Wednesday, 14 February 2018 10:19

Institutional vs Non-Institutional deliveries in India

Written by

Institutional Vs. Non-institutional Deliveries – India

The care required to a woman during the period of her fertility i.e from age 15  when she gets matured sexually and socially, gets married, conceives and gives birth to children to age 44 years of her life when she begins to reach her menopause is very important. If the care taken during the childbearing process is not hygienic, then it can affect the reproductive and overall health of the woman as well as the health and well-being of the newborn. Hence, the place of delivery of the pregnant women is a significant aspect of reproductive health care of the mother as the quality of care received by the mother and the newborn baby depends upon the place of delivery.

 

What is institutional delivery?

Giving birth to a child in a healthcare institution under the overall supervision of trained and competent health personnel where there are more amenities to handle the situation to care and save the life of the child and mother is Institutional delivery.

Giving birth at home is Non - institutional delivery. The chances of getting infected from the unhygienic environment are more in the case of delivery of a child at home. Sometimes, it is very tough or impossible to handle childbirth complications.

The ancient method of delivering the child at home is still prevalent practice in India. It is seen to be more common in rural areas as compared to urban areas.

Institutional births result in reduced infant and maternal mortality and increased overall health status of the mother and the child.

 

Institutional and Non-institutional Deliveries

According to 2001 census in India, a look at the break-up of the place of last delivery reveals that 59% of the children were delivered at an institution and the remaining 41% were given birth at home

Main Reasons for Delivering at the Institution

Reasons for Delivering

Response Rate % (No.)

Delivery is easy and convenient

73.7 (87)

Faith in doctor

21.2 (25)

Proximity to the hospital

19.5 (23)

Problems related to home deliveries

13.6 (16)

Advised by health functionaries

12.7 (15)

Worry about infection at home

6.8 (8)

All previous deliveries were at institution

5.9 (7)

Precipitate labor

4.2 (5)

 

 

At Home

Reasons for Delivering

Response Rate % (No.)

Cultural practice

68.3 (56)

Inadequate systems including a shortage of supplies and drugs in hospitals

25.6 (21)

Home delivery is easy and convenient

24.4 (20)

Poor quality of care

20.7 (17)

Onset of labor before the expected date/Precipitate labor

14.6 (12)

Distance of the hospital

13.4 (11)

Lack of transportation

9.8 (8)

Lack of escort during labor

8.5 (7)

All previous deliveries were at home

6.1 (5)

Fear about hospital

4.9(4)

Fear of surgical procedures

4.9 (4)

Family members preference for home delivery

3.7 (3)

Financial problems at home/worries about cost of care in the hospital

3.7 (3)

Inappropriate referral system leading to overcrowding in urban hospitals

3.7 (3)

Negative attitude of staff in health facilities

2.4 (2)


Place of Delivery

The following table shows the total percentage of children born in an institution, 89% of the deliveries were conducted in government facilities and only 11% had utilized the services of private healthcare sectors.

The old customs have played a vital role in case of place of the delivery of a child when it is non-institutional delivery. It is unfortunate that a woman bringing a new life on the earth sometimes treated as impure by her own family until she is allowed inside house only after having bath.  Hence about 32% of the deliveries were conducted either in a separate room or outside the home surrounded by a wall of a cloth or at the backyard.

Institutional deliveries

Non-institutional deliveries

Government hospital

Private

hospital

Inside the

house

Outside the house

In a room

Backyard of the house

89.0

(105)

11.0

(13)

61.0

(50)

4.9

(4)

31.7

(26)

2.4

(2)

No*: People involved in the survey.

 

Indian states ranking by institutional delivery

This is a list of the States of India ranked in order of percentage of children delivered in hospital. This information was gathered from Family Welfare Statistics 2011.[1][2]

Rank

States

Institutional delivery (%) Family Welfare Statistics 2011

Rank

States

Institutional delivery (%) Family Welfare Statistics 2011

1

Kerala

99.8

19

Jammu and Kashmir

76.1

1

Tamil Nadu

99.8

20

Manipur

75.5

3

Goa

99.5

21

Punjab

68.5

4

Andhra Pradesh

94.4

22

West Bengal

68.5

5

Arunachal Pradesh

94.2

23

Nagaland

66.8

6

Karnataka

93.7

24

Himachal Pradesh

63.5

7

Gujarat

91.8

25

Uttarakhand

60.7

8

Maharashtra

90.7

26

Uttar Pradesh

57.9

9

Rajasthan

88.5

27

Chhattisgarh

54.4

10

Bihar

85.4

U/T

Meghalaya

44.8

11

Madhya Pradesh

83.9

U/T

Puducherry

99.9

12

Tripura

83.6

U/T

Andaman and Nicobar Islands

98.7

13

Odisha

82.3

U/T

Delhi

95.3

14

Sikkim

81.8

U/T

Chandigarh

89.0

15

Mizoram

81.4

U/T

Daman and Diu

87.8

16

Haryana

80.2

U/T

Lakshadweep

73.4

17

Assam

78.1

U/T

Lakshadweep

54.4

18

Jharkhand

77.8

 

 

 

Programs by government to encourage institutional delivery

Many programs in India like the Child Survival and Safe Motherhood (CSSM) and the Reproductive and Child Health (RCH) programs are focused on this aspect. 

Under these programs, encouraging deliveries in proper hygienic conditions only by trained health staff and to provide better health care to the mothers and children are emphasized. Our government’s commitment in this direction is reflected in the goals of the National Population Policy (NPP), National Health Policy (NHP), and the National Rural Health Mission (NRHM) launched by the Honorable Prime Minister of India on 12 April 2005. The NRHM has a safe motherhood intervention program (Janani Suraksha Yojana-JSY). The objective of JSY is to reduce Maternal Mortality Rate (MMR) and Neo-natal Mortality Rate (NMR) through the promotion of institutional deliveries.

References: Health and Population: Perspectives and Issues Vol. 32 (3), 131-140, 2009

SUGATHAN K.S., VINOD MISHRA & ROBERT D. RETHERFORD (2001): Promoting Institutional Deliveries in Rural India: The Role of Ante-natal Care Services; National Family Health Survey Subject Reports, Number 20, December. 2. National Rural Health Mission (2005-2012), Mission Document, Ministry of Health and Family Welfare, Government of India. 3. International Institute for Population Sciences (1995): National Family Health Survey: Punjab 1992-93, Bombay, IIPS. 4. International Institute of Population Sciences and ORC Macro (2001): National Family Health Survey: Punjab 1998-‘99, Bombay, IIPS. 5. www.nfhsindia.org/factsheets. 6. Census of India 2001; Registrar General of India. 7. RAJESWARI BALAJI, DILIP T.R. & RAVI DUGGAL (2003): Utilization and Expenditure on Delivery Care Services: Some Observations from Nashik District, Maharashtra’, Regional Health Forum, WHO South-East Asia Region, Vol. 7, No. 2, 2003. 8. http://wcd.nic.in/nationalguidelines.pdf

 

[quix id='8' name='About our Pregnancy Blogs and Videos']

Last modified on Monday, 09 March 2020 06:00
Dr Padma

Dr Padma is a Family care physician and is the Founder and CEO of MedHealthTV.

www.medhealthtv.com

Leave a comment

Make sure you enter all the required information, indicated by an asterisk (*). HTML code is not allowed.