Effect of energy shortages on institutional delivery in India

IntroductionEnergy shortages are a common challenge in many low- and middle-income countries and can disrupt the operation of healthcare facilities, which can compromise patient outcomes and affect health service utilization. Maternal healthcare use, in particular, has been found to be negatively correlated with power outages in other contexts. The following study investigates the association between state-level energy shortages and institutional delivery rates in India and how the association varies according to womens socio-economic status. MethodsUsing data from the 1998-99 and 2005-06 India Demographic and Health Surveys, along with information on power outages from Indias Central Electricity Authority, we estimate the association between energy shortages and institutional delivery rates using both logistic and multinomial regressions. ResultsEnergy shortages were associated with reduced rates of institutional delivery: a 10% increase in the shortage level corresponded to a 1.1% decline in the percentage of women giving birth in a healthcare facility. Deliveries in public health facilities were more likely to be disrupted by energy shortages than deliveries in private facilities. ConclusionEnergy shortages are an important determinant of institutional delivery in India. Given that increasing institutional delivery rates is likely important to reduce maternal mortality, policymakers should work to mitigate the impact of energy disruptions on healthcare seeking behaviours.