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BMC Pregnancy and Childbirth

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Open Access 01-12-2020 | Care | Research article

Length of stay after childbirth in India: a comparative study of public and private health institutions

Authors: Pradeep Kumar, Preeti Dhillon

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Abstract

Background

This paper discusses length of stay (LOS) following childbirth as an indicator of quality of postnatal care in health institutions. This research aims to describe LOS according to both vaginal and cesarean deliveries in public and private health care institutions in India, and to identify any association of LOS with postnatal care and post-delivery complications.

Methods

We use recently released nationally-representative data from the National Family Health Survey-4 (2015–16) and apply the Cox proportional hazard model to determine the factors associated with LOS at the health facility after childbirth during a five-year period preceding the survey.

Results

Overall, the average LOS after childbirth is 3.4 days; 2.1 days for vaginal deliveries and 8.6 days for cesarean section (CS) deliveries. Strikingly, half of the women are discharged within 48 h. Women who give birth in private hospitals have a more prolonged stay than those who give birth in public health facilities. For vaginal birth in public hospitals, one-fourth of the women are discharged with insufficient LOS as against only 19.2% women in private hospitals. LOS is significantly related to the cost of delivery only in the case of private facilities. Uneducated women belonging to lower wealth quintile households and those living in rural areas stay for a shorter duration for vaginal deliveries but for a longer duration in case of cesarean deliveries. Women who get four or more antenatal check-ups (ANC) done have a longer stay, while those who receive benefits under the Janani Suraksha Yojna (JSY) have a shorter stay. Another key finding is that women who are discharged on the same day report lower levels of postnatal care and a higher proportion of post-delivery complications.

Conclusion

The study concludes that early discharge has a negative association with maternal health outcomes, which has important program implications. Therefore, it is essential to maintain an adequate LOS at a facility after childbirth. We recommend that government programs should strengthen the JSY scheme not only to improve delivery care, but also to provide effective postnatal care by promoting sufficient LOS at facilities.

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Title: Length of stay after childbirth in India: a comparative study of public and private health institutions
Authors: Pradeep Kumar
Preeti Dhillon
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Care
Published in: BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-020-2839-9

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Length of stay after childbirth in India: a comparative study of public and private health institutions

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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