Madhya Pradesh’s IMR and MMR still very high

Despite the figures of institutional deliveries for the current year in the state being quite impressive, Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) do not show the corresponding improvement. Furthermore, utter unavailability of specialist gynecologists and pediatricians in Community Health Centers (CHCs) and Primary Health Centers (PHCs) puts a question mark on the very figures of institutional delivery.

In the current year, the rate of institutional delivery is 58 % as against 50.3% of 2006-07. The figures have constantly shown an improvement from year 2000-01 when it was a mere 26.2%. Cleary, the rate of institutional delivery has more than doubled since, if figures are anything to go by. Nonetheless, the IMR is 70 per thousand (improved from 88 in 1997) and MMR 397 per lakh (improved from 498). These figures certainly do not show corresponding amelioration. "We have annual records of institutional delivery but IMR and MMR are not surveyed every year, so here is this difference." says Dr Archana Mishra, Consultant, National Rural Health Mission (NHRM) and Reproductive and Child Health (RCH). Her argument might look genuine at the first sight but it has flaws.

The figures do not show the institutional delivery in urban and rural areas separately and insiders say most of the institutional deliveries giving push to the figure are being done in urban areas. Second thing they reveal is that government has included private sector hospitals in its schemes to enhance institutional deliveries among below poverty line (BPL) mothers and pay them for each delivery. Most of these hospitals are in urban and semi-urban areas. "It's not necessary the data of institutional delivery provided by a certified hospital conducting free delivery of BPL mothers under a government scheme and receiving the due money from government is true," says an insider. "It might be exaggerated by certain means to claim more money from government."

Needless to mention, under the arrangement certified private hospitals are extending facilities of Janani Express Yojana, Janan Sahayogi Yojana and other health welfare schemes to card holders. Talking of rural areas, state is short of 478 PHCs and 188 CHCs as per a report of Ministry of Health and Family Welfare of Government of India released on March 2006. To add to this, just 13 gynecologists and 12 pediatricians are working in 229 existing CHCs of the state.Around 216 gynecologists and 217 pediatricians are required in these health centers. State government's attempts to post specialists in rural areas have met with failure over the years and dais conducting traditional deliveries has been banned around a year ago, leaving villagers with no option but to go for totally unsafe, unprofessional delivery at home.