scholarly journals Non-use of Janani Avam Bal Suraksha Yojana in a district of Bihar: ensuring safe deliveries needs strategy modification

Author(s):  
Madhumita Mukherjee ◽  
Rashmi Singh ◽  
Amrita Mukherjee ◽  
Madhulekha Bhattacharya

Background: India’s Janany Surakhsha Yojana (JSY) is the largest conditional cash transfer (CCT) program in the world in terms of the number of beneficiaries - covering about 9·5 million (36%) of 26 million women giving birth in India. Eleven States/UTs including Bihar, are still below the National estimate for institutional delivery of 78.9% (NFHS 4). In this study we attempted to find out the status of institutional and home deliveries in district Arwal of Bihar and reasons why in spite of cash incentives a proportion of mothers are opting for home delivery.Methods: A cross sectional descriptive design was used to interview 407 women, who had given birth to a child in previous one year. Focuss group discussions was held with community and health staff to corroborate the interview data.Results: Fifty nine percent of mothers were found to have preferred home delivery over institutional one. Reasons which came to light were home deliveries are cheaper (24.1%), unawareness about JSY (22%), unavailability of transport to reach hospital (22%) and better care being taken at home delivery (20.1%) variables. Older age, having a BPL card, and literacy of husband were found as favoring institutional delivery whereas dissatisfaction during a previous abortion or a livebirth in hospital were both associated with non-use.Conclusions: Better client awareness, strengthening of public health infrastructure, availability of skilled birth attendants at health subcentres (HSCs) and emergency transport in time can reduce number of home deliveries and lead to success of JBSY programme and subsequent reduction in maternal morbidity and mortality.

2019 ◽  
Author(s):  
Dejene Kassa ◽  
Henok Tadele ◽  
Birkneh Tilahun Tadesse ◽  
Akalewold Alemayehu ◽  
Teshome Abuka ◽  
...  

Abstract Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.


2012 ◽  
Vol 35 (3) ◽  
pp. 90-96 ◽  
Author(s):  
Md Mahbubul Hoque ◽  
Mohammad Faizul Haque Khan ◽  
Jotsna Ara Begum ◽  
MAK Azad Chowdhury ◽  
Lars Ake Persson

Background: Despite proven cost effective intervention, there has been little change in neonatal mortality. In Bangladesh neonatal mortality accounts for two third of infants death. About 90% deliveries take place in home and majority of neonatal death are taking place within 7 days of birth. Information about reasons for delivering at home and newborn care practices will be useful to undertake simple intervention measures by policy makers.Aims and objective: To see the knowledge, perception and behaviour of mothers towards their normal and sick newborn.Methods: A cross sectional study was carried out in Dhaka Shishu Hospital from June to November, 2007. A semistructured, pretested questionnaire was used to interview mothers attending inpatient (IPD) and outpatient department (OPD) of hospital.Results: A total 198 mothers were interviewed. Home deliveries were 35.5% and Institutional were 64.5%. Among the Institutional deliveries 35% (44 out of 127) were planned and tried first at home, but when failed mothers were taken to hospital. Majority (86%) of home deliveries were conducted by Dai/relatives. Umbilical cord was cut with new/boiled blade in 85% of home deliveries and household knife was used in 4% cases. Birth place were not at all heated in all home deliveries. In 32 % of home deliveries babies were given bath within 1 hour of birth and it was 15% in case of hospital deliveries. Forty-eight percent babies of home deliveries were wrapped within 10 minutes. Prelacteal feed was given in 51% of home deliveries in comparison to 23% of institutional deliveries. The rate of initiation of breast feeding within one hour of birth was 52% in home and 35% in institutional deliveries. In all cases breast milk was given within 48 hours. Main reasons cited for delivering at home were preference (43%) and fear about hospital (39%). In case of educated (graduate) mothers 72% deliveries took place at hospital. Less feeding (56%), vomiting (42%), less movement (32%), fever (29%) and cough (27%) could be recognized by mothers as signs of sickness.Conclusion: Home deliveries and poor newborn care practices are commonly found in this study. Traditional birth attendants should be adequately trained as they are conducting majority of home deliveries. Female education is very important to reduce home delivery as it is seen that deliveries of educated mothers are taking place in hospital. High risk traditional newborn care practices like delayed wrapping, early bathing, use of oil in umbilical stump and prelacteal feeding need to be addressed. This study also found that knowledge to identify sickness in newborn is still poor.DOI: http://dx.doi.org/10.3329/bjch.v35i3.10497  Bangladesh J Child Health 2011; Vol 35 (3): 90-96


