Birthing sops: Cashless delivery, free transport to hospital

Prahalad Samal and his wife Laxmipriya, both daily wagers from a village in Orissa’s coastal Nayagarh district, had a terrible tragedy early this year. They lost their first child, a boy, just five days after his birth.

The delivery, according to the young couple, was normal. Soon after complications set in and both mother and child took ill. They went to a local primary health centre. After treatment, Laxmipriya recovered but not the newborn.

The version of the doctor who treated her was on expected lines - the baby’s condition was critical by the time it arrived in the health centre. Like scores of pregnant women in rural Orissa, she had also delivered her baby at home with the help of a “dhai” (untrained helper with expertise in delivering babies) - one of the primary reasons behind high infant and maternal mortality rate in the eastern state. Ten years back, IMR in Orissa was as high as 95 for every 1000 child births which was one of the highest in the entire country. With government’s intervention it has now come down to 65. The figure is still considered very high compared to several other states. Similarly, at present the maternal mortality rate in the state stands at 258 for every one lakh child deliveries. It was 358 ten years back.

The Orissa government concedes that the high maternal and infant mortality rates were a shame to the state. “It is a stigma which we want to wipe out completely. The government intervention during the last ten years has reduced the IMR by 30 points, highest in the country. We are initiating steps which will considerably reduce both infant as well as maternal mortality rates”, says the state Health minister Prasana Acharya.

Two interesting schemes have been launched for this purpose - ’Mamata’ and “Janani Shishu Suraksha Karyakram (JSSK). While the former is a state government initiative, the latter is being implemented under National Rural Health Mission (NRHM).

Twin schemes

Under Mamata, pregnant women in rural areas who register their names with an anganwadi centre will receive a cash benefit of Rs 5,000 each in three instalments. The scheme, according to Health department sources, is already a big hit. Two lakh pregnant women have registered their names and 50,000 of them received the first instalment on the day the scheme was launched in mid-October.

Similarly, under JSSK, the pregnant women can avail “cashless” delivery, both normal and caesarean and free treatment to sick newborns up to 30 days after their birth in government hospitals, community health centres and primary health centres. Other benefits include free drugs, consumables, special diet during stay in the health centres and free blood if required. More importantly, there would be free transport facility from home to health centres and back after delivery. Transport between health facilities in case of referral would also be free.

The schemes, however, have failed to impress activists who are of the view that it would have been better had the government used the huge amount of money to educate the rural women and improve the infrastructure (facilities in hospitals) which continue to be poor in rural pockets. The state government would be spending a whopping ~350 crore a year on its Mamata scheme.