Bad roads, poor connectivity and unavailability of transport at night are some hurdles that women face in going for deliveries in dispensaries or hospitals in Jharkhand, a study found out.
One out of every seven women who prefer to deliver their baby at home cited fear of abuse by staff as the reason for avoiding institutional delivery.
The study, conducted by the Public Health Foundation of India; London School of Hygiene and Tropical Medicine, United Kingdom; and University of Aberdeen, United Kingdom, included 500 women who recently delivered babies in Jharkhand. In the state more than half the deliveries are still conducted at home.
The Centre has been promoting deliveries in medical institutions to reduce maternal deaths through Janani Suraksha Yojana (JSY) scheme in which women are assured a sum of Rs 1,400 if they go to institutions for delivery.
Following the introduction of the scheme in 2005, the proportion of institutional deliveries in India increased from 53 per cent of all deliveries in 2005 to 73 per cent in 2009-10, as per UNICEF statistics.
However, states like Jharkhand did not attract many women.
The study revealed that more than one-third women delivered at home because they could not reach a facility on time. More than 80 per cent could not arrange for transport to reach the facility.
Fear of abuse
One out of seven women preferred delivering their baby at home, fearing abuse in
hospital.
In the study, 12 per cent of women with institutional delivery reported abusive behaviour by the staff.
Nearly two-fifths of the women reported that they get better comfort and privacy at home.
Thirty-three per cent said they could not go to an institution as there was no one who could look after other children at home.
Close proximity of a dai (traditional birth attendant) also encouraged home deliveries.
Many felt institutional delivery was too expensive. This was corroborated by the fact that among those who went for institutional delivery, 40 per cent spent more than Rs 1,400.
High cost
The high cost is attributed mainly to drugs, which often have to be procured from outside the facility.
The study also found that about three-fourths women wanted to have their next child at a health facility, while 37 per cent of women who had recently delivered at home did not want their next child to be born at a medical institution.
Among those who preferred institutional delivery, assurance by community health worker (ASHA) emerged as a key factor. The study was conducted to understand women’s perception about institutional deliveries.
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