Author(s):  
Divya Sahu ◽  
Shanta P. Khes Beck ◽  
G. P. Soni ◽  
Abha Ekka ◽  
Srishti Dixit ◽  
...  

Background: Janani Suraksha Yojana (JSY) replaces the National Maternity Benefit Scheme. It was launched by the Government of India in April 2005. The aim was to reduce maternal and neonatal mortality by increasing institutional delivery by providing cash incentive to the beneficiaries as well as the link worker ASHA. Objectives of this study was to assess receipt of Janani Suraksha Yojana (JSY) cash incentive and to assess fields of utilization of Janani Suraksha Yojana (JSY) cash incentive.Methods: A Community based cross-sectional study was conducted among 384 mothers delivered within last one year in urban slum of Raipur city. Study centre was department of community medicine, Pt. J.N.M. medical college Raipur, Chhattisgarh. A pre-designed and pre-tested questionnaire was used to interview the study subjects.Results: Out of total 384 study subject’s cheque of JSY cash incentive was received by 70.83%. All (100%) beneficiaries who received cheque was stipulated amount as per JSY guideline. Reasons for not receiving cheque was no availability of BPL card for those who delivered in accredited private health facility. Other reasons were absconded after delivery, unaware of cash incentive, did not go back to get the cheque when called later, patient shifted to another ward. None of the study subjects who delivered at home received the cash incentive cheque. Realization of cheque was not done by 22.79% of study subjects due to complex procedure to open an account in bank. Cash incentive money was utilized in neonatal care, drugs, food, household activities and some deposited in bank.Conclusions: JSY scheme is definitely functioning well in terms of providing cash incentive cheque of JSY on delivery in Government Health facility. There is need to simplify the procedure to open an account so that beneficiaries can avail cash incentive money. There is need to address the problems to receive cheque in home delivery and accredited Private health facility in addition to motivation for institutional delivery.


Author(s):  
Ireen Chola Mwape Musonda

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.


2020 ◽  
Vol 36 (12) ◽  
Author(s):  
Débora Letícia Frizzi Silva ◽  
Doroteia Aparecida Höfelmann ◽  
Cesar Augusto Taconeli ◽  
Regina Maria Ferreira Lang ◽  
Camila Dallazen ◽  
...  

Abstract: Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children’s hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals’ data were collected using a structured questionnaire, and secondary and ecological data of children’s municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.


2020 ◽  
pp. 1-11
Author(s):  
Marília Moura e Mendes ◽  
Giovana de Montemor Marçal ◽  
Manuela Di Guaraldi Mafra Fragoso ◽  
Telma Maria de Menezes Toledo Florêncio ◽  
Nassib Bezerra Bueno ◽  
...  

