Numbers of individuals at each stage of study
The Total No. of pregnant women registered for ANC- Taken as total number of pregnancy for Jan to Dec-2018, Jan to Dec 2019, Jan to Dec 2020, and Jan to Dec 2021 was 28715284,29239176,27331061,21891305; respectively see table-4. This research study revealed that before start of pandemic in 2020, in which first case of COVID-19 was reported in India [3], year 2019 reported an increase in total number of pregnancy. During pandemic years this research study revealed a decrease in this numbers of several variables under study (see table – 4 and 5 and figure 1).
Table – 4 – Total Numbers of quantitative variables under study in different years
Period
|
Jan to Dec-2018
|
Jan to Dec 2019
|
Jan to Dec 2020
|
Jan to Dec 2021
|
Total No. of pregnant women registered for ANC- Taken as total number of pregnancy
|
28715284
|
29239176
|
27331061
|
21891305
|
Total No. of Deliveries (HD+ ID)
|
20842188
|
21571444
|
20375698
|
16864392
|
Total Number of Institutional Deliveries conducted (Including C-Sections)
|
19388411
|
19388411
|
19298327
|
16057132
|
Total HD
|
1453777
|
1243190
|
1077371
|
807260
|
Total Number of Home Deliveries attended by SBA
|
255814
|
228079
|
197151
|
160443.4
|
Total Home Deliveries attended by Non SBA
|
1197963
|
1015111
|
880220
|
646816.6
|
Total (Out of total ID) women discharged within 48 hours
|
6803202
|
6890913
|
6483022
|
5382451
|
Total Number of PW given Tablet Misoprostol during HD
|
80621
|
74416
|
78722
|
63822.13
|
Total Number of newborns received 7 HBNC in HD
|
938660
|
936941
|
891089
|
802483.6
|
Total Number of newborns received 6 HBNC visits after Institutional Delivery
|
6405013
|
7981529
|
8651475
|
8355130
|
There is a declining trend in No. of pregnant women registered for ANC- Taken as total number of pregnancy during pandemic years 2020 and 2021 as compared to pre-pandemic years. A similar trend was observed in all other variables in this research study except in 2020 1. Number of PW given Tablet Misoprostol during HD increased in number compared to previous year 2019 by 4306 and 5.78639 percent (%) 2. number of newborns received 6 HBNC visits after Institutional Delivery HD increased in number compared to previous year 2019 by 669946 numbers and 8.393705 percent (%).
Table – 5 – Increase and decrease in numbers and percentage of different variables taking 2018 base year
Period
|
Increase / Decrease 2019 to previous year 2018 - Numbers
|
Increase / Decrease 2020 to previous year 2019 - Numbers
|
Increase / Decrease 2021 to previous year 2020 - Numbers
|
Increase / Decrease 2019 to previous year 2018- percent
|
Increase / Decrease 2020 to previous year 2019 - percent
|
Increase / Decrease 2021 to previous year 2020 - percent
|
Total No. of pregnant women registered for ANC- Taken as total number of pregnancy
|
523892
|
-1908115
|
-5439756
|
1.824436074
|
-6.52588
|
-19.9032
|
Mean- No. of pregnant women
|
130973
|
-477029
|
-5008490
|
1.824436074
|
-6.52589
|
-73.3011
|
Total HD
|
-210587
|
-165819
|
-270111
|
-14.48550913
|
-13.3382
|
-25.0713
|
Total ID
|
939843
|
-1029927
|
-3241195
|
4.847447271
|
-5.06648
|
-16.7952
|
Total No. of Deliveries (HD+ ID)
|
729256
|
-1195746
|
-3511306
|
3.498941666
|
-5.54319
|
-17.2328
|
Mean- Total Number of Deliveries
|
60771
|
-99645
|
-292609
|
3.498922474
|
-5.54316
|
-17.2328
|
Number of Home Deliveries attended by SBA
|
-27735
|
-30928
|
-36707.6
|
-10.84186167
|
-13.5602
|
-18.619
|
Home Deliveries attended by Non SBA
|
-182852
|
-134891
|
-233403
|
-15.26357659
|
-13.2883
|
-26.5165
|
Number of PW given Tablet Misoprostol during HD
|
-6205
|
4306
|
-14899.9
|
-7.696505873
|
5.78639
|
-18.9272
|
Number of newborns received 7 HBNC in HD
|
-1719
|
-45852
|
-88605.4
|
-0.183133403
|
-4.8938
|
-9.9435
|
Number of Institutional Deliveries conducted (Including C-Sections)
|
900000
|
-1000000
|
-3200000
|
4.639175258
|
-4.92611
|
-16.5803
|
Out of total ID women discharged within 48 hours
|
87711
|
-407891
|
-1100571
|
1.289260557
|
-5.91926
|
-16.9762
|
Number of newborns received 6 HBNC visits after Institutional Delivery
|
1576516
|
669946
|
-296345
|
24.61378299
|
8.393705
|
-3.42537
|
All variables have shown an increase in 2019 except 1.Total HD 2. Number of newborns received 7 HBNC in HD 3.Home Deliveries attended by Non SBA 4.Number of PW given Tablet Misoprostol during HD 5.Number of Home Deliveries attended by SBA. This novel research study revealed that during pandemic years 2020 and 2021 all the variables reduced quantitatively except 1.Number of PW given Tablet Misoprostol during HD 2. Number of newborns received 6 HBNC visits after Institutional Delivery 3.Total HD 4. Home Deliveries attended by Non SBA which increased little in 2020 see- table 5 and figure 1 (first pandemic year). The statistical analysis of observation for years 2021, 2020, 2019 and 2018 is given in table- 6, 7, 8, and 9 and data for each year is given in 10, 11, 12, and 13.
