During Covid-19 lockdown, births at clinics plummet by 40%
Savitri Devi, 22, of Lucknow’s Narsingh Khera village, delivered a baby boy at her house on the first day of lockdown . The lockdown prevented her from travelling to a government-run health care centre where she would have otherwise given birth.
Mother and son are fine but her story is the story of thousands of women who delivered children at home because they couldn’t travel to the nearest community health centre or a hospital .
Data from states such as Uttar Pradesh, Bihar, West Bengal, Jharkhand, Odisha and Chhattisgarh shows that the number of institutional deliveries may have fallen by as much as 40% during the lockdown. That’s significant because institutional deliveries are believed to be behind the major strides India has made in reducing maternal and infant mortality in recent decades.
“Institutional delivery improves survival chances for a newborn manifold,” said Sayeeda Hamid, who was member in-charge of health in the Planning Commission for a decade till 2014. . “It is sad that institutional deliveries have come down but, I think, it is a temporary phase because of the lockdown. State governments should ensure proper supplements for mothers and their kids through Asha workers,” she said.
Infant mortality rate (IMR) has fallen from 129 per 1,000 live births in 1971 to 32 in 2018, according to Census Commissioner of India’s website. The biggest dip in IMR was between 2008 and 2018 with improvement in health infrastructure in rural areas. Similarly, the maternal mortality rate has fallen from 22 in 2008 to 12 per 1,000 live births in 2018, according to National Institution for Transforming India (NITI) Aayog.
According to National Family Health Survey, the proportion of institutional deliveries in India has increased from 38.7% in 2005-6 to 78.9% in 2015-16 due to improvement in rural health infrastructure and the presence of health workers in every village to monitor health of pregnant woman.
“Bihar reported 90,000 institutional deliveries during the first 30 days of the lockdown (March 25 to April 25), as compared to an average of 1.50 lakh deliveries a month,” a Bihar government health department official said on condition of anonymity. In Uttar Pradesh, the institutional deliveries in April was 98,515 compared to a monthly average of 1,12,681,said Mithilesh Chaturvedi, UP’s director, family welfare, adding that instructions have been issued to ensure all expecting mothers are admitted and those symptomatic, tested for Covid.
Jharkhand’s health secretary Nitin Kulkarni said that institutional deliveries in May dropped to 35,000 as compared to monthly average of about 50,000 in the first four months of this calendar year. “As compared to 80% institutional delivery rate in Jharkhand in 2019, the number during the lockdown period is around 55%,” said Dr Shailesh Chourasia, managing director, national health mission.
In Chhattisgarh, only 20,013 institutional deliveries were recorded in the month of April, as compared to 30,629 in the previous month. The number has witnessed slight increase in May but it is still less than the monthly average of about 34,000 institutional deliveries, officials said.
“People in villages are hesitant to come out thinking they would not be able to return to their villages. Moreover, non-Covid services were not available in most of the hospitals,” explained Deepak Soni, the collector of Dantewada district , which has seen the highest proportion of home deliveries in the state.
According to health department officials in West Bengal, institutional deliveries have reduced by around 25-30% during lockdown. “On an average around one lakh institutional deliveries take place every month. During the lock down it has gone down to around 70,000 to 75,000,” said a health department official, who asked not to be named. Most rivate nursing homes in the state were closed in April.
Odisha’s director family welfare, L Mishra, said that there has been some decrease in the institutional deliveries , but not much, because Odisha was the first state to have exclusive Covid-19 hospital that did not hamper routine hospital work in other government hospitals. “Close to 80% of the births took place in government run institutions during the lockdown period in April and May, 2020,” he said.
Those women fortunate enough to get to a hospital or a health centre in time, did so after jumping through hoops.
Radha Kumari, delivered a baby girl, her first child, at the Patna Medical College Hospital (PMCH) on Friday morning, but after her husband Golu Kumar, 21, a tile mason, ran around -- from a private hospital to a government run medical centre to PMCH. .
They reached PMCH at 4am on Friday and had to wait for several hours to get a bed. Finally, Kumari delivered a baby girl around 11 am.
In Uttar Pradesh’s Mathura district, Rajender Kumar hired a taxi for Rs 5,000 to take his wife Geeta, to the district hospital, 20 km away from their home. “There was no response at the government helpline number. I called a taxi owner, who agreed after much persuasion. At the hospital, they (hospital administration) refused to admit her saying she did not have a Covid free certificate. They later allowed her entry when I signed an undertaking that hospital will not be responsible if she tests positive for Covid,” he said.
In Narsingh Khera, Savitri Devi’s troules didn’t end with the birth of the child. She and her husband are now struggling to ensure post-birth check-ups for her and also or the child.
(With inputs from HTC New Delhi, Kolkata and Agra)