What is the impact of COVID-19 pandemic years on Deliveries and Home Based New Born Care in India?

doi:10.21203/rs.3.rs-1314021/v1

Background:

The COVID-19 pandemic caused by SARS-CoV-2 has led to disruption of health services globally. I assessed the effect of the ongoing pandemic on the Deliveries and Home Based New Born Care (HBNC) in India. The author is curious and suspects a rise in maternal and neonatal mortality due to possible negative effects of COVID-19 on maternal institutional delivery and HBNC. Hence author decided to find out answer to the research question mentioned as title above.

Methods:

I conducted a retrospective cross-sectional comparative study among total numbers of women and newborn who have received delivery and HBNC care at different health facilities in 36 states and union territories across India during the pandemic years with pre-pandemic years (comparing 2020 and 2021(up to May) with previous two years of pre-pandemic era i.e. 2018-2019). The data for the research study is extracted from electronic records of HMIS (health management information system) of MoHFW (ministry of health and family welfare), Govt. of India and analysed with stata and Microsoft office.

Results:

The mean number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)] during the pandemic year 2021 with total number of observation of 5 months across India was 15491, for years 2020, 2019,2018 it was 16429.25 ,19006.58 , 21317.83 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. This research study revealed that pandemic years have negative impact on number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. There is a decrease of 27.33 % in mean number of home deliveries attended by SBA in 2021 as compared to 2018.

Conclusions:

The ongoing COVID-19 pandemic has had negative effects on Deliveries and Home Based New Born Care (HBNC) in India. More research is required to investigate the direct and indirect consequence of the pandemic on birth and provision of HBNC as well as the health facility type which are not performing well in providing respectful maternity care and newborn services during pandemic period. The facility based research analysis is under process by the author which will be available in next version of this article.

Statistical Epidemiology

Obstetrics & Gynecology

General Practice

Home delivery

Institutional delivery

newborn

care

pandemic year

covid-19

As per the previous estimates of UNICEF (United Nations International Children's Emergency Fund) about 116 million babies will be born within 40 weeks of ongoing COVID-19 pandemic, straining health systems as well as medical supply chains globally – was declared as a pandemic on March 11[1]. Pregnant mothers as well as babies born during the ongoing COVID-19 pandemic are continued to be threatened by strained health systems involved in fighting with this novel disease. I assessed the effect of the ongoing pandemic on the Deliveries and Home Based New Born Care (HBNC) in India. The author is curious and suspects a rise in maternal and neonatal mortality due to possible negative effects of COVID-19 on maternal institutional delivery and HBNC. Hence author decided to find out answer to the research question mentioned as title above. Global containment measures like lockdowns etc; health centres overwhelmed with covid-19 response efforts added with supply and equipment shortages and a lack of sufficient skilled birth attendants because health workers, including midwives, are redeployed to treat COVID-19 patients [1]. During this ongoing pandemic years countries expected with highest numbers of births during the 9 months since the declaration of pandemic are 1.India (20.1 million) 2.China (13.5 million), 3.Nigeria (6.4 million), 4.Pakistan (5 million) and 5.Indonesia (4 million). As per available data most of these countries listed above had a high neonatal mortality rates (NMR) even before the covid-19 pandemic and these levels may increase with COVID-19 situations [1].

The key aim of this research study was to find out the impact of COVID-19 pandemic years on Deliveries and Home Based New Born Care in India. To fulfil the aim of study the objective was to collect, analyse, interpret the data for the research question.

I conducted a retrospective cross-sectional comparative study among total numbers of women and newborn who have received delivery and HBNC care in different ways at different health facilities in 36 states and union territories across India during the pandemic (comparing 2020 and 2021(up to May) with previous two years of pre-pandemic era i.e. 2018-2019). The data for the research study is extracted from electronic records of HMIS (health management information system) of MoHFW (ministry of health and family welfare), Govt. of India. For this retrospective cross-sectional study, available online data from HMIS is collected from January 2018 to May 2021(advance data after this period was not available). Newborn who utilized HBNC and deliveries reported during this period were included in this study. Data analyses including statistical analysis were done with stata and Microsoft office software. To know the impact on delivery and HBNC the following indicators are included as operational definition of impact of COVID-19 pandemic years on Deliveries and Home Based New Born Care in this research analysis:

