Shillong: Meghalaya’s institutional delivery rate has risen to 81 per cent, according to the latest Health Management Information System (HMIS) data, up from 65.6 per cent recorded in the National Family Health Survey-6, Health and Family Welfare Minister Wailadmiki Shylla informed the Assembly on Friday.
Shylla said the NFHS-6 figure represented a 12.9 percentage point improvement over the 58.1 per cent recorded in NFHS-5. The government, he said, is aiming to increase institutional deliveries to at least 95 per cent over the next three years, taking the State above the national average of 90 per cent.
“The institutional delivery of Meghalaya stands at 81 per cent” at present, Shylla said, adding that the government was confident of reaching or exceeding the national average by the next NFHS.
However, the minister acknowledged that Meghalaya continues to face challenges in ensuring that women deliver in health institutions, particularly because of difficult terrain, long distances, limited transport and shortages of specialist doctors.
Responding to Dr Celestine Lyngdoh, Shylla said three Primary Health Centres (PHCs) in the State were currently functioning without a Medical Officer.
He said most sanctioned Medical Officer posts had been filled, but the State continued to face a shortage of specialists. Recruitment drives had been conducted, but there had been limited participation.
According to Shylla, even when doctors were posted to the three PHCs without Medical Officers, they did not report for duty. He assured the House that efforts were being made to fill the vacancies immediately.
The minister said a number of interventions by the government had contributed to improvements in maternal and child health.
He said maternal deaths had fallen by more than 56 per cent, while infant deaths had declined by over 40 per cent based on 2020-21 data.
The government has also introduced an online system through the Mother App to track pregnant women up to the village level, allowing health workers to identify high-risk pregnancies and monitor expected delivery dates.
Under the Chief Minister Safe Motherhood Scheme, women are provided free transportation not only for delivery but also for antenatal and postnatal care. More than one lakh trips were made under the scheme last year, Shylla said.
The scheme also provides transit homes where pregnant women can stay before delivery, particularly those travelling from remote areas. Trained traditional birth attendants are also provided financial assistance of Rs 1,000 per delivery.
Shylla said the government had also expanded sonogram facilities, increasing the number of machines in the State from 23 to 85, with plans to add more.
Shylla admitted that the shortage of specialists, particularly those required for maternal and child healthcare, remained a major challenge.
VPP MLA Heavingstone Kharpran specifically asked whether the shortage of gynaecologists, paediatricians and anaesthetists was affecting maternal and child health services.
“Yes, definitely,” Shylla said, acknowledging that manpower played an important role in improving institutional deliveries and emergency maternal care.
He said the government had attempted recruitment but had struggled to attract sufficient numbers of specialists.
The minister said five First Referral Units (FRUs) in the State were currently functional, while three more were under construction. However, he did not have the details of the specialist manpower available at each FRU or the distance of these facilities from remote areas.
Responding to Ampati MLA Miani D Shira, Shylla said the government was working to make three Mother and Child Health (MCH) hospitals in South West Garo Hills, Nongstoin and Ri-Bhoi fully functional.
OPD services have already started at the Nongstoin and Umsing facilities through makeshift arrangements, he said, while recruitment of manpower is underway.
Shylla said the reasons for women opting for home deliveries were not limited to healthcare infrastructure.
He cited traditional preferences, reliance on local birth attendants, family decision-making, difficult terrain, scattered settlements, long distances, poor accessibility during monsoons and at night, transport costs and household responsibilities.
Concerns over referral and surgical intervention, as well as preference for familiar or female healthcare providers, also influenced decisions, he said.
The minister also provided a district-wise assessment based on NFHS-6.
West Garo Hills was identified as the best overall performer, followed by South Garo Hills and East Garo Hills, although some indicators such as antenatal care remained areas of concern.
West Khasi Hills was described as the weakest-performing district, with low institutional deliveries, high stunting and high child marriage despite high antenatal care coverage.
West Jaintia Hills was also categorised as weak across several maternal and reproductive health indicators.
South West Khasi Hills was identified as requiring attention because of poor institutional delivery rates and high stunting despite strong antenatal care contact. East Khasi Hills also showed weaker performance across several health service indicators.
Responding to concerns raised by MLA Rakkam A Sangma over delays in transporting pregnant women, Shylla admitted that not all PHCs and CHCs currently have functional ambulances and sonogram machines.
Rakkam had cited an instance in which a woman from Baghmara was referred to Tura but delivered on the way, with the baby not surviving.
Shylla said delayed referral and failure to reach a health facility in time remained among the major reasons for maternal and infant deaths.
He said the government was therefore seeking to strengthen ambulance services across health facilities and assured the House that the issue would be examined.
The minister also said the number of transit homes in the State had reached 117.
Shylla said the gap between rural and urban institutional deliveries had narrowed since NFHS-4, although he did not provide the exact figures.
Responding to a query from Chokpot MLA Sengchim N Sangma on healthcare access in geographically difficult areas, he said the government would consider strengthening delivery facilities, manpower, ambulance services and referral mechanisms.
The government’s target is to take institutional deliveries to at least 95 per cent over the next three years.
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Meanwhile, Leader of the Opposition Dr Mukul Sangma highlighted the role of ASHA workers in increasing antenatal care, institutional deliveries and postnatal care.
Shylla said the Janani Suraksha Yojana continues to provide financial assistance of Rs 1,400 per delivery to eligible women in rural areas. ASHA workers receive Rs 600 per delivery in rural areas and Rs 400 in urban areas.
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