Abstract Objective: To evaluate the association between Fe deficiency anaemia (IDA) and complementary feeding in children under 2 years old assisted by the Conditional Cash Transfer programme, Bolsa Família (BFP). Design: Cross-sectional study. Data were obtained through a standardised form, questionnaire to assess the eating habits of children under 2 years of age, capillary Hb (HemoCue®) and the Brazilian Household Food Insecurity Measurement Scale. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. Setting: Six municipalities from the State of Alagoas, Brazil. Participants: Children aged 6–24 months assisted by BFP. Results: A total of 1604 children were evaluated, among whom 58·1 % had anaemia. A higher number of food groups consumed (prevalence ratio (PR) = 0·97; 95 % CI 0·95, 0·99; P = 0·009), the consumption of dairy (PR = 0·86; 95 % CI 0·79, 0·84; P = 0·001) and meat (PR = 0·90; 95 % CI 0·83, 0·99; P = 0·030) in addition to bottle feeding (PR = 0·88; 95 % CI 0·82, 0·96; P = 0·004) were associated with a lower prevalence of IDA. Conclusions: IDA is still a serious public health problem in children under 2 years old assisted by BFP in Alagoas. We highlight the importance of promoting complementary feeding based on a diversified dietary intake, as well strengthening prophylactic supplementation programmes to increase children’s adherence in conjunction with the implementation of food and nutrition education to help reduce the prevalence of this condition.


Med Phoenix ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 6-15
Author(s):  
Bhaskar Ravi Kumar ◽  
Deo Krishna Kumar

Background: In this study, we expected to evaluate the utilization rate of institutional delivery services in Eastern Nepal. We also analyzed the socio-economic factors associated with institutional delivery and assessed the reason for their utilization.Methods: A cross-sectional quantitative study was conducted in Sunsari district of Eastern Nepal. Three hundred and seventy two women, who delivered their baby within period of one year preceding this study, were interviewed through household visit. Focus group discussions (FGDs) were also done to gather qualitative data.Results: We interviewed 368 women. The prevalence of institutional delivery was 55.1%. Logistic regression analyses revealed that women having good knowledge about importance of SBA utilized institutional delivery services more than nine times than women having poor knowledge (AOR=9.02, 95% CI: 2.61-31.09). Similarly, women exposed to media (AOR=6.56, 95% CI: 2.10-21.21), women from advantaged ethnicity (AOR=5.85, 95% CI: 1.78-19.74), women having higher level of autonomy (AOR= 5.93, 95%CI: 1.18- 29.53) and richer women (AOR=3.30, 95% CI: 1.24-8.72) were more likely to have institutional delivery than women unexposed to media, women from relatively disadvantaged ethnicity, women having low level of autonomy and poorer women respectively.Conclusions: Good knowledge on importance of SBA, completion of 4 ANC service, media exposure with maternal health service related massages, relatively advantaged ethnicity, higher rank of women’s autonomy and higher wealth rank were found significantly associated with institutional delivery service utilization. Provisions of community ambulance system can also be helpful to address the transportation problem. Encouraging women to complete their schooling and teaching/encouraging women to have antenatal care frequently are also important to increase institutional delivery services. Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 6-15 


2019 ◽  
Author(s):  
Abdinasir Abdullahi Jama ◽  
Ayodele O Arowojolu ◽  
IkeOluwapo O Ajay

Abstract Background: Homebirth (home delivery) is a birth that takes place in a residence rather than in a hospital or a birth center. Aims: The aim of the study is to determine factors influencing obstetric home delivery and the outcomes among women of reproductive age in Dusmareb district, Somalia. Methods: The study was used a descriptive cross-sectional study in Dusamreb district of Somalia with both qualitative and quantitative techniques of data collections and random technique was used to select 228 women of reproductive age. Well-structured questionnaires were administered by the interviewer to participants who gave their consent and also two focus group discussion sessions were conducted with discussion guides. Data were analysed using the Statistical Package for Social Sciences version 20.0. Descriptive , and Inferential statistics were used to test association, with the level of significance set at 5%. Results: The findings of this study show that 41% have had at least one child delivery at home. The mean age of the respondents was 32.9 ± 8.1 years; 15(6.6%) had tertiary education and Women with 4 – 6 children were four times more likely to have a home delivery (OR = 3.65, p = 0.002), Women with employment were 59% less likely to have a home delivery (OR = 0.41, p = 0.009); the study also found as outcome of home delivery that 22% of the women reported their baby was not okay and have taken to hospital, while 41(73.2%) reported the child died within 28 days following delivery while 24 (42.8%), women experienced prolonged labour during their last delivery at home.in the focus group discussion the women reported that there is poor communication relationship between the mothers and health staff. Conclusion: the study is highly recommended the government to create employment for the women,also the hospital directors were recommended to monitor the relationship between the care giver and the pregnant mother.