Number of Home Deliveries attended by Skill Birth Attendant(SBA) (Doctor/Nurse/ANM/ Midwife)
Number of Home Deliveries attended by Non SBA (Trained Birth Attendant(TBA) /Relatives/etc.)
Number of PW given Tablet Misoprostol during home delivery
Number of newborns received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery
Number of Institutional Deliveries conducted (Including C-Sections)
Out of total institutional deliveries number of women discharged within 48 hours of delivery
Number of newborns received 6 HBNC visits after Institutional Delivery

For this novel study, accredited data is obtained from electronic records of HMIS of MoHFW (Ministry of Health and Family Welfare), Government of India. The link for the source is available below:-

https://hmis.nhp.gov.in/#!/standardReports

The mean number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)] during the pandemic year 2021 with total number of observation of 5 months across India was 15491, for years 2020, 2019,2018 it was 16429.25 ,19006.58, 21317.83 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. There is a decrease of 27.33% in mean number of home deliveries attended by SBA in 2021 as compared to 2018. The details of data and statistical analysis are mentioned in Table 1,2,3,4,5,6,7,8,9, 10,11,12, 13,14,15,16 and the comparisons of various indicators are displayed in figures 1,2,3,4,5,6, and 7.

The mean number of Number of Home Deliveries attended by Non SBA (Trained Birth Attendant(TBA) /Relatives/etc. during the pandemic year 2021 with total number of observation of 5 months across India was 66145, for years 2020, 2019,2018 it was 73351.66 ,84592.58, 99830.25 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of home deliveries attended by Non SBA (Trained Birth Attendant (TBA) /Relatives/etc. There is a decrease of 33.74% in mean number of home deliveries attended by Non-SBA in 2021 as compared to 2018.

The mean number of Number of PW given Tablet Misoprostol during home delivery during the pandemic year 2021 with total number of observation of 5 months across India was 6065.8, for years 2020, 2019, 2018 it was 6560.16, 6201.33, and 6718.42 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on Number of PW given Tablet Misoprostol during home delivery. There is a decrease of 9.72% in mean Number of PW given Tablet Misoprostol during home delivery in 2021 as compared to 2018.

The mean number of newborns who received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery during the pandemic year 2021 with total number of observation of 5 months across India was 73158.2, for years 2020, 2019, 2018 it was 74257.42, 78078.42, and 78221.67 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of newborns received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery. There is a decrease of 6.47% in mean Number of newborns received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery in 2021 as compared to 2018.

The mean number of Institutional Deliveries (ID) conducted (Including C-Sections)during the pandemic year 2021 with total number of observation of 5 months across India was 1480859.8, for years 2020, 2019, 2018 it was 1608193.92, 1694021.12, and 1615700.92 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of Institutional Deliveries conducted (Including C-Sections). There is a decrease of 8.34% in mean number of Institutional Deliveries conducted (Including C-Sections) in 2021 as compared to 2018.

The mean number of women discharged within 48 hours of delivery out of total ID during the pandemic year 2021 with total number of observation of 5 months across India was 497037.2, for years 2020, 2019, 2018 it was 540251.83, 574242.75, and 566933.5 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of women discharged within 48 hours of delivery out of total ID. There is a decrease of 12.32% in mean number of women discharged within 48 hours of delivery out of total ID in 2021 as compared to 2018.

The mean number of newborns received 6 HBNC visits after Institutional Delivery during the pandemic year 2021 with total number of observation of 5 months across India was 747457.8, for years 2020, 2019, 2018 it was 720956.25, 665127.42, and 533751.08 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have positive impact on Number of newborns received 6 HBNC visits after Institutional Delivery. There is an increase of 40.03% in mean Number of newborns received 6 HBNC visits after Institutional Delivery in 2021 as compared to 2018.

Urgent attention and measures should be taken by government and policy makers to continue to provide maternal and newborn health services during ongoing COVID-19 pandemic. Government, policy makers should develop special need based guidelines, interventions-for the pregnant women and newborn. Continuous monitoring and routinely checking -the existing facilities health service in different levels of hospitals i.e. from local to tertiary specialised and rural-urban-public- private clinics. Legal regulations and strict enforcements so that health cares institutions cannot deny providing maternal and newborn services. Training and capacity building of the health workers including everyone and to sort out the barriers to access maternal-newborn health services during ongoing COVID-19. Raising awareness among PW and relatives about visiting health care facilities along with the positive behavioural change of the health workers to work in pandemic situations can help in mitigation of negative impacts of covid-19.

