Maternal and child health services are the foremost priorities of community health programmes.
According to WHO Maternal and child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother and child.
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MARKET OVERVIEW OF MOTHER AND CHILD HEALTH IN THE WORLD
- In 2015, an estimated 303 000 women worldwide died due to maternal causes. Almost all of these deaths (99%) occurred in low and middle-income countries (LMIC), with almost two thirds (64%) occurring in the WHO African Region.
- High-income and upper-middle-income countries more than 90% of all births benefitted from the presence of a trained midwife, doctor or nurse, less than half of all births in several low-income and lower-middle-income countries were assisted by such skilled health personnel.
- The world has made remarkable progress in reducing child mortality, with the global under-five mortality rate dropping from 93 per 1000 live births in 1990 to 41 per 1000 live births in 2016.
INDICATORS OF MOTHER AND CHILD HEALTH IN INDIA (2016)
MATERNAL HEALTH PROBLEMS
The states of Assam, Rajasthan, Uttar Pradesh/Uttarakhand still have a high maternal death rate above 300 per 100,000 live births.
- Nutritional Problems
- Infection Problems
- Reproductive Tract Infections (RTIs)/ Sexually Transmitted Infection (STI)
- Infection in general
- Puerperal Sepsis
- Disturbances and Menstruation
- Mature Gravida
- Adolescent Gravida
- Adolescent Parents Problems
- Unregulated Fertility
- Complications of Deliveries
- Uterine Prolapse
- Cancer of the cervix
COMMON CAUSES OF MATERNAL DEATHS IN INDIA
In India, about 56,000 women each year are lost in childbirth, that’s 1 every 8 minutes. This accounts for 19% of maternal deaths around the world.
The main causes of death are heavy bleeding (hemorrhage) and eclampsia (high blood pressure).
Social determinants such as early age of marriage, early and repeated childbearing where 47% of girls marry before the age of 18 are also contributing factors.
COMMON CAUSES OF UNDER-FIVE DEATHS IN INDIA
MATERNAL AND CHILD HEALTH SERVICES
- Prenatal/antenatal care services
- Intra-natal care services
- Postnatal care services
- Under five child health services
A large number of global maternal and neonatal deaths are from India. According to the State of World’s mothers report released in May 2013, by Save the Children, India ranked 142 out of 176 countries.
GOVERNMENT OF INDIA HAS POLICIES AND PROGRAMS
- Janani Suraksha Yojana, a safe motherhood cash assistance scheme, and now the Janani Shishu Suraksha Karyakram (JSSK)have facilitated the shift of births from homes to health facilities.
- The government started ambulance services like the Janani Express and 1098 services to address the challenges of transportation and reaching health facilities on time, but the implementation varies across the country.
- To address quality of care issues, quality protocols are being developed — for the labour room, ANC and PNC by the government and there is an attempt to standardize.
- The Chiranjeevi Yojana (CY) in Gujarat and the Thayi Bhagya Yojana (TBY) in Karnataka, aimed at improving maternal health, especially among women living below the poverty line.
- Facility based newborn care services at health facilities have been emphasized. Setting up of facilities for care of Sick Newborn such as Special New Born Care Units (SNCUs), New Born Stabilization Units (NBSUs) and New Born Baby Corners (NBCCs) at different levels is a thrust area under NHM.
- Facility Based Integrated Management of Neonatal and Childhood Illness (F-IMNCI)is to empower the Health personnel with the skills to manage new born and childhood illness at the community level as well as at the facility. Facility based IMNCI focuses on providing appropriate skills for inpatient management of major causes of Neonatal and Childhood mortality such as asphyxia, sepsis, low birth weight and pneumonia, diarrhea, malaria, meningitis, severe malnutrition in children. This training is being imparted to Medical officers, Staff nurses and ANMs at CHC/FRUs and 24×7 PHCs where deliveries are taking place. The training is for 11 days.
