In a revealing finding, 86 per cent of the deliveries in hospitals of Uttar Pradesh are conducted by auxiliary nurse midwives (ANMs) and eight in every 10 neonatal deaths occur within seven days of the birth and majority of these deaths take place at home.
The study, ‘An In-depth Study on Neonatal Health in 3 districts of Uttar Pradesh’, was conducted by CRY — Child’s, Rights and You — in the rural areas of three districts of UP, namely Kaushambi, Sonebhadra and Varanasi.
The study suggested that among the women who had institutional delivery, only one in every ten deliveries (14 per cent) were assisted by a doctor and a majority of them were conducted by an ANM (86 per cent). This figure was highest in Kaushambi where 88 per cent of the delivering mothers were assisted by ANMs and only 12 per cent by a doctor.
The findings of the study also highlight that 17 per cent of the deliveries are not assisted by any skilled or trained birth attendant — these were assisted by dais and relatives.
The study points out that eight in every 10 neonatal deaths occurred within seven days of the birth. Majority of these neonatal deaths occurred at home (58 per cent) and 38 per cent in health facilities (private: 20 per cent and public: 18 per cent) and the trend was similar in all the three districts.
Neonatal pneumonia and respiratory distress syndrome emerged as the two highest probable causes, accounting for 27 per cent and 24 per cent of neonatal deaths respectively.
Though, majority of deliveries were institutional (78 per cent), 69 per cent of the women who delivered in an institution were discharged on the same day of the delivery. Only 28 per cent mothers reported that the child received any post-natal check-ups in the first week after birth, thus grossly compromising the need of post-natal care to mother and her child.
In its conclusion, the study says that the need of the hour is to focus on improving the quality of institutional care and formulating and implementing the delayed discharge protocols as the institutional care can significantly bring down Neonatal Mortality Rate (NMR) especially early NMR.
“This study comes at a crucial time when the system is already struggling to deliver due to constraints brought in by the COVID-19 pandemic. The ongoing pandemic has directly impacted child survival, health and nutrition significantly with the access to health care facilities and nutritional meals being limited to the poor and vulnerable children,” Soha Moitra, regional director of CRY (North) said.
Putting light on the challenges during COVID-19, Shruti Nagvanshi said that maternal and child health facilities were badly hit during initial days of the lockdown imposed due to the pandemic.
“Though the system is getting normalised now but due to misconceptions and uncertainty of the pandemic, families, especially from marginalised communities, are being deprived of medical attention,” Nagvanshi said.
