The number of deliveries taking place in primary health centres, the bottom of the public health services tier, has climbing steadily over the years in Tamil Nadu. From a mere 7.8 per cent in 2004-2005, the 1,614 PHCs in the State now cater to 27.2 per cent of all deliveries. Clearly, the PHCs are attracting patients from all other healthcare institutions.
Patients are shifting from Health Sub-Centres, Government Hospitals, and even the private sector, according to the latest figures available with the Directorate of Public Health. Just under a third of the 11.3 lakh deliveries in the State are happening at the PHC, very often the first point of care in rural areas.
In 2004-2005, about 42.8 per cent of all deliveries in Tamil Nadu took place in private health care institutions; it came down by 10 percentage points to about 32.8 per cent in 2011-2012. While some of them have gone to government hospitals, the bulk have shifted to PHCs closer to their homes. The one improvement that public health officials said really gladdens them is the reduction in the percentage of domiciliary deliveries, or deliveries happening at home. What was about 35 per cent in 1993 has come down dramatically down to 0.2 per cent in 2011-2012.
The benefits of shifting deliveries to institutions from homes are numerous, public health officials add. Several complications can be addressed, there is better infection control, and emergency resuscitation can be performed for both mother and infant to save lives. Consequently, the Maternal Mortality Rate has nearly halved from 145 in 2001-02 to 73 in 2011-12.
Not surprisingly, Tamil Nadu is among the better performance indicators in maternal and child health in the country.
“The main reason for this shift is that PHCs are now equipped to provide services to women and children. Some PHCs conduct even Caesarian section surgeries, but the bulk of them are equipped to provide normal deliveries too. Round the clock, trained nurses and anaesthesiologists are available,” J. Radhakrishnan, Health Secretary, said. Comprehensive emergency Mother and Newborn Centres have also been set up across the state to take care of maternal conditions.
A big draw to the PHCs, in addition to the facilities, is the Muthulakshmi Reddy Maternity Assistance Scheme. As per this scheme a sum of Rs. 12,000 is being provided in three instalments: at the time of registering the mother at the health centre, at the time of delivery and after the child has received the full course of immunisation. This has made a big difference to the attitude of people, especially in rural areas, Dr. Radhakrishnan added.