This is a novel cross-sectional retrospective research study based on accredited secondary data which was one of the limitations of this research study. Another limitation is data availability is not for latest time and date. Accredited and established source of data recognized worldwide is not available for the same study anywhere else. The main strength is that the whole study is based on real time based accredited government data sources and this kind of research study is unique and not available for the context of India or other countries as found by the researcher of this novel study.

The ongoing COVID-19 pandemic has had negative effects on Deliveries and Home Based New Born Care (HBNC) in India. More research is required to investigate the direct and indirect consequence of the pandemic on birth and provision of HBNC as well as the health facility type which are not performing well in providing respectful maternity care and newborn services during pandemic period. The facility based research analysis is under process by the author which will be available in next version of this article. The author recommends following:

Establishment of exclusive specialised birth centres as pregnant women feels usually worried about giving birth in multipurpose hospitals.
Helping pregnant women to receive ANC checkups, delivery care, postnatal care, COVID-19 care as needed;
Ensuring availability of skilled health workers with PPE (personal protective equipment), priority testing and vaccination so that they can deliver care to all pregnant women and newborn babies without spreading infection during the pandemic;
Application of infection prevention and control measures in health facilities during childbirth and care immediately after;
Raising awareness among pregnant women through home visits,
Encouraging women and their relatives in remote areas to use maternal health facilities and HBNC
Training, protecting and capacity building of health workers with clean birth kits for home births when health facilities are not available or closed;
Allocating more resources to maternity and newborn services and supplies.
Educating PW to protect themselves from exposure to covid-19, and take advice from the designated health facility if experience symptoms;
Seek medical care timely from accredited health facility and avoid jhola-chaap(fake medical practioners) as well as quacks if they live in remote areas and have fever, cough or difficulty breathing;
Continue breastfeeding their baby as the virus has not been found in samples of breast milk [2]. Wear a mask while feeding baby; wash hands; and routinely clean and disinfect surfaces; if not Covid positive continue to hold the newborn as well as perform skin-to-skin care;
Ask designated doctor and health staff the safest place to give birth;
Have a birth plan in advance to reduce stress and to ensure place on time;
Routine immunizations, after the baby is born.

Home Based New Born Care (HBNC); COVID-19- corona virus disease 2019; SARS-CoV-2- severe acute respiratory syndrome coronavirus 2; SBA [(Skill Birth Attendant); HMIS (health management information system); MoHFW (ministry of health and family welfare); HD – home delivery; PW- pregnant women; ID- institutional delivery; PPE (personal protective equipment); ANC – antenatal care;

-This version of paper has not been previously published in any peer reviewed journal and is not currently under consideration by any journal. The document is Microsoft word with English (United States) language & 2321words excluding reference and declaration (4517 words Total including all).

- Ethics approval and consent to participate: Not applicable. This study has not involved any human or animals in real or for experiments. The submitted work does not contain any identifiable patient/participant information.

-Consent for publication: The author provides consent for publication.

-Availability of data and materials: Electronic records from HMIS (health management information system) of MoHFW (ministry of health and family welfare), Government of India.

-Conflicts of Interest/ Competing Interest: There are no conflicts / competing of interest

- Funding-Self sponsored. No aid taken from individual or agency etc.

- Authors' contributions: The whole work is done by the Author - Dr Piyush Kumar, M.B.B.S., E.M.O.C., P.G.D.P.H.M., -Senior General Medical Officer- Bihar Health Services- Health Department- Government of Bihar, India.

- Acknowledgements- I am thankful to Advocate Anupama my wife and daughters Aathmika-Atheeva for cooperation.

- Author information: The author is currently working as Senior General Medical Officer for the government of Bihar.

