In a worrying sign for maternal health in Karnataka, 162 out of 880 primary health centres (PHCs) that operate round the clock did not record a single childbirth in the past year. The figures reveal serious underuse of basic healthcare facilities meant to support safe deliveries for rural women.
The state government has been trying to reduce maternal mortality by strengthening human resources, but many PHCs and community health centres (CHCs) are falling short. These centres are supposed to handle normal deliveries and provide emergency care for expectant mothers, yet their numbers show otherwise.
Among 275 CHCs in Karnataka, only six percent of all institutional deliveries took place in these centres. Of them, just 42 CHCs met the government’s target of at least 30 deliveries per month, while the remaining 233 performed far below expectations.
PHCs are expected to conduct about 10 deliveries a month. However, 130 of them managed just one delivery per month, and 279 centres reported fewer than six deliveries. The most alarming finding is that 162 PHCs saw no deliveries at all, despite being equipped to function 24/7.
Health Minister Dinesh Gundu Rao said the poor performance was due to a mix of factors, including lack of motivation among doctors and inadequate training among nurses. Some staff at these centres are reportedly not confident in handling childbirth cases, which leads expectant mothers to travel to district hospitals or private facilities.
To fix the issue, the state plans to redeploy staff from underperforming PHCs to busier ones where the need is higher. This is expected to balance workloads and ensure that qualified staff are available where they are most needed.
One centre that stands out for good performance is the PHC at Rajankollur in Yadgir district. Despite limited staff, including just a general duty medical officer and a few nurses, it records over 100 deliveries every month. This example shows that dedication, teamwork, and proper management can make a huge difference.
Researchers analysed data from rural India to see how well-equipped PHCs influenced where women delivered. They created a “Facility Index” to rate infrastructure like labour rooms, trained staff, and 24-hour services, then matched it with delivery patterns. Districts with well-equipped PHCs saw women 2.45 times more likely to deliver there compared to poorly equipped ones. But once facilities reached top quality, the rise in deliveries flattened, showing that good infrastructure alone does not guarantee use, confidence, trust, and community outreach matter just as much. 1
While PHCs are struggling, the overall maternal mortality rate in Karnataka has shown improvement. Between January and October this year, 366 maternal deaths were reported, compared to 483 during the same period in 2024. This 24 percent drop suggests that larger hospitals and better emergency care are having a positive impact, even as smaller centres lag behind.
The state government has also approved 125 new super-specialist posts in 15 district hospitals, including cardiologists, nephrologists, and neurologists. These specialists will support complicated pregnancies and improve access to advanced care.
References:
1. Mustafa, Rukhsana, Samiran Nundy, and Nachiket Mor. “A Situation Analysis of Child Delivery Facilities at Primary Health Centres (PHCs) in Rural India and Its Association with Likelihood of Selecting PHC for Child Delivery.” BMC Health Services Research 21, no. 1 (2021): 1225. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07254-x?
(Rh/ARC/MSM)