown, the number of institutional deliveries fell to 32,529 in April.
Of the 28 districts in Chhattisgarh, 20 saw a drop in numbers in April, while eight districts saw marginal increase. Some districts recorded a steep drop from March to April. Durg, for instance, saw 3,752 deliveries in March and only 1,583 in April, a drop of 57.8 per cent. Similarly, Bilaspur saw a drop of 45.35 per cent.
A district collector from Chhattisgarh said the drop was a cause of concern, but it was expected because of three main factors. “The first is that when the lockdown was imposed, public transport was off the roads. So getting to hospitals from villages became difficult. While people could use private vehicles, there was a fear of delay and being stopped by overzealous officials. The second was the fear of hospitals, as many thought they would get Covid there. The third clear reason is that many deliveries would happen at small private nursing homes. In the Covid atmosphere, many have shut shop,” the official said.
Chhattisgarh Health Minister T S Singhdeo told The Indian Express, “We have been reviewing it every week. The figures dropped as coming and going from villages was very restricted. We have taken it as a challenge, and movement has improved. The department is holding up bravely. Even in vaccinations, initially there was a drop, but we paid attention to non-Covid health concerns, and that has gone up to 94 per cent.”
Earlier this month, after the Jharkhand High Court rapped the state over reports of two stillborn children due to lack of health facilities, Principal Health Secretary Nitin Kulkarni had stated, “As of date we have a list of 52,000 pregnant mothers who may deliver child in May and we have asked all health establishments to be ready. If the delivery is expected in the next few days all the tests need to be done now.”
However, as on May 21, only 3,070 deliveries happened across Jharkhand’s government institutions such as district hospitals and community health centres.
Kulkarni said: “As many as 26,870 deliveries were conducted in CHCs, Sadar Hospitals in April. And till May 21, only 3,070 deliveries were conducted.”
April had already witnessed a 20 per cent drop from the usual delivery figures of 35,000-37,000 in the state.
Asked for reasons for the dip in Jharkhand, Kulkarni said, “The 52,000 are listed numbers, of which 30% do not go for institutional delivery. As for the rest, the numbers will increase by the month end. The entire health machinery is battling Covid-19, so non-Covid health services took a toll. Secondly, there is a general health scare among patients and health workers. Patients do not want to go to hospitals.”
The stillborn birth of photo-journalist Vinay Murmu’s child after a frantic search for hospitals in Ranchi was taken up by the Jharkhand High Court. In its response, the Health Department said that Murmu was advised to go to Rajendra Institute of Medical Science (RIMS) Ranchi but instead he went to CHC Doranda, adding that it appeared that the death happened much earlier.
Murmu, however, said, “At RIMS pregnant women were said to be testing Covid-19 positive and we were scared. However, at Sadar Hospital there was no staff. At CHC Doranda I did not get any response. At last I went to Gurunanak Hospital where my child was declared stillborn.”
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