Centre’s mother care scheme delivers

If latest data released by the health ministry is anything to go by, Indian mothers appear to be in the pink of health. Thanks to aggressive government intervention under the Janani Suraksha Yojana (JSY), there has been a sharp rise in the number of institutional deliveries. Post-natal care has also improved, leading to a steep decline in maternal (MMR) and infant mortality rates (IMRs).

Surveys by independent institutions Registrar General of India and International Institute for Population Sciences, Mumbai, reveal that the number of institutional deliveries increased from 40.9% in 2002-04 to a national average of 69% in 2008-09. The state-wise breakup is as follows: Jharkhand (lowest 18.3%), Chhattisgarh, UP and Meghalaya below 40%, and Puducherry (highest 100%), Tamil Nadu (TN), Karnataka, Arunachal, Andhra Pradesh, Delhi, Dadra and Nagar Haveli, Andaman and Nicobar Islands, Lakshadweep (100%), Daman and Diu (100%), MP, Maharashtra and Gujarat above 80%.

Besides, there has been a close to 15%-45.9% (2002-04) to about 60% (2008-09) - jump in immunisation of children aged up to 2 years. MMR is down to 254 (2004-06) from 301 per lakh live births (2001-03) and IMR to 55 (2007) from 58 per 1,000 live births (2005).

JSY is a safe motherhood intervention programme under the national rural health mission to reduce maternal and neo-natal mortality by promoting institutional deliveries among poor pregnant women. It is a 100% centrally-sponsored scheme, under which the government pays Rs1,400 per institutional delivery to rural poor women and Rs1,000 to urban poor women. The government tracks these women through accredited social health activists and anganwadi workers.

JSY’s evaluation revealed a shift in institutional deliveries from district hospitals to community health centres and primary health centres where over 70% deliveries taking place. Besides, many births take place in homes with the assistance of skilled attendants.

The national average for such ‘safe’ deliveries was 84%, with Puducherry, Daman & Diu and Lakshadweep topping the chart at 100% each. Chandigarh was at the bottom with 8.3%.

Goa, Chandigarh and Meghalaya reported less than 45% ‘safe’ deliveries, while Puducherry, TN, Karnataka, Arunachal, Daman and Diu, Lakshadweep and Andhra reported above 95%. Eighteen other states and union territories reported above 84% such deliveries.

The results for early breastfeeding were, however, not as encouraging, with the national average of newborns breastfed within an hour of birth in 2008-09 being 26.7%. The ratio of newborns breastfed within an hour of birth and the number of women staying in hospitals for at least 48 hours post delivery was about 2/3, which means at least 1/3rd of the women delivering in public institutions did not breastfeed newborns within an hour of delivery.

A woman delivering in an institution is required to stay put for at least 48 hours for doctors to monitor her recovery, since about 60% of deaths occur in the post-partum period with most complications arising in the first 48 hours.  The all-India figure for 48-hour stay post delivery in public institutions in 2008-09 was 76.5%. The national average for women receiving post-natal care within 48 hours of delivery in 2008-09 was 48%.