Each year, nearly 50 thousand antenatal cases are examined in these maternity homes alone. Approximately 50 percent of these mothers deliver in the Government maternity homes Independent reviews; stakeholder consultations and media reports in the past have significantly highlighted poor service delivery and alarming levels of corruption in the maternity homes. Various groups working for the poor in the city had expressed a strong demand to carry out a user feedback survey to empirically assess the quality of care particularly that of the service delivery process at the maternity homes. As a response to this, Public Affairs Centre undertook a unique Citizen Report Card survey of maternity homes, India Population Project (IPP) Centres and Urban Family Welfare Centres (UFWC) in partnership with five city based NGOs in 2000. A total of 500 patients and 77 staff of these facilities were interviewed. The purpose of the survey was to get corroborative evidence on the poor quality of services provided, and the widespread corruption in the Maternity Homes to strengthen the advocacy work of Civil Society Organisations. The Citizen Report Card highlighted the following issues.

1. The most distressing finding concerned the prevalence of corruption. While none of the facilities seemed corruption free, maternity homes stood out in terms of the severity of the problem. Payments were demanded or expected by staff for almost all services, but most of all, for delivery and seeing the baby. The proportion of people paying bribes varied from one service to another. On the whole, 90 percent of the respondents reported paying bribes for one service or the other at maternity homes at an average of INR 700 (1 USD = 45 INR) per head. Nearly 70 percent paid for seeing their own babies! One out of two paid for delivery.
2. If a poor woman paid for all services, it would have cost her over INR. 1000 for a delivery. It was reported that a nursing home might give her hassle free and better quality service for INR. 2000. A rough estimate of the bribes being paid in all these facilities may have been between INR 10 and 20 million annually. A similar estimate based on the finding that 90 percent of the women pay an average of about INR 700 at the Maternity Homes would put the total amount of bribes paid at about INR 16 million then.
3. Most staff denied that they practiced corruption. They complained about the constraints on facilities, and shortage of staff, supplies and resources. Doctors emphasised the need to improve the awareness of patients, especially with respect to the need to be regular in their visits.
4. While only 39 percent of the patients were given medicines free of cost at the maternity homes, 61 percent and 63 percent were supplied free medicines at the UFWCs and IPP Health Centres respectively. Money was demanded for the medicines from 11 percent of the women at the maternity homes while only 4 and 3 percent reported being asked to pay money for medicines at UFWCs and IPP Health Centres respectively. The average amount paid for medicines was higher at INR 94 at maternity homes than INR 30 paid at UFWCs. But the least amount was paid at IPP Health Centres (INR. 15). Interestingly, all doctors, nurses and other staff at all the three types of facilities reported free medicines being given to all patients all the time.
5. IPP health Centres were, on the whole, rated better than the UFWCs and Maternity Homes. For similar services provided by all three, the rating was the highest for IPP Health Centres and lowest for Maternity Homes.

The final report can be downloaded here.