Maternal Healthcare in Rural Uttar Pradesh: Influence of free Services on Healthcare-Seeking behaviour of Women

2020 ◽  
Vol 40 (3) ◽  
pp. 362-380
Author(s):  
Lakshmi Devi ◽  
Manvinder Kaur
Keyword(s):  
Rural Women ◽  
Uttar Pradesh ◽  
Healthcare Services ◽  
Policy Implications ◽  
Strategic Choices ◽  
Maternal Healthcare ◽  
Healthcare Seeking ◽  
Home Based ◽  
State Financing ◽  
The Impact

This field-based study evaluates the impact of free maternal healthcare services on the healthcare-seeking behaviour of 125 pregnant women in six villages of Uttar Pradesh. The 87 Muslim and 38 non-Muslim women participating in this project appreciated the antenatal and postnatal care processes on offer. Yet, various government efforts to encourage women to give birth in government hospitals to comply with international benchmarks on reduction of maternal mortality rates were unsuccessful. The study explores the various reasons for the strategic choices made by these rural women, who continue to favour home-based delivery. The findings raise policy implications about how state financing of maternal healthcare provisions in India is to be delivered, in the best possible manner, at local levels.

scholarly journals Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

2020 ◽  
Vol 5 (9) ◽  
pp. e002879
Author(s):  
Thomas Druetz ◽  
Lalique Browne ◽  
Frank Bicaba ◽  
Matthew Ian Mitchell ◽  
Abel Bicaba
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Negative Binomial ◽  
Terrorist Attack ◽  
Healthcare Services ◽  
Terrorist Attacks ◽  
Cesarean Sections ◽  
Maternal Healthcare ◽  
District Hospitals ◽  
The Impact

IntroductionMost of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso.MethodsThis longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections).ResultsDuring the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5).ConclusionTerrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.

scholarly journals Household food insecurity is independently associated with poor utilization of maternal healthcare services in Bangladesh

FACETS ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 969-983 ◽  
Author(s):  
Ghose Bishwajit ◽  
Sanni Yaya
Keyword(s):  
Food Insecurity ◽  
Wealth Index ◽  
Healthcare Services ◽  
Sociodemographic Factors ◽  
Outcome Variable ◽  
Household Food Insecurity ◽  
Maternal Healthcare ◽  
Individual Level ◽  
Household Food ◽  
The Impact

Introduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.

scholarly journals Impact of COVID-19 on maternal healthcare in Africa and the way forward

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Edward Kwabena Ameyaw ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Carolyne Njue
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Expert Advice ◽  
Maternal Healthcare ◽  
African Countries ◽  
Family Planning Services ◽  
The Impact

Abstract Background The impact of COVID-19 is weighing heavily on many African countries. As of November 14th 2021, 6,109,722 cases had been recorded with 151,173 deaths and 2.5% case fatality rate. Studies reveal substantial morbidity and socioeconomic impacts when accessing quality maternal healthcare including fear of infection and the containment measures in place, including social distancing and community containment. The pandemic has put additional strain on healthcare systems that are overburdened and under-resourced even in normal times and has exposed the vulnerabilities of high-risk population groups in addressing critical healthcare concerns. This study presents a mini review of how COVID-19 has disrupted maternal healthcare in Africa, and it further proposes ways to improve the situation. Main body COVID-19 has disrupted antenatal, skilled birth, and postnatal family planning services. Women and girls are vulnerable to the impact of COVID-19 on several fronts and represent a group whose needs including antenatal, skilled birth, and postnatal family planning services have been disrupted, leading to unmet needs for contraception and an increase in unintended pregnancies. Restricted travel due to the fear and anxiety associated with contracting COVID-19 has resulted in delays in accessing prompt skilled care and essential healthcare services such as pregnancy care, immunisation, and nutritional supplementation. Misconceptions relating to COVID-19 have prompted concerns and created distrust in the safety of the healthcare system. Innovative measures are required to address these obstacles and ensure women are not denied access to available, accessible, acceptable, and quality maternal healthcare services in spite of COVID-19. Conclusions In the immediate term while physical distancing measures remain in force, deliberate effort must be made to provide evidence-based guidelines, good practice and expert advice that addresses the unique sexual and reproductive health context of African countries. Efforts to train and motivate healthcare providers to adopt online, remote approaches such as use of telemedicine, and expand the involvement of frontline maternal healthcare providers to deliver information on the availability of services through phone-based referral networks, culturally appropriate social media, community radio and folklore messaging strategies are critical to mobilise and secure community confidence in the safety of sexual and reproductive health and maternal care services.

