Analysing more than 77,000 delivery cases recorded in the National Family Health Survey (NFHS-4 and NFHS-5), the study reports a neonatal mortality rate of 51 deaths per 1,000 live births in private hospitals, compared with 32 per 1,000 in government hospitals. Researchers say the risk of death is nearly 60% higher for infants born in private facilities.
The contrast is especially striking because mothers choosing private hospitals are generally more educated, wealthier and better nourished than those delivering in public institutions. According to RICI researcher Nathan Franz, “The gap cannot be explained by maternal health conditions. It points to systemic problems within private facilities.”
The study highlights that private hospitals often separate newborns from mothers immediately after birtha practice linked to avoidable complications. In UP, the separation rate in private hospitals stands at about 35%, compared with 25% in government facilities. This separation, researchers say, triggers a chain of unwarranted procedures including excessive warmer use, early bathing and unnecessary medication.
District comparisons in Bihar showed that villages with easier access to private centres saw an 8% rise in private deliveries accompanied by 11 additional neonatal deaths per 1,000 births. Similar patterns were recorded in UP, where a 10% increase in private hospital births corresponded to three more newborn deaths per 1,000.
The report concludes that aligning private hospital practices with government protocols could save more than 37,000 newborns each year in UP and Bihar. Eliminating unnecessary interventions alone, it estimates, could prevent over 1.1 lakh deaths annually, underscoring the need for immediate policy and regulatory action.