2020 ◽  
pp. 1-9 ◽  
Author(s):  
Giovana de Montemor Marçal ◽  
Marília Moura e Mendes ◽  
Manuela Di Guaraldi Mafra Fragoso ◽  
Telma Maria de Menezes Toledo Florêncio ◽  
Nassib Bezerra Bueno ◽  
...  

Abstract Objective: To evaluate the association between the consumption of ultra-processed foods (UPF) and the practice of breast-feeding in children under 2 years of age assisted by the conditional cash transfer programme, Bolsa Família Programme (PBF). Design: A cross-sectional study. The consumption of UPF and the practice of breast-feeding were assessed using a structured 24-h recall. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. Setting: Six counties from the state of Alagoas, Brazil. Participants: Children aged 6−24 months, assisted by PBF. Results: A total of 1604 children were evaluated, 11·7% of whom were overweight, and most had consumed UPF (90·6%) in the last 24 h. The most consumed UPF were biscuits, chocolate milk and baby food with 74·8, 66·8 and 24·9%, respectively. Through multivariable analysis, an association was found between lower consumption of UPF in the continuation of breast-feeding until the second year of life (prevalence ratio (PR) 0·91, 95 % CI 0·86, 0·96) and in the first year of life (PR 0·93, 95 % CI 0·88, 0·99). Conclusions: It was found that the studied population had a high consumption of UPF, which harmed continued breast-feeding. We highlight the importance of strengthening public policies aimed at the promotion, protection and support of breast-feeding and healthy complementary feeding aimed at populations that have difficulties in physical and economic access to a healthy and adequate diet.


2021 ◽  
pp. 1-26
Author(s):  
Marília Moura e Mendes ◽  
Giovana de Montemor Marçal ◽  
Ana Elisa Madalena Rinaldi ◽  
Nassib Bezerra Bueno ◽  
Telma Maria de Menezes Toledo Florêncio ◽  
...  

Abstract Objective: This study aimed to verify the association between socioeconomic and demographic characteristics and dietary patterns (DP) of children assisted by the Conditional Cash Transfer Program, Bolsa Família (BFP). Design: This is a cross-sectional study. DP were defined using a principal component analysis. The association of the predictive variables and DP was modelled using multilevel linear regression analysis. Setting: This study was conducted in six municipalities from the State of Alagoas, Brazil. Participants: The participants were children aged 6–24 months who were assisted by the BFP. Results: A total of 1,604 children were evaluated. Four DPs were identified (DP1, DP2, DP3, and DP4). DP1 is composed of traditional Brazilian food. DP2 is formed mostly from ultra-processed foods (UPF). DP3 consists of milk (non-breast) with added sugar, while DP4 consists of fresh and minimally processed foods. Caregivers with higher age and education (β = −0.008; 95%CI: [−0.017; −0.000]; β = −0.037; 95%CI: [−0.056; −0.018], respectively) were negatively associated with DP2. We observed a negative association between households with food insecurity (β = −0.204; 95%CI: [−0.331; −0.078]) and DP4 and a positive association between caregivers with higher age and education (β = 0.011; 95%CI: [0.003; 0.019]; β = 0.043; 95%CI: [0.025; 0.061], respectively) and DP4. Conclusion: This study identified the association between socioeconomic inequities and DP early in life, with an early introduction of UPF, in children assisted by BFP in the State of Alagoas.


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