ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

ChildbirthSubscribe to Childbirth

Too Much Care

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.

Utilisation of Health Facilities for Childbirth and Out-of-pocket Expenditure

Using data from the household surveys on health conducted by the National Sample Survey Office between 2004 and 2014, the utilisation patterns of health facilities for childbirth and the associated out-of-pocket expenditure are analysed. The findings reveal that the utilisation of public facilities for childbirth increased three times in rural areas and almost one and a half times in urban areas between 2004 and 2014, but that most deliveries took place in district hospitals. Also, the average medical expenditure on childbirth in government health facilities declined by 36% in rural areas and by 5% in urban areas. Considerable interstate variations in regard to oop expenditure on drugs, diagnostics and transportation were also witnessed. Though government policies to promote institutional births have improved the utilisation of public facilities and reduced the overall oop expenditure, more needs to be done for the benefits to reach the vulnerable sections, especially in urban areas.

How Gender-Sensitive Are Obstetrics and Gynaecology Textbooks?

Several health needs are a result of gender inequity, and care seeking is affected by constraints emerging from gender, social and economic disparities. Gender sensitive provision of health care, especially obstetric and gynaecological services aimed at reducing gender inequity would allow women to overcome social constraints, even empowering them. This is the perspective informing a critical review of three textbooks in the two disciplines. The review aims to explore whether the textbooks sensitise students to the relationship between gender, social inequity and care-seeking behaviour, areas where reproductive rights are likely to be violated by providers, and the special needs of adolescents and older women.
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