9 Lakh C-sections done by Private hospitals are for Financial benefits: IIM Study

A study done by Indian Institute of Management-Ahmedabad (IIM-A) reveals that as many as nine lakh Caesarean section (C-section) deliveries out of 70 lakh were practised in private hospitals which were not necessary but carried out for financial incentives.

According to a research published in The Lancet medical journal in October 2018, in at least 15 countries, more than 40 per cent of all babies born are delivered by C-section.

Such "medically unjustified" births not just cause "large out-of-pocket expenses" but also "delayed breastfeeding, lower birth-weight, respiratory morbidities" among other troubles for the newborn, it says.

The study finds "a woman opting for private facility is 13.5-14 percentage points more likely to undergo an unplanned C-section (compared to public facilities)".

The figure is based on the fourth round of the National Family Health Survey (NFHS), carried out in 2015-16, which found that 40.9 per cent births in private facilities in India were through C-section as against 11.9 per cent in public facilities.

The study observes that "supplier-induced demand" for unplanned C-section births in private facilities is mainly driven by "financial incentives."

"Even though private providers might be more responsive to patients and exert more effort, they are also more likely to provide over-intensive treatments either as a response to demand from patients or due to financial incentives," it says.

"When medically justified, C-sections prevent maternal and perinatal mortality and morbidity. But if performed when not needed, they impose huge burden on the mother and the child that go beyond large out-of-pocket expenses," the study states.

"For the new-born, it means delayed breastfeeding, lower birth weight, respiratory morbidities, increased rate of hospitalisation, lower Apgar scores and its implication in the long run," it says.

The study seeks "to evaluate whether the private sector can be an effective partner in providing health services," especially in the light of the National Health Policy 2017, which provides cover of Rs 5 lakh for poor households to seek secondary and tertiary health care in public or empanelled private hospitals.

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