LEARNING ABOUT WOMEN. ECONOMIC DEVELOPMENT, ENTREPRENEURSHIP AND THE ENVIRONMENT IN INDIA: A CASE STUDY

2007 ◽  
Vol 12 (04) ◽  
pp. 467-478 ◽  
Author(s):  
NANCY BERTAUX ◽  
ELAINE CRABLE
Keyword(s):  
Economic Development ◽  
Service Learning ◽  
Rural Women ◽  
Rural Areas ◽  
Indian Women ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Home Based ◽  
The Impact

On a recent semester-long stay in India, students from Xavier University (Cincinnati, Ohio) learned about a variety of social and economic development issues, with an emphasis on the role and status of women. This study describes and assesses the impact and effectiveness of their learning with a particular focus on their exposure to Meerut Seva Samaj (MSS), one economic development initiative concentrating on rural women. The Indian economy has recently witnessed an increase in entrepreneurship among women. Entrepreneurship often allows women to engage in home-based work so that they still can attend to their domestic duties, while also helping to financially support the family. Banks, companies, and NGOs (non-governmental organizations) are finding that offering micro-credit, or small loans, and other types of entrepreneurial assistance can help women start businesses. Meerut Seva Samaj provides a concrete example of how Indian women, especially in rural areas, can become successful entrepreneurs with the help of technology, training and other resources. MSS also assists local communities in the use of biogas, an environmentally friendly energy source that improves the environment and fertility of land in rural areas. The study places this service learning case study from India in the context of the literature on women, economic development, entrepreneurship and environmental issues.

scholarly journals Factors influencing maternal healthcare seeking in a highland region of Madagascar: a mixed methods analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Voahirana Tantely Andrianantoandro ◽  
Dolorès Pourette ◽  
Olivier Rakotomalala ◽  
Henintsoa Joyce Valentina Ramaroson ◽  
Rila Ratovoson ◽  
...  
Keyword(s):  
Skilled Birth Attendant ◽  
Healthcare Services ◽  
Traditional Healers ◽  
School Level ◽  
Maternal Healthcare ◽  
Healthcare Facilities ◽  
Healthcare Seeking ◽  
Qualitative Approaches ◽  
Origin Region ◽  
Depth Interviews

Abstract Background In Madagascar, maternal mortality remains stable and high (426 deaths per 100,000 live births). This situation is mainly due to a delay or lack of use of maternal healthcare services. Problems related to maternal healthcare services are well documented in Madagascar, but little information related to maternal healthcare seeking is known. Thus, this paper aims to identify and analyze the factors that influence the utilization of maternal services, specifically, the use of antenatal care (ANC) during pregnancy and the use of skilled birth attendants (SBAs) at delivery. Method We used quantitative and qualitative approaches in the study. Two communes of the Vakinankaratra region, which are located in the highlands, were the settings. Data collection occurred from October 2016 to July 2017. A total of 245 pregnant women were included and followed up in the quantitative survey, and among them, 35 participated in in-depth interviews(IDIs). Logistic regressions were applied to explore the influencing factors of antenatal and delivery healthcare seeking practices through thematic qualitative analysis. Results Among the 245 women surveyed, 13.9% did not attend any ANC visits. School level, occupation and gravidity positively influenced the likelihood of attending one or more ANC visits. The additional use of traditional caregivers remained predominant and was perceived as potentially complementary to medical care. Nine in ten (91%) women expressed a preference for delivery at healthcare facilities (HFs), but 61% of births were assisted by a skilled birth attendant (SBA).The school level; the frequency of ANCs; the origin region; and the preference between modern or traditional care influenced the use of SBAs at delivery. A lack of preparation (financial and logistics problems) and women’s low involvement in decision making at delivery were the main barriers to giving birth at HFs. Conclusion The use of maternal healthcare services is starting to gain ground, although many women and their relatives still use traditional caregivers at the same time. Relatives play a crucial role in maternal healthcare seeking. It would be necessary to target women’s relatives for awareness-raising messages about ANC and childbirth in healthcare facilities and to support and formalize collaborations between traditional healers and biomedical caregivers.