-Financial Support & sponsorship: Nil

-Author contact information
Department of Health, Government of Bihar, MOBILE - +919955301119/+917677833752, Email [email protected]

1. Pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services - https://www.unicef.org/press-releases/pregnant-mothers-and-babies-born-during-covid-19-pandemic-threatened-strained-health

2. Breastfeeding and COVID-19 – WHO- available at links below

https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19

Table – 1-Summary- statistics-2021 (Jan to May)

Variable \|	Obs	Mean	Std. Dev.	Min	Max
No. of HD by SBA \|	5	15491	1474.644	13263	17301
No. of HD by non SBA \|	5	66145	8546.646	53151	75810
No. given Misoprost-HD \|	5	6065.8	545.2859	5251	6629
No. received7 HBNC-HD \|	5	73158.2	8344.909	62140	81396
No. of ID (including C-secn) \|	5	1480860	245181.8	1247082	1826745
ID discharged <48hrs \|	5	497037.2	81020.06	403324	589308
No. received 6 HBNC-ID \|	5	747457.8	86818.81	651878	829656

Table – 2-Total estimation - 2021- Number of obs = 5

Variable	Total	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	77455	3297.404	68299.94 86610.06
No. of HD by non SBA \|	330725	19110.88	277664.7 383785.3
No. given Misoprost-HD \|	30329	1219.296	26943.69 33714.31
No. received7 HBNC-HD	365791	18659.78	313983.1 417598.9
No. of ID (including C-secn)	7404299	548243.2	5882132 8926466
ID discharged <48hrs	2485186	181166.4	1982188 2988184
No. received 6 HBNC-ID	3737289	194132.8	3198290 4276288

Table – 3-C.I (confidence interval) means – 2021

Variable	Obs	Mean	Std. Err.	[95% Conf. Interval]
No. of HD by SBA	5	15491	659.4807	13659.99 17322.01
No. of HD by non SBA	5	66145	3822.176	55532.94 76757.06
No. given Misoprost-HD	5	6065.8	243.8593	5388.738 6742.862
No. received7 HBNC-HD	5	73158.2	3731.957	62796.63 83519.77
No. of ID (including C-secn)	5	1480860	109648.6	1176426 1785293
ID discharged <48hrs \|	5	497037.2	36233.27	396437.5 597636.9
No. received 6 HBNC-ID	5	747457.8	38826.55	639658 855257.6

Table – 4-Summary- statistics-2020 (Jan to Dec)

Variable \|	Obs	Mean	Std. Dev.	Min	Max
No. of HD by SBA \|	12	16429.25	3373.569	8047	20183
No. of HD by non SBA \|	12	73351.67	14621.01	33185	86457
No. given Misoprost-HD \|	12	6560.167	1241.477	4251	8580
No. received7 HBNC-HD \|	12	74257.42	17327.82	28639	87890
No. of ID (including C-secn)\|	12	1608194	197666.5	1219729	1849115
ID discharged <48hrs \|	12	540251.8	91445.49	364659	648151
No. received 6 HBNC-ID \|	12	720956.3	123371.7	461874	869027

Table – 5-Total estimation - 2020 - Number of obs = 12

Variable	\| Total	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	197151	11686.38	171429.4 222872.6
No. of HD by non SBA \|	880220	50648.66	768743 991697
No. given Misoprost-HD \|	78722	4300.604	69256.43 88187.57
No. received7 HBNC-HD \|	891089	60025.33	758974.1 1023204
No. of ID (including C-secn) \|	1.93e+07	684736.8	1.78e+07 2.08e+07
ID discharged <48hrs \|	6483022	316776.5	5785802 7180242
No. received 6 HBNC-ID \|	8651475	427372.2	7710835 9592115

Table – 6-C.I (confidence interval) means – 2020

Variable \|	Obs	Mean	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	12	16429.25	973.8654	14285.79 18572.71
No. of HD by non SBA \|	12	73351.67	4220.722	64061.92 82641.41
No. given Misoprost-HD \|	12	6560.167	358.3837	5771.37 7348.964
No. received7 HBNC-HD \|	12	74257.42	5002.111	63247.84 85266.99
No. of ID (including C-secn) \|	12	1608194	57061.4	1482603 1733785
ID discharged <48hrs \|	12	540251.8	26398.04	482150.1 598353.5
No. received 6 HBNC-ID \|	12	720956.3	35614.35	642569.6 799342.9

Table – 7-Summary- statistics-2019 (Jan to Dec)

Variable \|	Obs	Mean	Std. Dev.	Min	Max
No. of HD by SBA \|	12	19006.58	1652.682	16387	20793
No. of HD by non SBA \|	12	84592.58	6727.217	70630	91917
No. given Misoprost-HD \|	12	6201.333	531.5118	5253	6959
No. received7 HBNC-HD \|	12	78078.42	7856.47	63616	87138
No. of ID (including C-secn)	12	1694021	168219.1	1409794	1895697
ID discharged <48hrs \|	12	574242.8	72415.95	443409	671254
No. received 6 HBNC-ID \|	12	665127.4	85338.78	542151	781203

