Rampant Caesarean births in private clinics driven by profit?

State’s percentage of such births 33 against 17 across India

Zehru Nissa
Srinagar, Publish Date: Jun 23 2018 12:57AM | Updated Date: Jun 23 2018 12:57AM
Rampant Caesarean births in private clinics driven by profit?Representational Pic

A decadal report by the National Family Health Survey has revealed that three out of every four births in Jammu and Kashmir’s private hospitals happen through surgical procedures, pointing to “unnecessary and possibly economically driven” methods.  

According to the latest, 4 (NFHS-4) decadal survey, total percentage of births in J&K through C-Section was 33, the highest among all states in India except for southern states of Telengana, Andhra Pradesh, Lakshadweep, Kerala, Tamil Nadu and Puducherry.

Last year Union health ministry shot a letter to all states including J&K to carry out a prescription audit of C-sections in private hospitals stating that over 10 percent share of the births were through surgical procedures.

However, in J&K, where 75 percent of births in private hospitals are through the surgical procedure, state health authorities have chosen to ignore the directive.

The countrywide percentage of births through CS was just 17.

If these births through surgical procedures are analyzed separately for government-run hospitals and private hospitals the situation is grim in the latter category.

In private hospitals of J&K, three out of every four births happen through surgical procedures, the survey revealed, hinting at a profit-driven medical practice.

Although, the CS is termed “necessary” by gynecologists in most cases, World Health Organization (WHO) has raised flag over the surging practice.

According to the world body CS percentage higher than 10 percent at population level was not associated with reductions in maternal and newborn mortality rates and could be instead driven by profits. 

“As in other surgeries, caesarean section deliveries also have inherent risk of surgical and anesthetic complications,” according to the WHO.

The WHO concern prompted Union Ministry of Health and Family Welfare direct states “to conduct periodic prescription audits in private sector which could also be extended to public sector.”

But the state’s health department has taken no steps in past one year to audit the practice in both the private hospitals and government-run ones.

“This audit would have brought true picture to the fore. The study of the cases would have revealed that whether the CS was a necessity driven by complications, or the patient could have experienced normal delivery,” said a senior doctor at Government Medical College (Srinagar), wishing not to be named. 

“Only when the audit is undertaken we can conclude whether the surge in the cases is driven due to economic benefits or complicacies.”

In Kashmir however, gynecologists have a different explanation.

The cite manpower shortage as the basic reason for high CS percentage.

“If one doctor is looking after 10 patients at a time, the CS will be high without any doubt,” said Prof Shehnaz Taing, head department of gynecology at Government Medical College Srinagar said.

Taing insisted only strengthening and auditing manpower in hospitals across Kashmir would produce better outcomes.

“No other audit will do the job.”

In Kashmir, doctors are usually available in private hospitals for limited hours, which could also explain the high rate of births through surgical procedures. The doctors would be required to be available for 8-16 hours for each normal delivery.

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