Fewer women opt for public hospitals for childbirth in Uttarakhand: NFHS survey

Dehradun: The National Family Health Survey-6 (NFHS 2023-24) has revealed a decline in the proportion of births taking place at public health facilities in Uttarakhand, with the figure falling from 53.3% in NFHS-5 (2019-21) to 49.9% in NFHS-6. The decline comes even as overall institutional deliveries and births attended by skilled health personnel have improved in the state.

According to the survey, overall institutional births increased from 83.2% in NFHS-5 to 88.9% in NFHS-6, while births attended by skilled health personnel rose from 83.7% to 90.3%. The figures suggest that while more women are opting for institutional births, a growing proportion are doing so outside the public health system.

The survey also recorded a rise in caesarean section births. The overall rate increased from 20.4% in NFHS-5 to 25.9% in NFHS-6. As seen nationally, the highest proportion of surgical births was recorded in private facilities, here the rate rose from 43.3% to 47.7%. In public facilities, the increase was marginal, from 14% to 14.7%.

Among Himalayan states, institutional births at public health facility in NFHS-6 stood at 75.6% in Assam, 74.7% in Mizoram, 74.6% in Tripura, 71.7% in Sikkim, 70.6% in Himachal Pradesh, 55.7% in Meghalaya and 44.7% in Nagaland.
Like Uttarakhand, Tripura Himachal Pradesh and Sikkim also recorded a decline in deliveries at public facilities. In Tripura, the figure fell from 78.6% in NFHS-5 to 74.6% in NFHS-6, in Himachal Pradesh it declined from 71.7% to 70.6%, and in Sikkim it plunged from 78.6% to 71.7%.

The figures are noteworthy given Uttarakhand's relatively better socio-economic profile compared to several other hill states. NFHS-5 data had shown Himachal Pradesh recording significantly higher institutional delivery rates at public facilities, while Sikkim reported strong utilisation of govt health services, supported by better infrastructure connectivity in a smaller and more manageable terrain.

Health officials attributed the decline in public facility deliveries to a combination of factors, including inadequate infrastructure in remote hill areas, poor road connectivity limiting access to district hospitals, a shortage of specialist doctors and migration to the plains. They said some women continue to deliver at home, particularly in districts such as Haridwar and Udham Singh Nagar, while others increasingly prefer private healthcare facilities.

Despite the decline in deliveries at public health facilities, the survey recorded improvement in skilled birth attendance, indicating continued progress in access to maternity care across the state.