Madhya Pradesh recorded a fall of 18.6% in institutional deliveries in April, the first month of the COVID-19 lockdown, casting a shadow on an improving trend, National Health Mission (NHM) data show.
Private and government-run health centres recorded 97,881 births in April 2019, around 18.1% more than the previous year. However, the count dipped to 79,619 in the corresponding month this year, the Health Management Information System, Ministry of Health and Family Welfare data showed. Institutional deliveries shot up to 90% in 2019, and were growing by 2-3% each year.
Diversion of health infrastructure for the pandemic, including accredited social health activists and auxiliary nurse midwives, and the 108 ambulance service, and disrupted transport network contributed to the decline, said an official of the NHM State unit.
“The pandemic inhibited people from visiting a health centre, fearing they would contract COVID-19. Further, many private health centres shut during the lockdown,” said Saloni Sidana, Additional Mission Director, NHM State unit.
In April, private centres in 17 districts registered no deliveries, while in the whole of 2019-20, six districts witnessed no deliveries at private centres.
Tribal districts hit
Witnessing fewer institutional deliveries, tribal districts, most of which have few private units and have low awareness levels, were further hit, said Dr. Sidana.
In three districts where at least every second person is a tribal, institutional deliveries dipped by 35% in Alirajpur, 25% in Jhabua and 20% in Barwani compared to April last year. Further, among districts worst hit by the pandemic, Indore saw a dip of 36%, Bhopal 31% and Ujjain 27%.
The State government, said Dr. Sidana, had directed district hospitals in all the 52 districts to reserve at least 30% services for non-COVID-19 care and to continue emergency care. “We are strengthening primary and secondary-level health services essential to deliveries,” she said.
The State had suffered a decline of 35% in real terms, explained Sachin Jain, a child rights worker with Vikas Samvad. “It is time the State government stopped promoting private health services and provided quality universal maternal and child health services,” he said.
Mr. Jain further said the decline pointed to non-functioning health institutions and restricted outreach services “Although the Centre’s order designates health services as essential, there is no system to implement it,” he said.
Did the government assume all deliveries would stop during the pandemic, asked Vandana Prasad, community paediatrician and public health professional. “Of course, we had to plan for COVID-19, but there are established forecasts for non-COVID-19 medical situations,” she said. According to Dr. Sidana, January-April and October-December see more deliveries. Efficient transport was the key in enabling institutional deliveries, Dr. Prasad said.