Table – 8 -Total estimation -2019 Number of obs = 12

Variable	\| Total	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	228079	5725.058	215478.2 240679.8
No. of HD by non SBA \|	1015111	23303.76	963819.8 1066402
No. given Misoprost-HD \|	74416	1841.211	70363.52 78468.48
No. received7 HBNC-HD \|	936941	27215.61	877039.8 996842.2
No. of ID (including C-secn) \|	2.03e+07	582728	1.90e+07 2.16e+07
ID discharged <48hrs \|	6890913	250856.2	6338782 7443044
No. received 6 HBNC-ID \|	7981529	295622.2	7330869 8632189

Table – 9 - C.I (confidence interval) means – 2019

Variable \|	Obs	Mean	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	12	19006.58	477.0882	17956.52 20056.65
No. of HD by non SBA \|	12	84592.58	1941.98	80318.31 88866.85
No. given Misoprost-HD \|	12	6201.333	153.4342	5863.627 6539.04
No. received7 HBNC-HD \|	12	78078.42	2267.967	73086.65 83070.18
No. of ID (including C-secn) \|	12	1694021	48560.67	1587140 1800902
ID discharged <48hrs \|	12	574242.8	20904.68	528231.8 620253.7
No. received 6 HBNC-ID \|	12	665127.4	24635.18	610905.7 719349.1

Table – 10 - Summary- statistics-2018 (Jan to Dec)

Variable \|	Obs	Mean	Std. Dev.	Min	Max
No. of HD by SBA \|	12	21317.83	1730.307	19091	24266
No. of HD by non SBA \|	12	99830.25	9646.946	84554	116307
No. given Misoprost-HD \|	12	6718.417	657.5543	5411	7564
No. received7 HBNC-HD \|	12	78221.67	7188.477	68640	87132
No. of ID (including C-secn)	12	1615701	176173.3	1363935	1856881
ID discharged <48hrs \|	12	566933.5	73511.3	448374	660925
No. received 6 HBNC-ID \|	12	533751.1	63534.34	440685	624944

Table- 11- Total estimation - 2018 Number of obs = 12

Variable	Total	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	255814	5993.958	242621.4 269006.6
No. of HD by non SBA \|	1197963	33418	1124410 1271516
No. given Misoprost-HD \|	80621	2277.835	75607.52 85634.48
No. received7 HBNC-HD \|	938660	24901.61	883851.9 993468.1
No. of ID (including C-secn)	1.94e+07	610282.2	1.80e+07 2.07e+07
ID discharged <48hrs \|	6803202	254650.6	6242720 7363684
No. received 6 HBNC-ID \|	6405013	220089.4	5920600 6889426

Table- 12- C.I (confidence interval) means – 2018

Variable \|	Obs	Mean	Std. Err.	[95% Conf. Interval]
No. of HD by SBA \|	12	21317.83	499.4965	20218.45 22417.22
No. of HD by non SBA \|	12	99830.25	2784.833	93700.87 105959.6
No. given Misoprost-HD \|	12	6718.417	189.8196	6300.627 7136.207
No. received7 HBNC-HD \|	12	78221.67	2075.135	73654.33 82789.01
No. of ID (including C-secn)	12	1615701	50856.85	1503766 1727636
ID discharged <48hrs \|	12	566933.5	21220.89	520226.6 613640.4
No. received 6 HBNC-ID \|	12	533751.1	18340.78	493383.3 574118.9

Table- 13 - Observation for the year - 2021

Indicator	Number of Home Deliveries attended by SBA	Home Deliveries attended by Non SBA	Number of PW given Tablet Misoprostol during HD	Number of newborns received 7 HBNC in HD	Number of Institutional Deliveries conducted (Including C-Sections)	Out of total ID women discharged within 48 hours	Number of newborns received 6 HBNC visits after Institutional Delivery
Total Jan 2021	17301	75810	6629	81396	1615041	551895	829656
Total Feb 2021	15975	70376	6434	78307	1452146	517895	781658
Total March 2021	15791	68104	5826	77450	1826745	589308	817272
Total April 2021	13263	53151	5251	62140	1247082	422764	656825
Total May 2021	15125	63284	6189	66498	1263285	403324	651878

