Chennai: The share of births taking place in Tamil Nadu govt hospitals has fallen from more than 65% in 2017-18 to below 51% now, health minister K G Arunraj said on Sunday, calling for a detailed study of why women are increasingly choosing private facilities.After inaugurating the Obstetric and Gynaecological Society of South India mid-year conference 2026 in the city, Arunraj said the decline had occurred despite investments in infrastructure and services at govt hospitals. “I was told some private medical colleges offer free deliveries. Deliveries themselves are not covered under the state health insurance programme, he said. But eligible women who give birth in private hospitals can receive maternity assistance through the Dr Muthulakshmi Reddy Maternity Benefit Scheme. These could be some of the reasons, but we need to study this in detail,” he said.A National Sample Survey Office health survey found that a woman delivering in a govt hospital spends about ₹1,200 out of pocket, largely on travel, food and incidental expenses. The comparable cost of a delivery in a private hospital is about ₹67,000, according to the survey. To bring more women to public hospitals, the state has set aside ₹560 crore for the Thai Maaman Thanga Mothiram Thittam, under which newborns delivered in govt hospitals will receive a one-gram gold ring.Nearly 99% of births in Tamil Nadu take place in health facilities, the minister said, and infant and maternal mortality rates are among the lowest in the country. “We want to reduce this further. We also want to make sure cost is low,” he said. Arunraj also warned that Tamil Nadu must prepare for the consequences of a rapidly ageing population. About 16 of every 100 residents are now over 60, he said, reflecting the state’s transition from a predominantly young population to an ageing one. Tamil Nadu’s population is projected to rise from 7.2 crore in 2011 to 7.7 crore in 2026 and 7.8 crore in 2036. But its total fertility rate has fallen sharply from about 3.9 children per woman in 1971 to 2.7 in 1986, below 2 by 2000, to 1.6 in 2017, and to about 1.3 now.“That is well below the replacement-level fertility rate of 2.1, the level needed for a population to remain stable over the long term without migration. We must examine policies to ensure that the population does not decline drastically,” he said, noting that some states, including Andhra Pradesh, had begun experimenting with incentives for larger families as they confronted similar demographic pressures.
