Public health facility quality and place of delivery in India

Overview:
In India, many women still give birth at home instead of hospitals or health centers, and there are big differences in these rates from one state to another. Giving birth at home can feel more comfortable and personal for some families, but when it happens without skilled medical support or proper/hygienic facilities, it can carry serious risks for both mother and baby.  

In this article, One Health Trust researchers sought to understand whether the quality of public health facilities plays a role in where mothers choose to give birth. 

The Question:
Do improvements in the quality of public delivery services, such as improved infrastructure, more staff, and well-equipped facilities, increase the likelihood of women choosing to give birth in health centers rather than at home? 

The Findings:
Using data from the Integrated Child Health and Immunization Survey (2015–2016), which covered over 44,000 households across India, the researchers found that: 

• Women living near better-quality public health facilities were more likely to give birth in those facilities and less likely to deliver at home or in private hospitals.  

• The availability of medical equipment and vaccines had the strongest influence on delivery choices, followed by the availability of health staff in urban areas and infrastructure quality in rural areas.

• Poorer households tended to live near lower-quality facilities, which partly explains why institutional delivery rates are lower among them. 

The findings show that improving the quality of public health facilities, especially in low-income areas, can encourage more women to give birth in safe, institutional settings, helping reduce risks for mothers and babies. 

Read the article in SSM Health Systems here.