Table- 14 - Observation for the year 2020

Indicator	Number of Home Deliveries attended by SBA	Home Deliveries attended by Non SBA	Number of PW given Tablet Misoprostol during HD	Number of newborns received 7 HBNC in HD	Number of Institutional Deliveries conducted (Including C-Sections)	Out of total ID women discharged within 48 hours	Number of newborns received 6 HBNC visits after Institutional Delivery
Total Jan 2020	17364	81458	6452	86904	1686421	564526	765405
Total Feb 2020	17321	75444	5690	84736	1534676	518676	738549
Total Mar 2020	14060	67611	5134	76170	1527869	511141	695368
Total April 2020	8047	33185	4251	28639	1219729	364659	461874
Total May 2020	14364	66359	5763	60682	1395381	435889	584777
Total Jun 2020	14946	67389	6253	64834	1409429	442182	618175
Total Jul 2020	15200	71088	6724	66954	1576238	517349	665568
Total Aug 2020	19355	80333	7479	75412	1725793	603254	740827
Total Sep 2020	20183	86457	8580	85804	1811424	648151	798730
Total Oct 2020	19388	84215	7991	86738	1849115	643160	852982
Total Nov 2020	18412	85274	7567	87890	1813584	627710	860193
Total Dec 2020	18511	81407	6838	86326	1748668	606325	869027

Table- 15 - Observation for the year 2019

Indicator	Number of Home Deliveries attended by SBA	Home Deliveries attended by Non SBA	Number of PW given Tablet Misoprostol during HD	Number of newborns received 7 HBNC in HD	Number of Institutional Deliveries conducted (Including C-Sections)	Out of total ID women discharged within 48 hours	Number of newborns received 6 HBNC visits after Institutional Delivery
Total Jan 2019	20559	90459	6959	77446	1660316	586521	609397
Total Feb 2019	19620	89852	6239	77616	1472340	523286	578978
Total March 2019	20325	91917	6504	80964	1717500	566155	614187
Total April 2019	16395	70630	5253	63616	1409794	443409	542151
Total May 2019	16387	75644	5370	67538	1544936	494842	581991
Total Jun 2019	17670	78944	5556	70976	1548487	501656	614269
Total Jul 2019	17582	82948	6255	72506	1710352	567274	662672
Total Aug 2019	20793	90982	6288	82663	1895697	671254	727880
Total Sep 2019	20572	88290	6305	85882	1871061	660643	760083
Total Oct 2019	20213	88023	6681	85424	1879063	652288	781203
Total Nov 2019	19661	85232	6490	85172	1848889	624935	752457
Total Dec 2019	18302	82190	6516	87138	1769819	598650	756261

Table- 16 - Observation for the year 2018

Indicator	Number of Home Deliveries attended by SBA	Home Deliveries attended by Non SBA	Number of PW given Tablet Misoprostol during HD	Number of newborns received 7 HBNC in HD	Number of Institutional Deliveries conducted (Including C-Sections)	Out of total ID women discharged within 48 hours	Number of newborns received 6 HBNC visits after Institutional Delivery
Total Jan 2018	24266	116307	7564	85372	1537515	580841	495132
Total Feb 2018	22174	105130	6770	81164	1414812	533569	480260
Total March 2018	22682	104756	6826	83942	1559206	556698	505544
Total April 2018	19091	84554	5411	68640	1363935	448374	440685
Total May 2018	19981	89514	5599	69383	1479816	485796	478596
Total Jun 2018	19993	91476	6225	70263	1455342	478528	492563
Total Jul 2018	20255	95981	7194	74076	1590046	543513	512433
Total Aug 2018	21100	100816	7054	76342	1795922	643962	551799
Total Sep 2018	23731	110616	7066	87132	1845585	660925	596423
Total Oct 2018	22394	105652	7189	85570	1856881	660268	622508
Total Nov 2018	21046	103762	7084	85039	1802810	641385	624944
Total Dec 2018	19101	89399	6639	71737	1686541	569343	604126

What is the impact of COVID-19 pandemic years on Deliveries and Home Based New Born Care in India?

Status:

Version 1

Abstract

Figures

Background

Aim And Objective

Methodology

Data Availability

Results

Discussion

Study Strength And Limitation

Conclusion And Recommendation

Abbreviations

Declarations

References

Tables

Status:

Version 1