- A new scheme has been launched to incentivize ASHA for providing Home Based Newborn Care.ASHA will make visits to all newborns according to specified schedule up to 42 days of life. The proposed incentive is Rs. 50 per home visit of around one hour duration, amounting to a total of Rs. 250 for five visits. This would be paid at one time after 45 days of delivery, subject to the following:
- Recording of weight of the newborn in MCP card
- Ensuring BCG , 1st dose of OPV and DPT vaccination
- Both the mother and the newborn are safe till 42 days of the delivery, and
- Registration of birth has been done
- Navjat Shishu Suraksha Karyakram (NSSK)is a programme aimed to train health personnel in basic newborn care and resuscitation, has been launched to address care at birth issues i.e. Prevention of Hypothermia, Prevention of Infection, Early initiation of Breast feeding and Basic Newborn Resuscitation. The objective of this new initiative is to have a trained health personal in Basic newborn care and resuscitation at every delivery point. The training is for 2 days and is expected to reduce neonatal mortality significantly in the country.
MOTHER AND CHILD HEALTHCARE INVENTIONS
1. The Pink Clutch Purse Helping Women Deliver Safely
The basic $3 kit contains simple items to provide the “six cleans” of childbirth recommended by the World Health Organization, ensuring a safe and sterile delivery (gloves, soap, surgical scalpel, blood-absorbent under-pad, umbilical cord clamp, and baby wiping cloth). The kit comes packaged in a biodegradable jute bag that mothers reuse as a purse.Use of clean birth kits have been associated with a 57% reduction in newborn death in India.
2. The Software Platform Improving Pre-Natal & Post-Natal Care
CommCare, built by Dimagi, is a software platform that enables anyone to build mobile apps. CommCare was built to support frontline workers at the last mile across all sectors. By replacing paper-based forms with mobile applications, frontline workers can utilize CommCare as a job aid to track and support clients with registration forms, checklists, SMS reminders, multimedia and much more.
Catholic Relief Services (CRS) uses CommCare on a project in Uttar Pradesh, India, the most populous state in India and one that has some of the highest infant mortality rates in the country. CRS developed a CommCare app to help improve the delivery of community-level prenatal and postnatal care and support services. With CommCare, they were able to increase coverage of care by over 50%. In addition, there was a 41% increase in prenatal checkups.
A mobile health education service designed to help new and expecting mothers make healthier choices and lead longer lives on a national platform for the Government of India. Kilkari delivers free, time-appropriate audio messages about pregnancy, child birth and child care directly to families’ mobile phones via Interactive Voice Response (IVR).
PREVALENCE OF MOTHER AND CHILD HEALTHCARE IN INDIA
- Maternal complications and poor prenatal outcome are highly associated with non utilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient.
- Complications in pregnancy and childbirth are the leading cause of death among adolescent girls in most developing countries, including India.
- It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies.
- One in four children in India’s most populous cities is malnourished.
- The prevalence of stunted children rose to 25.7% among aged 36-47 months.
- The prevalence of wasting remained fairly steady between 13% and 16% throughout the first five years of life, while prevalence of overweight remained between 1.7% and 3.6%.
MOTHER AND CHILD HEALTHCARE IMPACT ON ECONOMY OF INDIA
- The government expenditure saw an uptick in healthcare spending both as a share of GDP and in real terms.
- On healthcare, the country spends about 1.3% of its GDP, and this has been flat for the past two years; and 4.9% of its total expenditure, while it is 19.5% as a percentage of spending in social services.
- India needs to spend more on maternal and childcare health to grow at a faster pace.
- Among states and union territories (UTs), 65.7% households (among those where a woman had delivered) in Telangana were pushed into poverty – more than any other state/UT – due to childbearing expenses, followed by Chhattisgarh (53.7%) and Puducherry (53.4%).
- Out-of-pocket (OOP) health spending has pushed 50.6 million people back into poverty.