scholarly journals Predictors of Utilisation of Skilled Maternal Healthcare in Lilongwe District, Malawi

2019 ◽  
Vol 8 (12) ◽  
pp. 700-710 ◽  
Author(s):  
Isabel Kazanga ◽  
Alister C. Munthali ◽  
Joanne McVeigh ◽  
Hasheem Mannan ◽  
Malcolm MacLachlan
Keyword(s):  
Low Income ◽  
Rural Women ◽  
Secondary Data ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Maternal Healthcare ◽  
Skilled Attendant ◽  
Income Status ◽  
Poor Women ◽  
Skilled Health

Background: Despite numerous efforts to improve maternal and child health in Malawi, maternal and newborn mortality rates remain very high, with the country having one of the highest maternal mortality ratios globally. The aim of this study was to identify which individual factors best predict utilisation of skilled maternal healthcare in a sample of women residing in Lilongwe district of Malawi. Identifying which of these factors play a significant role in determining utilisation of skilled maternal healthcare is required to inform policies and programming in the interest of achieving increased utilisation of skilled maternal healthcare in Malawi. Methods: This study used secondary data from the Woman’s Questionnaire of the 2010 Malawi Demographic and Health Survey (MDHS). Data was analysed from 1126 women aged between 15 and 49 living in Lilongwe. Multivariate logistic regression was conducted to determine significant predictors of maternal healthcare utilisation. Results: Women’s residence (P=.006), education (P=.004), and wealth (P=.018) were significant predictors of utilisation of maternal healthcare provided by a skilled attendant. Urban women were less likely (odds ratio [OR] = 0.47, P=.006, 95% CI = 0.28–0.81) to utilise a continuum of maternal healthcare from a skilled health attendant compared to rural women. Similarly, women with less education (OR = 0.32, P=.001, 95% CI = 0.16–0.64), and poor women (OR = 0.50, P=.04, 95% CI = 0.26–0.97) were less likely to use a continuum of maternal healthcare from a skilled health attendant. Conclusion: Policies and programmes should aim to increase utilisation of skilled maternal healthcare for women with less education and low-income status. Specifically, emphasis should be placed on promoting education and economic empowerment initiatives, and creating awareness about use of maternal healthcare services among girls, women and their respective communities.

scholarly journals Evolutionary Game Analysis of Coal Enterprise Resource Integration Under Government Regulation

2021 ◽  
Author(s):  
Ziyuan Sun ◽  
Wei Wang ◽  
Weixing Zhu ◽  
Lin Ma ◽  
Yuting Dong ◽  
...  
Keyword(s):  
Government Regulation ◽  
Evolutionary Game ◽  
Policy Implications ◽  
Resource Integration ◽  
Strategic Choices ◽  
Government Regulations ◽  
Coal Enterprise ◽  
The Government ◽  
Coal Enterprises ◽  
The Impact

Abstract Based on the perspective of government regulation, this paper discusses how to guide and restrict coal enterprises to conduct resource integration behavior, and whether the government supervises this behavior. First, through empirical research, government regulations of coal enterprises are given practical policy implications. Second, using evolutionary game and simulation technology, from the perspective of government regulation, we explore the complex behavioral interaction mechanism between the dominant and inferior coal enterprises, the mechanism between the government and coal enterprises, and analyze the impact of key factors on the dynamic evolution process. Finally, the sensitivity analysis of the selected parameters is discussed in details, which provides useful decision-making suggestions for the government and enterprises. Results demonstrate that:(1) when the power gap between enterprises is great, government regulations are not effective for inferior enterprises;(2) the combination of government regulation can help to improve the efficiency of coal enterprise strategy selection;(3) excessive government regulations make the strategic choices of the government and coal enterprise tend to swing, failing to achieve effectively resource integration and government supervision.

scholarly journals Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 218
Author(s):  
Xiaodong Di ◽  
Lijian Wang ◽  
Liu Yang ◽  
Xiuliang Dai
Keyword(s):  
Family Support ◽  
Social Background ◽  
Healthcare Services ◽  
Home Based ◽  
The Social ◽  
Utilization Of Healthcare ◽  
The Impact ◽  
The Relationship ◽  
Positive Effect

