New Delhi: For newborns in India, home births overseen by health professionals are safer than hospital deliveries, which are slightly less riskier than births supervised by traditional midwives, a report has found.
For every 10,000 hospital births, 255 died, compared with 198 deaths for every 10,000 home deliveries mediated by professionals and 272 in those assisted by traditional midwives, the Infant and Child Mortality India report said, based on data collected by the 2007 national family health survey.
The report, prepared by National Institute of Medical Sciences, Indian Council of Medical Research and United Nations Children’s Fund (Unicef), was released on Thursday.
One possible explanation for the findings is that hospitals handle more complicated deliveries than those supervised at home, experts said.
The report’s authors, however, maintain that the “higher risk of neo-natal deaths among hospital births may also indicate inadequate quality of care at health institutes”.
“In the rural context, if you don’t have complications during delivery, the delivery is likely to be at home,” said Pavitra Mohan, a health specialist at Unicef. “Death rates in hospitals tend to be higher because they get complicated cases. Having said that, the more important aspect is that institutional delivery is not necessarily safer. It depends on the quality of care the woman gets, either at home or in the hospital.”
Between now and March 2017, India’s 12th five-year plan period, the health ministry wants to tap the skills of allied health personnel and train them to provide emergency care in both cities and villages, Mint reported on 1 November.
Improving the mortality rate is purely a matter of providing correct training to those assisting births, according to Kavita Narayan, hospital and health systems expert at Public Health Foundation of India, a public-private initiative.
“Currently, a majority of human resources in health is providing care—home based and institutional—with less than desirable formal training,” Narayan said. “The biggest cause of mortality during birthing is infection. Trained birth attendants can be taught good nursing practices to improve infant and maternal mortality, whether at home or in hospitals. This model is already being implemented successfully in villages.”
India is likely to miss the United Nation’s millennium development goal of reducing infant mortality to 27 per 1,000 births and under-5 mortality to 42 per 1,000 births by 2015, the study predicted.
Only six Indian states—Kerala, Tamil Nadu, Maharashtra, Punjab, Himachal Pradesh and West Bengal—are likely to achieve the goal by 2015, according to latest official data.
The Planning Commission aims to reduce the infant mortality rate to 25 per 1,000 births by 2017. On the basis of the past rate of decline, India’s infant mortality rate is projected at 38 by 2015 and 34 by March 2017, according to the United Nations.
“Looking to the future, one message comes out clearly. In order for India to reach the goals set and make a difference for children, we need to aim at programme delivery alliance and ensure multiple ways of engagement as required,” said M.K. Bhan, secretary at the department of biotechnology.