- Households where the mothers were illiterate were the most affected, with 61% – despite having the lowest maternal health OOP expenditure at Rs 3,600–compared to 36.7% of households where women were graduates and above, who had an OOP expenditure of Rs 19,250.
- More illiterate women prefer public hospitals for delivery in both rural (79.2%) and urban areas (67.7%), which possibly explains their low OOP.
- Among women of different social groups, women belonging to scheduled tribes (STs) had the least maternal OOP expenditure at Rs 2,962, but 71.5% of them were pushed into poverty. As many as 85% ST women in rural areas delivered in public hospitals–more than any other social group.
GLOBAL MARKET OF MOTHER AND CHILD HEALTHCARE
- From 1990 to 2015, the number of maternal deaths worldwide dropped from more than 532,000 to 303,000—a decline of 44%.
- While substantial progress has been achieved, only nine countries reduced their maternal mortality ratio by at least 75% between 1990 and 2015.
- About 99% of the world’s maternal deaths occur in developing regions, with Sub-Saharan Africa alone accounting for two in three (66%) deaths.
- Child mortality rates have plummeted since 1990. Under-five deaths have dropped from 12.7 million per year in 1990 to 5.9 million in 2015.
- Although the global progress has been substantial, 16,000 children under five still die every day.
- A child’s chance of survival is still vastly different based on where he or she is born: Sub-Saharan Africa has the highest under-five mortality rate in the world with one child in 12 dying before his or her fifth birthday—more than 12 times higher than the one in 147 average in high-income countries.
- The Global Financing Facility(GFF) supports reproductive, maternal, newborn, child and adolescent health (RMNCAH) The objectives of the GFF, a new financing model, are to achieve measurable and equitable results and close the financing gap for RMNCAH.
- The annual amount of additional financing required has been estimated at more than $33 billion in 2015. This amount will prevent the deaths of an estimated 24-38 million women, children, and adolescents by 2030.
MOTHER AND CHILD HEALTHCARE MARKET IN INDIA
- WHO estimates show that out of the 529,000 maternal deaths globally each year, 136,000(25.7%) are contributed by India. This is the highest burden for any single country.
- Though India has achieved a remarkable feat in arresting maternal and infant mortality rates and would surpass Sustainable Development Goals (SDG) of reducing maternal mortality to 70 per lakh live births by 2025
- Expected to touch an annualised growth rate of 38 percent, the maternity and childcare hospital market in India is expected to be worth $27 billion by 2020.
- While birthing services compose the overall majority within this market segment, encouragingly it is the pre-natal services care segment that will drive most of this growth, expected to increase by 42 percent year on year.
- Size of the Market India has a handful of paediatric centres in spite of having the highest percentage of 0-14 year olds (29% population). There are close to 2,000-plus paediatric beds in India. This translates into a market size of about Rs 1,500 crore. The overall paediatric market in India is about Rs 55,000 crore
- Growth Rate -The paediatric market is growing at 14-18% per annum.
MOTHER & CHILD MARKET CHALLENGES IN INDIA
- Problem of supplies (drugs, medicines) in the remote areas.
- Inadequate human resources to take care of the population.
MOTHER & CHILD MARKET DRIVERS IN INDIA
- Shortage of facilities offering super-specialty care
- Growing willingness among parents to seek opinion from super-specialists
LIST OF MOTHER AND CHILD HOSPITALS IN INDIA
1. Surya Hospital- Mumbai
Surya Hospitals have been a pioneer in offering modern healthcare services for Women & Children in India since 1985. India’s largest level 3 NICU facility, dedicated neonatal ambulances for free transport of neonates.
- 200 bedded Single/Twin/Suite/General Occupancy Indoor Facility
- 20 OPD consulting rooms with multi-speciality consultants
- 3 fully equipped Ultra-Modern Operation Theatres
- India’s largest 105 bedded Neonatal Intensive Care Unit (NICU)
- 14 bedded Paediatric Intensive Care Unit (PICU)
- 24 hours Paediatric Emergency services
2. Cloudnine Hospital
It is a chain of maternity, childcare, and fertility hospitals headquartered in Bengaluru, India. It was founded by neonatologist Dr. R. Kishore Kumar with his team of three co-founders, in 2007.
