Home delivery, a journey on dark side of the road from womb to tomb: A case study in Tangi- Odisha (India)

Home delivery a journey on dark side of the road

Abstract

Worldwide, every year nearly 300,000 women die due to reasons related to pregnancy and child birth, with India being the largest contributor. Significant steps have been taken to strengthen the health care delivery system. Despite of these, pregnant woman in India continue to die due to factors ranging from poverty to ineffective or inaccessible health services. Through this case report we try to uncover some of the factors, responsible for home delivery, and non-utilisation of essential maternal & child health services, in spite of a family experiencing continued poor health outcomes. Nisha (named changed) mother of six living children underwent four home deliveries and two of her youngest children expired during the infancy period owing to congenital birth defects. Conditional cash transfers, free ambulance service for to and fro transfers around delivery, availability of incentivised ASHAs, are some of the steps to ensure institutionalised deliveries but its availability and utilisation varied from place to place. We hope that this case study will help the concerned stakeholders to view these problems more holistically and initiate corrective measures to curb corruption, ensure availability of right information to patients and the health system, at the right time, while seeking care and thus ensure larger health gains in the near future.