Jaipur, June 5 -- Caesarean deliveries in Rajasthan rose from 10.4% to 15.6% while births in government hospitals fell from 77% to 70.5%, according to the latest National Family Health Survey (NFHS-6). As per NFHS-6 (2023-24), Caesarean deliveries increased across both urban and rural Rajasthan. In urban areas, the rate rose from 19.7% in NFHS-5 (2019-21) to 32.8% in NFHS-6 , while in rural areas it increased from 8.1% to 11.4%. Overall, the state's Caesarean rate climbed from 10.4% to 15.6%. The data reveals that overall institutional deliveries have declined slightly from 94.9% in NFHS-5 (2019-2021) to 94.1% in NFHS-6. In urban areas, the institutional births stood at 98.1% while in rural areas, they were 93.1%. However, institutional births in public health facilities declined to 70.5% in NFHS-6 as compared to 77% in NFHS-5. Moreover, births attended by skilled health personnel are also down from 95.6% in NFHS 5 to 94.9% in the current survey. Public health experts have raised concerns about quality of maternal and reproductive health services and called for measures to ensure equitable access to safe and quality maternal healthcare. Coordinator of the NGO Jan Swasthya Abhiyan (JSA), Chhaya Pachauli, said, "The decline in several key health indicators reflects the weakening effectiveness of the state's health, nutrition and family welfare programmes." She said that despite multiple maternal health schemes, declining institutional deliveries suggested either that services were not reaching intended beneficiaries or that people were losing confidence in government health facilities. The JSA submitted a memorandum to state health minister Gajendra Singh Khimsar, demanding immediate and concrete corrective action. There are primarily three maternal health schemes in Rajasthan. The Janani Suraksha Yojana offers direct cash assistance and free medical services to pregnant women who opt for delivery in a government or recognized private hospital. Under the scheme, women in rural areas are given assistance of Rs.1400 and in urban areas, they receive Rs.1,000. Under Pradhan Mantri Matri Vandana Yojana, a cash incentive of Rs.5,000 in three instalments is paid to pregnant women and lactating mothers for first living child. Under the Mukhya Mantri Matritva Poshan Yojana, Rs.6,000 is given for a second pregnancy. Director of Integrated Child Development Services (ICDS), Vasudev Malavat, said that the government is reviewing the data. "We are studying the data and will identify the gaps so that remedial action can be initiated," he said. Experts said the rise in Caesarean deliveries and declining reliance on public facilities may be linked to broader changes in healthcare-seeking behaviour and gaps in public health infrastructure. Dr Narendra Gupta, a public health expert, said that private hospitals encouraged Caesarean sections because it is more lucrative. "Women also opt for Caesarean sections because they don't want to undergo labour pains." However, Dr Sunil Chugh, national vice president of the Indian Medical Association, said contrary to popular perception, private doctors don't push for Caesarean deliveries. "Many factors are responsible. Earlier women had many kids. These days women have one or two children. Doctors don't want to take any risk with the delivery. Often, women themselves ask for C-section because it is convenient," he said. Noting that there is no clarity on the reasons for rise in Caesarean deliveries, Pachauli suggested that the government study the reasons for this. Dr Gupta advocated strengthening the primary healthcare system, arguing that the decline in institutional births was partly linked to the closure of government facilities. "Some government healthcare facilities in peripheral and sub-divisional areas have closed, mainly due to staff crunch. If services are not available at primary healthcare centres, people are forced to travel long distances to district hospitals. This overburdens the district hospitals."...