In what can be read as signs of India’s expanding health network and increasing medical awareness, more children are being born in government and private medical institutions than ever before, according to the Sample Registration System (SRS) survey for the year 2018.
The increase in deliveries at medical institutions comes at the cost of births supervised by ‘qualified professionals’ such as doctors, nurses and midwives, and those by untrained functionaries such as relatives.
Nearly 82.5% of all live births in India that were documented for this survey happened either at government or private hospitals. In 2017, this figure was 81.8% and in 2016 at 80.8%.
At the same time deliveries that were supervised by a ‘qualified professionals’ dropped from 10.3% in 2016, to 9.9% in 2017 to 9.7% in 2018. Deliveries that were not supervised by any medical professional but by ‘untrained functionaries’, most likely at homes, also dropped consistently from 8.9% in 2016 to 8.2% the following year to 7.8% in 2018.
Kerala was the only state in the country where more births were registered in private institutions, 54.9%, than in government institutions, 44.9%. In Rajasthan, fewest deliveries were registered in private institutions, 17.7%, consequently the proportion of deliveries at government institution was highest in the country at 70.8%.
Only three states among the 22 states and Union Territories that were surveyed by the census commissioner’s office had a very high proportion of deliveries
carried out by ‘untrained functionaries’ — Jharkhand, Bihar and Uttar Pradesh had such deliveries, carried out with any medical supervision. 21.3% of deliveries registered in Jharkhand were carried out through without medical supervision. In fact, almost as many deliveries were carried out by ‘unqualified professionals’ in the state as were registered in private hospitals, 21.7%.
Jharkhand was followed by Bihar at 19% and Uttar Pradesh at 13.9%. Only these three states registered the proportion of non-institutional, non-medically supervised, live births in double digits. They have consistently been occupying the top three places, in the same order, in this unenviable category for at least three consecutive years now, starting from 2016.
Their tallies show the huge disparity that exists within the country in the primary healthcare system. A look at states such as Kerala, Andhra Pradesh, Tamil Nadu, with more robust networks of institutional healthcare exemplifies this gap. Only 0.1% of all the births that happened in Kerala in 2018 happened without proper medical supervision. The same proportion of births was registered in Delhi as well. In Tamil Nadu and Andhra Pradesh this figure stood at 0.2%. A total of 81 lakh people in 22 states and UTs were surveyed for the 2018 SRS.