Institutional deliveries in India on the rise, but home deliveries still a norm: Govt data

NEW DELHI: Institutional deliveries in India have seen a hike, but home deliveries continue to be a norm, especially in the north-east and some north Indian states like Uttar Pradesh, Uttarakhand and Delhi in 2021-22, as per the latest health ministry data.

Three states, including Telangana and Tamil Nadu, and two union territories, reported hundred per cent institutional deliveries in 2021-22, while nine states, including Karnataka, Kerala, Andhra Pradesh, Gujarat, and Maharashtra, saw over 99 per cent births in institutes.

Puducherry and Lakshadweep are the two union territories that saw one hundred per cent institutional deliveries in the same period.

States	Institutional delivery                (2021-22)
Tamil Nadu	100 per cent
Telangana	100 per cent
Goa	100 per cent
Puducherry	100 per cent
Lakshadweep	100 per cent
Karnataka	99.9 per cent
Kerala	99.9 per cent
Andhra Pradesh	99.9 per cent
Gujarat	99.8 per cent
Dadra and Nagar Haveli and Daman and Diu	99.6 per cent
Sikkim	99.5 per cent
Maharashtra	99.4 per cent
Punjab	99 per cent
All India	95.5 per cent

However, there cause for concern is that states like Meghalaya, Nagaland, Manipur, Bihar, Uttarakhand, Mizoram, Assam, Uttar Pradesh, Arunachal Pradesh, Himachal Pradesh, Tripura, Jammu and Kashmir and Delhi in 2021-22 have reported home deliveries more than the national average of 4.5 per cent.

In 2020-21, also, these 13 states reported a high number of home deliveries, more than the all-India percentage of 5.2 per cent, according to the latest report of the Health Management Information System (HMIS), which is a complete source of information for facility level health data nationwide.

Experts said institutional deliveries are important to reduce Maternal Mortality Ratio (MMR) in India and home delivery is still happening because hospitals are still not readily accessible in far-fetched areas. MMR in India has declined from 130 in 2014-16 to 97 in 2018-20.

Institutional deliveries in India increased from 70.6 per cent in 2008-09 to 95.5 per cent in 2021-22. In 2021-22, only Meghalaya saw 57.2 per cent of institutional deliveries. In 2020-21, only Tamil Nadu, Puducherry and Lakshadweep had achieved hundred per cent institutional deliveries.

 Though home delivery saw a slight dip in the last two years, two states – Meghalaya and Arunachal Pradesh – saw a hike last year. While in 2020-21, home delivery in Meghalaya was 40.6 per cent, it went up to 42.8 per cent in 2021-22.

Similarly, in Arunachal Pradesh, home delivery was 8.8 per cent. It touched 9.4 per cent last year.

Surprisingly, Delhi also figures among the 13 states where home delivery is still occurring. Though, there is a slight dip in percentage. In 2020-21, the figure stood at 5.4 per cent, it was 4.7 per cent in 2021-22.

States	Home Delivery (2021-22)
Meghalaya	42.8 per cent
Nagaland	21.7 per cent
Manipur	19.4 per cent
Bihar	13.3 per cent
Uttarakhand	11.5 per cent
Mizoram	12.8 per cent
Assam	8.7 per cent
Uttar Pradesh	8.8 per cent
Arunachal Pradesh	9.4 per cent
Himachal Pradesh	7.3 per cent
Tripura	5.4 per cent
Jammu and Kashmir	5.1 per cent
Delhi	4.7 per cent
All India	4.5 per cent

In India, 1067470 home deliveries were reported in 2020-21 and 922637 in 2021-22.

“The maternal delivery at home without skilled care at birth is a major public health issue. Maternal death is a severe public health problem where home delivery without skilled care at birth has a significant detrimental impact,” said the HMIS analytical report.

“Most importantly, as women die from preventable causes during childbirth, non-institutional or home delivery needs to be eliminated. Sustainable Development Goal 3 (SDG-3) targets: “reducing the global MMR to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average,” the report further added.

Prof. Dileep Mavalankar, Director, Indian Institute of Public Health (IIPHs), Gandhinagar, Gujarat, said home delivery happens in places where hospital delivery is not easily accessible or not affordable. Also, women prefer home delivery due to tradition or fear of caesarean section or instrumental delivery.

“To reduce MMR further, we need to improve emergency obstetric services and availability of blood transfusion at Community Health Centres or sub-district level,” Mavalankar, an expert on maternal health, told TNIE.

Dr S. Shantha Kumari, past president of the Federation of Obstetric and Gynecological Societies of India (FOGSI), told TNIE that institutional deliveries are essential to reduce MMR and home deliveries are still happening due to socio-economic and cultural barriers in northeast states, and rugged hilly terrain where medical facilities are not readily available.

“The review of HMIS data in India shows that despite major initiatives taken by the government in the last ten years, some states still show high home deliveries,” the report added.