Table –6-Summary- statistics-2021 (Jan to Dec)
Table –6-Summary- statistics-2021 (Jan to Dec)
|
Variable
|
Obs
|
Mean
|
Std. Dev.
|
Min
|
Max
|
|
|
|
|
|
|
No. of HD by SBA
|
12
|
13370.28
|
2235.476
|
10275.74
|
17301
|
No. of HD by non SBA
|
12
|
53901.39
|
12868.63
|
36336.46
|
75810
|
No. given Misoprostol-HD
|
12
|
5318.511
|
811.0819
|
4141.267
|
6629
|
No. received7 HBNC-HD
|
12
|
66873.63
|
7590.975
|
60215.57
|
81396
|
No. of ID (including C-secn)
|
12
|
1338094
|
195455.9
|
1207656
|
1826745
|
ID discharged <48hrs
|
12
|
448537.5
|
65624.69
|
401151
|
589308
|
No. received 6 HBNC-ID
|
12
|
696260.9
|
69886.11
|
646157.3
|
829656
|
Total estimation - 2021
|
Total estimation
|
Number of obs
|
=
|
12
|
|
Variable
|
Total
|
Std. Err.
|
[95% Conf. Interval]
|
No. of HD by SBA
|
160443.4
|
7743.915
|
143399.1
|
177487.6
|
No. of HD by non SBA
|
646816.6
|
44578.24
|
548700.6
|
744932.7
|
No. given Misoprostol-HD
|
63822.13
|
2809.67
|
57638.09
|
70006.17
|
No. received7 HBNC-HD
|
802483.6
|
26295.91
|
744606.7
|
860360.5
|
No. of ID (including C-secn)
|
1.61e+07
|
677079
|
1.46e+07
|
1.75e+07
|
ID discharged <48hrs |
|
5382451
|
227330.6
|
4882099
|
5882802
|
No. received 6 HBNC-ID
|
8355130
|
242092.6
|
7822288
|
8887973
|
C.I (confidence interval) means – 2021
|
Variable
|
Obs
|
Mean
|
Std. Err.
|
[95% Conf. Interval]
|
|
|
|
|
|
No. of HD by SBA
|
12
|
13370.28
|
645.3262
|
11949.93 14790.63
|
No. of HD by non SBA
|
12
|
53901.39
|
3714.853
|
45725.05 62077.72
|
No. given Misoprostol-HD
|
12
|
5318.511
|
234.1392
|
4803.174 5833.848
|
No. received7 HBNC-HD
|
12
|
66873.63
|
2191.326
|
62050.56 71696.71
|
No. of ID (including C-secn)
|
12
|
1338094
|
56423.25
|
1213908 1462281
|
ID discharged <48hrs |
|
12
|
448537.5
|
18944.22
|
406841.6 490233.5
|
No. received 6 HBNC-ID
|
12
|
696260.9
|
20174.38
|
651857.4 740664.4
|
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 forecasted up to December 2021across India was 13370.28, 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.
Table – 7-Summary- statistics-2020 (Jan to Dec)
Table – 7-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 Misoprostol-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
|
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 Misoprostol-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
|
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 Misoprostol-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
|
This research study revealed that pandemic years have less number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. There is a decrease of 37.28% 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-6, 7, 8, 9, 10, 11, 12, 13, 14 and the comparisons of various indicators are displayed in figures 1. 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 forecasted up to December 2021across India was 53901.39, 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 less 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 forecasted up to December 2021across India was 5318.511, 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 less 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.
Table – 8-Summary- statistics-2019 (Jan to Dec
Table – 8-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 Misoprostol-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
|
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 Misoprostol-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
|
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 Misoprostol-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
|
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 forecasted up to December 2021across India was 66873.63, 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 decreased 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 researcher is pointing out the fact that less number of different variables during pandemic years may be due less number of pregnancy and resultant deliveries during covid-19era. The prevalence rate discussed at end will clear the scenario.
