Question : Caesarean Surgery

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

(a) whether the percentage of Caesarean (C-section) deliveries in the country is constantly on the rise;

(b) if so, the details thereof and the reasons therefor;

(c) the details of Caesarean deliveries performed in the Government and private hospitals during each of the last three years and the current year, State/UT-wise; and

(d) the steps taken/being taken by the Government to bring down C-section deliveries and maintain C-section rates within acceptable norms in the country?

THE MINISTER OF HEALTH AND FAMILY WELFARE
(SHRI JAGAT PRAKASH NADDA)
(a) & (b): As per the World Heath Statistics 2015 report released by WHO, the percentage of births by caesarean section between 2007-2014 was 8% for India.
However as per the National Family Health Survey -3 (2005-06) and NFHS-4 (2015-16) percentage of births by Caesarean section has increased from 11 % (13 states) to 23 %( 17 states) between 2005-06 and 2015-16. Report is placed at Annexure.

(c): The details (survey data) of Caesarean deliveries performed in the Government and private hospitals during each of the last three years are not available. Therefore NFHS 3(2005-06) and NFHS 4(2015-16) data has been compared and is placed at Annexure 1. C-Section in Private sector has increased from 32% to 47% in NFHS-3 compared to NFHS-4 and in Public health sector it has increased from 15.6% to 17.8% between NFHS-3 and NFHS-4.


(d): The Medical officers staff nurses and ANM are being trained regularly in empowering their skills for intrapartum care and early detection of complications.
World Health Organisation (WHO) in its new statement released in April, 2015 has said that every effort should be made to provide Caesarean sections (CS) to women requiring C section based on clinical diagnosis, rather than striving to achieve a specific CS rate. Government of India (GoI) has already written to all States and UTs sharing the latest WHO statement. At population level, Caesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates. Government of India (GoI) has already written to all States and UTs sharing the latest WHO statement. In addition, States have been informed to conduct periodic prescription audit in the private health facilities under the Clinical Establishment Act. They have also been informed that prescription audits can be extended to public health facilities.
A communication has also gone to Federation of Obstetrical & Gynecological Societies of India (FOGSI) which is the largest profession body of Obstetricians and Gynecologists in India for sharing the WHO guidance note to all their State chapters and the Obstetricians and Gynecologists registered under them.