Even as Odisha has figured among the top five states in the country with high Maternal Mortality Rate (MMR), the irony is giving birth to a child, even in a public hospital in the State, has been the costliest in the country.
Only the states like J&K, Manipur (highest in the country), Tripura, Assam, Kerala and Karnataka have a higher rate chart.
NFHS-5 Revelation
The big revelation made by NFHS-5 is the average Out-of-Pocket (OoP) expenditure per childbirth in a public health facility in Odisha is Rs 4, 139.
On the contrary, the national average (Rs 2,916) has been nearly 1.5 times less than State’s average OoP, the survey reveals.
Moreover, Odisha is the only one among the poorer states to quote such a high Out-of-Pocket expenditure on childbirth.
Mamata Yojana And Child Birth
In order to meet the expenses and nutritional needs of a pregnant mother, the Odisha government had launched the Mamata Yojana a decade ago.
This scheme was launched by the State government to bring a drastic reduction in MMR by encouraging the poor expecting mothers to opt for institutional delivery.
Under the scheme, a sum of Rs 3000 is given to a pregnant mother before child delivery.
Another Rs 2000 will be deposited in the bank account after delivery to address the nutritional requirements of both mother and child.
A sum of Rs 1000 is provided by the Union govt under Janani Suraksha Yojana (JSY) for institutional delivery.
A look shows that this scheme has been launched to cater to the needs of a pregnant woman- both pre and post-delivery needs.
However, as per the NFHS-5 data, the average Out-of-Pocket expenses per childbirth at a govt hospital is around Rs 4.139k – which is nearly Rs 1k more than the pre-delivery amount of Mamata Yojana.
If the JSY aid and Mamta first installment are added, then too the total Out-of-Pocket expenditure is still marginally more in Odisha.
Niramaya Yojana
The high Out-of-Pocket expenses per childbirth in Odisha is beyond comprehension as the Naveen Patnaik led govt has launched the free medicine scheme – Niramaya Yojana.
Moreover, the State govt claims that each and every test in connection with child delivery is being performed free of cost.
Still, the expenses are one of the rare costliest in the country.
NSSO Reason
An earlier National Sample Survey report in 2017 had reasoned that the average total medical expenditure a pregnant woman incurred during stay at rural Government hospitals in the country was Rs 2,598.
As Per NFHS-5, the average Out of Pocket expenditure per childbirth in rural areas is Rs 3 998 and Rs 5,006 in urban govt hospitals.
The NSS report hints at the reason as ‘stay in govt hospitals’. The NSS report points to a longer stay, which is a crucial determinant in bringing down the MMR.
The Impact
Even in 2020-21, institutional delivery at public health centres remained at below 80 percent.
The NFHS-5 report shows that childbirths reported at Government hospitals in Odisha have been around 78.7 percent.
While it is just 80 percent in rural areas, the percentage is around 70 in urban areas.
In the last five years, the rate has increased by around 3 percent (75.8% in 2015-16).
Odisha Vs Rajasthan
In 2020, the Union health ministry had lauded Rajasthan for bringing a 22 point decline in MMR, which was the highest in the country.
On the contrary, the decline in Odisha had been below 15 points.
In Rajasthan, the average Out-of-Pocket expenses at govt hospital is Rs 2, 102.
And the childbirth in the govt hospitals increased by a whopping 14 percent to touch 77 percent.
In contrast, the rise in Odisha is a mere 3 percent.