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ShareAHMEDABAD: The Gujarat Health Department may have hit upon a scheme which could put India at par with western Europe, at least on one count - the maternal mortality rate (MMR). Not a single death has been reported from over 16,000 deliveries undertaken under the 'Chiranjeevi' scheme in five backward districts of Gujarat since December 2005.
Looking at Gujarat's MMR of 389 per one lakh live births, 90 women could have lost their lives during these 16,000 deliveries, but none did. The success of the scheme has caught the attention of the planning commission, which intends to incorporate it in the next five-year plan.
Born out of the Gujarat health department's decision to gradually do away with the practice of deliveries at home conducted by 'dai', the scheme outsources maternity care to private hospitals. The government will foot the bill for deliveries instead of spending more on existing government hospitals and health centres.
"Any woman living in Dahod, Panchmahals, Kutch, Sabarkantha or Banaskantha can walk into one of the160 hospitals in these districts, flash her BPL (below the poverty line) card and get a free delivery done," says SR Patel, a consultant with the state health department.
"The government hospitals are in a dismal state with barely a third of the required gynecologists and obstetricians practicing. But in the private sector there are about 215 gynecologists in these districts. We have roped in most of them," says the state health commissioner, Amarjit Singh.
Talking about the genesis of the project, he said, "We deliberated with different people for solutions. Insurers quoted Rs12,000 to Rs15,000 for a special insurance for mothers. But deliveries at private hospitals were done at a fraction of this cost with good medical care." But all is not rosy. Against a target of nearly 50,000 deliveries in the first six months, only 16,000 have taken place. In some districts, there have been complaints of patients with complications being turned away.
IIM-A professor Dilip Mavlankar, who is an advisor for the project, is optimistic: "Two more years and the scheme will pick up. Currently, there is no monitoring. Since the doctors are offered a fixed payment, it is important to find out how many cases they actually treat. The scheme will not be viable if there are only a few private practitioners."