NEW DELHI: Institutional deliveries in India have seen a hike, but home deliveries continue to be a norm, especially in the north-east and some north Indian states like Uttar Pradesh, Uttarakhand and Delhi in 2021-22, as per the latest health ministry data. Three states, including Telangana and Tamil Nadu, and two union territories, reported hundred per cent institutional deliveries in 2021-22, while nine states, including Karnataka, Kerala, Andhra Pradesh, Gujarat, and Maharashtra, saw over 99 per cent births in institutes. Puducherry and Lakshadweep are the two union territories that saw one hundred per cent institutional deliveries in the same period. States               Institutional delivery                (2021-22)   Tamil Nadu      100 per cent          Telangana            100 per cent         Goa      100 per cent      Puducherry      100 per cent      Lakshadweep      100 per cent    Karnataka   99.9 per cent Kerala   99.9 per cent Andhra Pradesh    99.9 per cent Gujarat       99.8 per cent Dadra and Nagar Haveli and Daman and Diu      99.6 per cent Sikkim         99.5 per cent   Maharashtra      99.4 per cent Punjab       99 per cent All India       95.5 per cent   However, there cause for concern is that states like Meghalaya, Nagaland, Manipur, Bihar, Uttarakhand, Mizoram, Assam, Uttar Pradesh, Arunachal Pradesh, Himachal Pradesh, Tripura, Jammu and Kashmir and Delhi in 2021-22 have reported home deliveries more than the national average of 4.5 per cent. In 2020-21, also, these 13 states reported a high number of home deliveries, more than the all-India percentage of 5.2 per cent, according to the latest report of the Health Management Information System (HMIS), which is a complete source of information for facility level health data nationwide. Experts said institutional deliveries are important to reduce Maternal Mortality Ratio (MMR) in India and home delivery is still happening because hospitals are still not readily accessible in far-fetched areas. MMR in India has declined from 130 in 2014-16 to 97 in 2018-20. Institutional deliveries in India increased from 70.6 per cent in 2008-09 to 95.5 per cent in 2021-22. In 2021-22, only Meghalaya saw 57.2 per cent of institutional deliveries. In 2020-21, only Tamil Nadu, Puducherry and Lakshadweep had achieved hundred per cent institutional deliveries.  Though home delivery saw a slight dip in the last two years, two states – Meghalaya and Arunachal Pradesh – saw a hike last year. While in 2020-21, home delivery in Meghalaya was 40.6 per cent, it went up to 42.8 per cent in 2021-22. Similarly, in Arunachal Pradesh, home delivery was 8.8 per cent. It touched 9.4 per cent last year. Surprisingly, Delhi also figures among the 13 states where home delivery is still occurring. Though, there is a slight dip in percentage. In 2020-21, the figure stood at 5.4 per cent, it was 4.7 per cent in 2021-22. States       Home Delivery (2021-22) Meghalaya  42.8 per cent                       Nagaland                          21.7 per cent                         Manipur                              19.4 per cent                     Bihar                           13.3 per cent                           Uttarakhand                               11.5 per cent               Mizoram                    12.8 per cent                              Assam                                  8.7 per cent             Uttar Pradesh                8.8 per cent                Arunachal Pradesh             9.4 per cent                 Himachal Pradesh                   7.3 per cent Tripura      5.4 per cent Jammu and Kashmir    5.1 per cent Delhi     4.7 per cent                      All India                                 4.5 per cent     In India, 1067470 home deliveries were reported in 2020-21 and 922637 in 2021-22. “The maternal delivery at home without skilled care at birth is a major public health issue. Maternal death is a severe public health problem where home delivery without skilled care at birth has a significant detrimental impact,” said the HMIS analytical report. ALSO READ | SC asks AIIMS to examine if 29 weeks pregnancy can be terminated “Most importantly, as women die from preventable causes during childbirth, non-institutional or home delivery needs to be eliminated. Sustainable Development Goal 3 (SDG-3) targets: “reducing the global MMR to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average,” the report further added. Prof. Dileep Mavalankar, Director, Indian Institute of Public Health (IIPHs), Gandhinagar, Gujarat, said home delivery happens in places where hospital delivery is not easily accessible or not affordable. Also, women prefer home delivery due to tradition or fear of caesarean section or instrumental delivery. “To reduce MMR further, we need to improve emergency obstetric services and availability of blood transfusion at Community Health Centres or sub-district level,” Mavalankar, an expert on maternal health, told TNIE. ALSO READ | Delhi: ‘Miraculous’ delivery of baby after complicated IVF pregnancy Dr S. Shantha Kumari, past president of the Federation of Obstetric and Gynecological Societies of India (FOGSI), told TNIE that institutional deliveries are essential to reduce MMR and home deliveries are still happening due to socio-economic and cultural barriers in northeast states, and rugged hilly terrain where medical facilities are not readily available. “The review of HMIS data in India shows that despite major initiatives taken by the government in the last ten years, some states still show high home deliveries,” the report added.