The mean number of Institutional Deliveries (ID) conducted (Including C-Sections)during the pandemic year 2021 with total number of observation of 5 months forecasted up to December 2021across India was 1338094, 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 less 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.
Table – 9 - Summary- statistics-2018 (Jan to Dec)
Table – 9 - 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 Misoprostol-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
|
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 Misoprostol-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
|
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 Misoprostol-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
|
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 forecasted up to December 2021across India was 448537.5, 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 less 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 forecasted up to December 2021across India was 696260.9, 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 less 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.
Table- 10- Prevalence of different study variables per 100000 in different years
Period
|
Jan to Dec-2018
|
Jan to Dec 2019
|
Jan to Dec 2020
|
Jan to Dec 2021
|
Total No. of pregnant women registered for ANC- Taken as total number of pregnancy
|
28715284
|
29239176
|
27331061
|
21891305
|
Total No. of Deliveries-TD (HD+ ID) registered per 100000 ANC registered
|
72582.21092
|
73775.82734
|
74551.43436
|
77036.94229
|
Total Number of Institutional Deliveries(ID) conducted (Including C-Sections) per 100000 Total delivery
|
93024.83501
|
89879.98671
|
94712.47071
|
95213.22797
|
Total HD per 100000 TD
|
6975.164987
|
5763.128328
|
5287.529291
|
4786.772034
|
Total Number of Home Deliveries attended by SBA per 100000 HD
|
17596.50896
|
18346.27048
|
18299.26738
|
19875.05884
|
Total Home Deliveries attended by Non SBA per 100000 HD
|
82403.49104
|
81653.72952
|
81700.73262
|
80124.94116
|
Total (Out of total ID) women discharged within 48 hours per 100000 ID
|
35089.01271
|
35541.40151
|
33593.6996
|
33520.62498
|
Total Number of PW given Tablet Misoprostol during HD per 100000 HD
|
5545.623572
|
5985.891135
|
7306.860868
|
7906.019126
|
Total Number of newborns received 7 HBNC in HD per 100000 HD
|
64566.98655
|
75365.87328
|
82709.5773
|
99408.3195
|
Total Number of newborns received 6 HBNC visits after Institutional Delivery per 100000 ID
|
33035.26524
|
41166.49374
|
44830.18139
|
52033.76294
|
The prevalence of total No. of Deliveries-TD (HD+ ID) registered per 100000 ANC registered was 72582.21092, 73775.82734, 74551.43436, 77036.94229, for 2018, 2019, 2020 and 2021 respectively whereas prevalence for total number of Institutional Deliveries (ID) conducted (Including C-Sections) per 100000 total delivery was 93024.83501, 89879.98671, 94712.47071, 95213.22797 for the years 2018, 2019, 2020 and 2021 respectively see table-10 figure-2 and 3. Regarding total HD per 100000 TD the prevalence was 6975.164987, 5763.128328, 5287.529291, 4786.772034, and total Number of Home Deliveries attended by SBA per 100000 HD the prevalence were 17596.50896, 18346.27048, 18299.26738, and 19875.05884 for 2018, 2019, 2020 and 2021 respectively. Total Home Deliveries attended by Non SBA per 100000 HD was 82403.49104, 81653.72952, 81700.73262, 80124.94116, and total (Out of total ID) women discharged within 48 hours per 100000 ID were 35089.01271, 35541.40151, 33593.6996, 33520.62498, for 2018, 2019, 2020 and 2021 respectively. Total Number of PW given Tablet Misoprostol during HD per 100000 HD for 2018, 2019, 2020 and 2021 respectively was 5545.623572, 5985.891135, 7306.860868, 7906.019126, and total Number of newborns received 7 HBNC in HD per 100000 HD was 64566.98655, 75365.87328, 82709.5773, 99408.3195, respectively see table-10 figure-2 and 3. The total Number of newborns received 6 HBNC visits after Institutional Delivery per 100000 ID was 33035.26524, 41166.49374, 44830.18139, 52033.76294, for 2018, 2019, 2020 and 2021 respectively. This research study revealed that during covid-19 era there is increase in prevalence of following:
- Total No. of Deliveries-TD (HD+ ID) registered per 100000 ANC registered
- Total Number of Institutional Deliveries (ID) conducted (Including C-Sections) per 100000 Total deliveries
- Total Number of Home Deliveries attended by SBA per 100000 HD
- Total Number of newborns received 6 HBNC visits after Institutional Delivery per 100000 ID
- Total Number of newborns received 7 HBNC in HD per 100000 HD
- Total Number of PW given Tablet Misoprostol during HD per 100000 HD
There is decrease in prevalence of following during covid-19 era:
- Total Home Deliveries attended by Non SBA per 100000 HD
- Total HD per 100000 TD and Total (Out of total ID) women discharged within 48 hours per 100000 ID.