Himachal Performs Well In Institutional Delivery

Y.S. Rana

The writer is a Hamirpur based Himachali settled in Chandigarh

The score-sheet of directorate of health services, Himachal Pradesh compiled by the National Family Health Survey-4 (NFHS-4) conducted in 2015-16 and made available now, reads like a success story in health care. While in some fields, Himachal Pradesh has scored significantly, in other it has considerably improved upon its tally over the last survey conducted in 2005-06. Despite a sharp increase in institutional deliveries, the state recorded 76.4% though a marginal below the national average of 79%. Twelve States/UTs viz. Himachal Pradesh, West Bengal, Assam, Chhattisgarh, Manipur, Uttarakhand, Uttar Pradesh, Bihar, Jharkhand, Arunachal Pradesh, Meghalaya and Nagaland are below the National value 78.9% during 2015-16 (NFHS-4). Yet Himachal Pradesh did fare well when it comes to initiating breastfeeding within one hour of birth.

At 67% state is well ahead of Kerala and Tamil Nadu having the highest institutional births of 99.9% and 99.2% respectively across the country. According to the survey, despite institutional delivery recorded sharp increase nearly 79% nationally, the number of children in the country breastfed within one hour of birth is still less than 42% (near 43% in urban areas and 41% in rural India).

According to National Family Health Survey -4, Chandigarh tops the list with 91.6% followed by Punjab with 90.5% institutional deliveries. While Haryana recorded 80.5% and Jammu and Kashmir another hill state has 85.7% institutional deliveries. The state has also recorded decline in number of home delivery. While it was 5.4% in NFHS-3, it decreased to 3.4% in NFHS-4. It has also recorded a high jump in safe delivery 78.9% in NFHS-4, which was 47.9% in NFHS-3.

Dr Anadi Gupt, OSD-I, Directorate of Health Services, Himachal Pradesh, while talking to Himachal This Week on telephone said that the increasing trend in institutional deliveries in the state during the past one decade was an indicator of the improving quality of health care in public hospitals in general and of obstetric care in particular. He further stated that a number of initiatives taken by the state government in health sector played key role and resulted in big jump in institutional deliveries.

Janani Suraksha Yojana

The Janani Suraksha Yojana—cash incentives to pregnant women to attend antenatal clinics and opt for institutional deliveries has led to a sharp increase in institutional delivery from 43.1% in NHFS-3 to 76.4% in 2015-16, he added. He also revealed that the state has 74 hospitals, 12 dispensaries, 79 CHCs and 518 PHCs. There are around 57 medical institutions per lakh population in the state. A recent study by the University of Maryland and National Council for Applied Economic Research also revealed that JSY has succeeded in achieving its goal across the country. Besides, 108 national ambulance service played a major role in the state in providing quality health care.

Bihar Shows Improvement

Bihar has shown the most improvement in initiating breastfeeding within one hour of birth from four percent in 2005-06 to 35% in 2015-16. Punjab and Haryana in the region have also shown improvement on this front. All states have registered an improvement in the case of breastfeeding of children under six months of age.

Why It Is Important?

Understand why it is important for births to take place in an institution and assisted by a skilled attendant. First 24 hours after delivery are very crucial for the lives of mother and new born, says C.K. Mishra, Secretary, Ministry of Health and Family Welfare. Breastfeeding babies soon after birth can prevent a significant number of neonatal deaths. About 20% newborn deaths and 13% under-five deaths occur in India, according to Mishra. Thanks to the slew of initiatives taken by the state government in healthcare, health indices in the state are consistently making the ascending graph.

Top Performers

The health survey further reveals that increasing trend has been seen in India in percentage of Institutional births, 38.7% in 2012-13 (NFHS-3) and 78.9% in 2015-16 (NFHS-4). Kerala, Lakshwadweep and Puducherry have highest percentage of Institutional Births 99.9% during 2015-16 (NFHS-4). Nagaland has lowest percentage of Institutional Births 32.8% during 2015-16 (NFHS-4) in comparison to other states. Similarly, Maharashtra with 90% institutional deliveries has 57.5% for early initiation of breastfeeding.

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