Lok Sabha Question No. 1675 (UNSTARRED), answered on 2016-11-25
Subject: Rise in Caesarian Operation in Private Hospitals
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DEVJI MANSINGRAM PATEL

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 1675 TO BE ANSWERED ON 25 TH NOVEMBER, 2016

## RISE IN CAESARIAN OP ERATION IN PRIVATE H OSPITALS

## 1675. SHRI DEVJI M. PATEL:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  Government  is  aware  that  due  to  commercial  gains  caesarian  operation private hospitals are more than Government hospitals, if so, the details thereof; and
- (b) if so , the action taken by the Government to check such type of greed?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a): World Health Organisation (WHO) in its new statement released in April, 2015 has said thatat  population  level,  Caesarean  section  rates  higher  than  10%  are  not  associated reductions  in  maternal  and  newborn  mortality  rates however  Caesarean  section  is  a  critical intervention in saving lives of mother and newborn and is based on the clinical judgm doctor.

As per National Family Health Survey - 4 (2015 - 16) data available for 18 states, caesarean section rate in private h ospital is higher in comparison to public health facility. Across th States, caesarean section rate in private sector ranges from 25.3% to 74.9% whereas in facility it ranges from 2.6% to 40.6%. NFHS - 4 data for 18 states is placed at Annexure .

- (b) : World Health Organisation (WHO) in its new statement released in April, 2015 has s that  e very  effort  should  be  made  to  provide  Caesarean  sections  (CS)  to  women  requiring section  based  on  clinical  diagnosis,  rather  than  striving  to  ach ieve  a specific  CS  rate.  At population level, Caesarean section rates higher than 10% are not associated with reduct maternal  and  newborn  mortality  rates.  Government  of  India  (GoI) has already  written  to  all States and UTs sharing the latest WHO sta tement.In addition, States have been informed to conduct periodic prescription audit in the private health facilities under the Establishment Act. They have also been informed that prescription audits can be extend public health facilities.

A communication has also gone to Federation of Obstetrical & Gynecological Societi of  India  (FOGSI) which is the largest profession body of Obstetricians and Gynecologists India for sharing the WHO guidance note to all their State chapters and the Obs tetricians and Gynecologists registered under them.

……………

## Annexure

| Birth in Health Fcaility by Caesarean Section (%)   | Birth in Health Fcaility by Caesarean Section (%)   | Birth in Health Fcaility by Caesarean Section (%)   | Birth in Health Fcaility by Caesarean Section (%)   |
|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|-----------------------------------------------------|
| S.No.                                               | States                                              | Public Facility                                     | Private Facility                                    |
| 1                                                   | Andaman & Nicobar                                   | 16.9                                                | *                                                   |
| 2                                                   | Andhra Pradesh                                      | 25.5                                                | 57                                                  |
| 3                                                   | Assam                                               | 12.9                                                | 53.3                                                |
| 4                                                   | Bihar                                               | 2.6                                                 | 31                                                  |
| 5                                                   | Goa                                                 | 19.9                                                | 51.3                                                |
| 6                                                   | Haryana                                             | 8.6                                                 | 25.3                                                |
| 7                                                   | Karnataka                                           | 16.9                                                | 40.3                                                |
| 8                                                   | Madhya Pradesh                                      | 5.8                                                 | 40.8                                                |
| 9                                                   | Maharashtra                                         | 13.1                                                | 33.1                                                |
| 10                                                  | Manipur                                             | 22.6                                                | 46.2                                                |
| 11                                                  | Meghalaya                                           | 9.8                                                 | 31.4                                                |
| 12                                                  | Puducherry                                          | 30.4                                                | 48.3                                                |
| 13                                                  | Sikkim                                              | 18.1                                                | 49.3                                                |
| 14                                                  | Tamilnadu                                           | 26.3                                                | 51.3                                                |
| 15                                                  | Telangana                                           | 40.6                                                | 74.9                                                |
| 16                                                  | Tripura                                             | 18.1                                                | 73.7                                                |
| 17                                                  | Uttarakhand                                         | 9.3                                                 | 36.4                                                |
| 18                                                  | West Bengal                                         | 18.8                                                | 70.9                                                |

Source-National Family Health Survey - IV (2015 - 16)

*Percentage not shown; based on fewer than 25 unweighted cases