Shillong, Dec 14: Caesarean delivery (CD) is the most commonly performed surgical procedure globally and is vital to safeguard the lives of both mothers and neonates. Globally, 21% of women give birth by CD, and projections suggest that this figure is expected to increase to 28% by 2030.
But Meghalaya has one of the lowest CD rates in India, recorded at 8.2% which is significantly below the national average of 21.5%, according to a study published in Lancet Regional Health Southeast Asia journal. This low rate is comparable to Nagaland (5.2%) and Bihar (9.7%), which also have low CD rates.
The study “State-wise variation and inequalities in caesarean delivery rates in India,” provides an analysis of caesarean delivery (CD) rates in India based on data from the National Family Health Survey-5 (2019–2021).
India’s caesarean delivery (CD) rate of 21.5% suggests adequate national access to CD but may mask significant disparities. In India, CD rates have steadily increased. Data from the National Family Health Surveys (NFHS) demonstrate an increase in the CD rates of 8. of 5% in 2005–2006, 17.2% in 2015–2016, and 21.5% in 2019–2021.
Despite government schemes introducing subsidised CD in public hospitals in India, access to economically disadvantaged populations remains limited. For example, Janani Suraksha Yojana (JSY) is a government scheme that provides cash assistance for institutional deliveries, including CDs, to women living below the poverty line. The nationwide reach of the JSY stands at 36.4% of the target population, with significant variations observed across regions and socioeconomic groups.
In fact, there is significant inequality in access to CDs between the richest and poorest wealth quintiles.
“The relative inequality ratio for Meghalaya is 10.9, indicating that the richest quintile has 10.9 times higher access to CD services compared to the poorest quintile. This reflects stark disparities in access to healthcare services” the study says.
Like Meghalaya, Himachal Pradesh (13.4), Nagaland (10.4), and Assam (10.9, have much higher inequality compared to the national average. This means that in these states, wealthier or urban populations are far more likely to have access to C-section deliveries compared to poorer or rural groups.
“North-eastern states like Nagaland with low CD rates and high inequality, face challenges tied to the Rashtriya Swasthya Bima Yojana (RSBY) insurance program. This is the primary health insurance scheme for those living below the poverty line in the region and has been found to negatively influence CD access as beneficiaries of the program were found to have lower CD rates than those not funded by the program” the study says.
Experts say high inequality in caesarean delivery rates could indicate inequitable access to healthcare. Wealthier or urban communities might have more access to private hospitals that recommend C-sections, while rural or poorer populations may face barriers to such medical services.
Read:Â Manipur CM N Biren Singh calls for unity among indigenous communities
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