Home-based healthcare service has gradually become the most important model to cope with aging in China. However, the contradiction between oversupply and insufficient demand of healthcare services is becoming increasingly serious. How to effectively improve the realized utilization of healthcare resources has become a key issue in the development of healthcare services. Based on the social background of “getting old before getting rich”, this article explores the relationship between economic accessibility and realized utilization, and finds that the impact of economic accessibility on realized utilization is inverted U-shaped, not a linear positive effect. In addition, considering the moderating role of family support, it is found that family support can strengthen the inverted U-shaped effect of economic accessibility on realized utilization. Therefore, exerting the role of family and improving economic accessibility can effectively solve the dilemma of low utilization of healthcare services.

scholarly journals Evaluation of policies for free maternal healthcare in low/middle-income countries: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031557
Author(s):  
Regina Poima Seki ◽  
Delia Hendrie ◽  
Judith Daire
Keyword(s):  
Maternal Health ◽  
Scoping Review ◽  
Financial Burden ◽  
Healthcare Services ◽  
Global Strategy ◽  
Maternal Healthcare ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Impact

IntroductionImproving maternal health remains a health priority at the global and national levels. As part of the global strategy, many low/middle-income countries (LMICs) have implemented free primary healthcare policies for different service packages including maternal health. Free maternal healthcare policies aim to improve maternal health by removing the financial burden of accessing maternal healthcare services. The objective of this scoping review is to assess evaluations of free maternal healthcare policies and the impact on maternal health in LMICs. This will help identify theoretical and methodological approaches (or gaps if any) for evaluating the impact of free maternal healthcare policies to inform future work. It will also provide an evidence base for policymakers and other stakeholder with an interest in planning, funding and implementing evidence based and effective interventions to improving maternal health outcomes.MethodsThe scoping review will follow the methodological framework proposed by Arksey and O’Malley and refined by Joanna Briggs Institute. It will involve a literature search of the PubMed, Scopus ScienceDirect, Web of Science and CINAHL databases for peer-reviewed journal articles related to the impact of free maternal health policies in LMICs published from 2000 to the present. Two reviewers will screen and appraise eligible articles using preset criteria based on the ‘population-concept-context’ framework. A data extraction framework will be used to extract and chart data from the reviewed articles. The results will be analysed using descriptive numerical summary analysis and qualitative thematic analysis.Ethics and disseminationEthical approval is not required as the scoping review will synthesise information from publicly available materials. Dissemination will be through publication in a peer-reviewed journal and presentation at relevant conferences and workshops.

scholarly journals Birth preparedness and Complications Readiness among Women of Reproductive Age in Rural Benue State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Joyce Rumun Akpenpuun ◽  
Joy Nguavese Waroh ◽  
Celina Amaechi Eze ◽  
Nguemo Audu
Keyword(s):  
Rural Communities ◽  
Rural Women ◽  
Rational Choice Theory ◽  
Healthcare Services ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Women Of Reproductive Age ◽  
Maternal Healthcare ◽  
Complication Readiness ◽  
Pregnancy And Childbirth

In many sub-Saharan African countries, including Nigeria, pregnancy and childbirth complications are among the leading causes of mortality and morbidities among women of reproductive age especially in rural communities. This paper examined how women in rural Benue State prepare for births especially as it relates to utilization of maternal healthcare services to avoid potential pregnancy and childbirth related complications. It specifically investigated the factors that hinder rural women from birth preparedness and complication readiness (BPCR). The study which was anchored on Rational Choice Theory utilized intra method triangulation to elicit qualitative data from women of reproductive age (15-49), Woman leaders and community health personnel from 6 rural communities drawn from 3 local government areas in Benue State. Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were the main instruments used for data collection in order to capture the nuances involved. Findings indicate that utilization of maternal health services in preparation for births among rural women is poor. Cost of transportation, poor knowledge and concerns over cost of service were key barriers to BPCR. The study recommends that policy makers and all stake holders should intensify awareness on the needs and importance of BPCR, and that government should consider complete removal of user-fees on maternal healthcare services in order to improve BPCR.

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