3. Apollo Cradle
It is the country’s leading and most trusted healthcare destination, both for the mother as well as for the child. Apollo Cradle offers patients the highest quality care and most advanced treatment in the country in nearly every medical specialty including Gynaecology, Laparoscopy, Paediatrics & Neonatology, Fertility, Fetal Medicine & NICU etc., all supported with the highly qualified specialists.
4. Fortis La Femme- Bangalore
It is a 72 bedded dedicated for women and child care. Fortis La Femme is India’s leading healthcare provider for all stages of a woman’s lifespan-birth, adolescence, motherhood, menopause and beyond.
5. Ovum Hospitals
It is run by Neonatal Care & Research Institute (NCRI), is an organization formed by a group of doctors with national and international experience in the field of paediatrics and gynaecology. Ovum is a maternity hospital which strives to deliver standardized, high quality, patient-centric, and effective healthcare solutions in the field of maternal and child health across India.
6. Wellspring- Bangalore
Wellspring established in 2006, offer gynaecology treatment, delivery, infertility care or paediatrics care with the most extensive health care services available in the region.
7. Motherhood hospital- Chennai
Motherhood, a speciality hospital chain of Bengaluru-based Rhea Healthcare, provides Women and Child care and has delivered more than 16500 babies through its six hospitals in the last 8 years. Pregnancy care, Fertility care, Gynaecology, Advanced Laparoscopy Surgery, Neonatology, Paediatrics, Foetal Medicine, Cosmetology and Radiology are the key specialities.
8. Elizabeth Mother children Hospital- Chennai
A speciality hospital in the suburbs, where we treat each patient as our own with special care, striving for the best quality, deepest compassion and most efficient care.
- Only hospital in the area to have 2 Operation theatres, fully equipped NICU and level 2 PICU.
- Only hospital in the area where Specialists are available 24 X 7.
9. Institute of Child Health- Kolkata
The Institute of Child Health was set up by Dr K.C. Chaudhuri, the doyen of Indian pediatrics, in Kolkata in 1956. The out-patient department with full-fledged laboratory services of the institute opened on 23 January 1956. The in-patient department, with its fifty beds, opened on 15 June 1956. Facilities for the new-born were available as well.
Kilkari Mother and Child Centre at GNH Hospital Gurgaon is a full-fledged women care and maternity centre.
11. Asian Institute of Medical Sciences- Haryana
425-bedded super specialty tertiary care hospital is truly futuristic in its services & technology and brings together some of the most talented medical professionals in India. The hospital has been accredited with NABH and NABL accreditations and is equipped with state-of-the-art technology. The hospital provides preventive, diagnostic, therapeutic, rehabilitative, palliative and supportive services all under one roof and is designed to meet patient care and research requirements of the new millennium.
12. Rainbow Hospital
It is an Indian chain of Paediatric Hospitals headquartered in Hyderabad, India. Founded by Dr. Ramesh Kancharla in 1999, the hospital’s main focus is paediatric and maternal healthcare services.
- The government programmes lacked in increase the overall rates of institutional delivery, nor did they improve maternal and child health was noted in many of the rural areas of India.
- The increase in Out-Of-Pocket expenses for pregnant women was observed.
- Lack of human resources, equipments, shortage of paediatric facilities hampers the mother and child health in India.
- By providing the adequate numbers of resources and facilities would help in gaining the health of mother and child in coming years.
Are you planning to build or restructure or venture – Mother & Child Healthcare in India? Looking for information about the major healthcare players in Government, Private diagnostic centers that are available in India? Are you looking to find out which part of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of Mother & Child Healthcare facilities scenario in India.
Below is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on firstname.lastname@example.org or email@example.com Or you can visit our website on www.hhbc.in