Gujarat's poor performance in health indices, particularly having a high percentage of babies with low birth weight as revealed in the Niti Aayog's Health Index report, is perhaps a reflection of grand schemes staying put on paper.
Gujarat ranks eighth among 21 big states as far as high proportion of babies with low birth weight is concerned. In fact, Gujarat's performance deteriorated from the base year to reference year. The percentage of low birth weight babies among newborns rose from 10.5% to 12.3%. States like Bihar, Uttar Pradesh and Chhattisgarh had better performance on these indices than Gujarat.
Experts in the field of child and maternal health say it is nothing but a reflection of the poor maternal health which results in low birth weight of babies. Babies with low birth weight are prone to neonatal deaths than babies with normal birth weight. Gujarat also performs poorly in neonatal deaths.
Sandhya Choksi, who was earlier associated with Sahaj, an organisation that works on child and maternal health, said there is no dearth of schemes for child and maternal health.
"The health of a newborn is directly dependent on the health of the mother and in Gujarat we have a lot of schemes to take care of it. Unfortunately, all these schemes often remain at the bureaucratic level," said Choksi.
She said there is lack of awareness about these schemes. "For example, three months into pregnancy a mother is entitled to help from the state for nutritious food. But pregnant women, particularly in tribal and poor areas, are not aware of these schemes. Even if they come to know of them, there are a whole lot of documents to be produced before they can access these schemes which often acts as hindrance," she said.
Choksi, who has dealt with a lot of health officials to apprise them of the situation, said many genuinely believe that the schemes were reaching the poor. "They would show us records that were excellent. But they were not aware whether those in the records were actually getting access to these schemes or not," said Choksi.
Divya Ravindranath, a researcher in maternal health who works with migrant population, said many of the migrant mothers and their newborns stay bereft of the schemes because they don't stay at one place.
"Moreover, one more important aspect is that in tribal areas women still prefer to give birth at home. Overall, Gujarat's institutional delivery rate must be excellent but a look at the NFHS 4 report will show that in tribal pockets it is worse than some of the poorest places in the country," said Ravindranath.
She said the fact that some of the most vulnerable population can't access institutional deliveries automatically translates to them being denied many other entitlements available for pregnant women and their newborns. "This is because a lot of the schemes available also ask for details of the hospital where the delivery takes place. In the absence of such details, the person concerned may no longer have access to it," siad Ravindranath.
It should be noted that though Gujarat ranks second in the country in institutional deliveries (91.6%) but the number of such deliveries has come down from the previous year when it was 97.8%.
