The administration in Uttarakhand’s Nainital district has built on an existing ‘doli’ (palanquin) service for pregnant women to facilitate institutional deliveries in villages in hilly areas which have poor road connectivity to hospitals. This service will help women when they go into labour as well as for their antenatal check-ups.
In Nainital, over half of the population lives in hilly areas, and this service will be available in the remote villages of five blocks—Ramgarh, Dhari, Okalkanda, Betalghat and Bhimtal. A palanquin service is already in practice in certain hilly villages which are not accessible by vehicles. In such areas, villagers ferry pregnant women on a makeshift palanquin to hospital or the nearest road where they can get transport.
Under the National Health Mission (NHM), the Central government provides an incentive of Rs 2,000 per visit of the palanquin. However, the number of visits a palanquin can make to a district is limited to just 60, and a woman can avail the facility only once — either for the antenatal check-ups or for delivery.
The Nainital administration found that such restrictions discouraged the practice. In order to encourage pregnant women to visit hospitals by using this facility, a sum of Rs 10 lakh has been allocated so that palanquins can make 500 visits to the district per year, and a pregnant woman can avail of the service as many times as she wants.
“Reimbursement (of Rs 2,000) will be done for each visit. If found required, number of visits would be increased further and budget will be provided,” Nainital District Magistrate Savin Bansal said. He said the Chief Medical Officer will transfer the budget to the medical officer in-charge of hospitals.
The administration has also planned to procure palanquins for those gram panchayats where the palanquins are in poor condition. These villages will be identified by January 15, and these palanquins will protect the woman from sun and rain, will have sanitized sheets and pillows and will have ample space to carry necessary baggage. “A comfort level will be maintained,” Bansal said.
According to the Uttarakhand Medical Health and Family Welfare Department, the infant mortality rate (IMR) in the state is 32, Maternal Mortality Ratio is 165 and institutional delivery percentage is 87.
As per a special bulletin on maternal mortality in the period 2016-18, released by the office of the Registrar General of India (RGI) earlier this year, the national Maternal Mortality Ratio (MMR) had declined to 113 from 122 in the period 2015-17. As per that report, the MMR in Uttarakhand was 99 and maternal mortality rate was 6.4 in 2016-18.
According to data released by the RGI in May, the national infant mortality rate was 32 in 2018, while the figure for Uttarakhand in the corresponding period was 31.
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