scholarly journals Utilization, Equity and Determinants of Full Antenatal Care in India: Analysis from the National Family Health Survey 4

2019 ◽  
Author(s):  
Gunjan Kumar ◽  
Tarun Shankar Choudhary ◽  
Akanksha Srivast ◽  
Ravi Praksah Updhyay ◽  
Sunita Taneja ◽  
...  

Abstract Objectives: We examined the utilisation, equity and determinants of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods: We analysed a sample of 190,898 women from India's National Family Health Survey 4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable logistic regression model was used to examine the factors associated with full ANC utilization. Results: In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions: Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program. Key words: Antenatal care, India, NFHS-4

2019 ◽  
Author(s):  
Gunjan Kumar ◽  
Tarun Shankar Choudhary ◽  
Akanksha Srivast ◽  
Ravi Praksah Updhyay ◽  
Sunita Taneja ◽  
...  

Abstract Objectives: We examined the utilisation, equity and determinants of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods: We analysed a sample of 190,898 women from India's National Family Health Survey 4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable logistic regression model was used to examine the factors associated with full ANC utilization. Results: In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions: Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program. Key words: Antenatal care, India, NFHS-4


2019 ◽  
Author(s):  
Gunjan Kumar ◽  
Tarun Shankar Choudhary ◽  
Akanksha Srivast ◽  
Ravi Praksah Updhyay ◽  
Sunita Taneja ◽  
...  

Abstract Objectives We estimated the utilisation, determinants and equity of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods We used data from India’s National Family Health Survey-4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable binary logistic regression model was used to examine the factors associated with full ANC utilization. Results In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program.


2020 ◽  
Vol 7 (11) ◽  
pp. 2157
Author(s):  
Sankar Goswami ◽  
Rituparna Acharjee ◽  
Sanku Dey

Background: Childhood anaemia is a major public health threat that can increase susceptibility to infections, risk of mortality together with serious degrading consequences on cognitive and physical development. The aim was to examine the prevalence of anaemia in children aged under-five years in Assam, India, exploring 2015-2016 National Family Health Survey (NFHS-4) data.Methods: Statistical analysis is performed on the cross-sectional data of 10,309 children from 2015-2016 National Family Health Survey (NFHS-4), using binary logistic regression model, to assess the significance of some risk factors of child anaemia. Anaemia was diagnosed by WHO cut-off points on hemoglobin level.Results: The prevalence of child anaemia was 35.7 per cent in Assam, India, with mean haemoglobin concentration 11.36 gm/dl (95% CI, 11.32-11.38); male and female being equaled proportionately anaemic. Out of 27 districts in Assam, the highest prevalence was found in Dibrugarh (52.2 per cent), followed by Nalbari (46.7 per cent) and Darrang (45.6 per cent); and the least prevalence was found in Karbi-Anglong (24.4 per cent). The findings indicate that rural children and lower age-groups were at greater risk of anaemia. Higher birth order, low level of maternal education, low level of maternal nutrition and non-intake of iron supplements during pregnancy increased the risk of anaemia among children (p<0.05).Conclusions: The findings suggest a need for proper preventive measures to combat child anaemia. Rural population should be given special attention. Maternal education, nutrition, and birth control measures should be priorities in the programs.


2018 ◽  
Vol 13 (1) ◽  
pp. i31
Author(s):  
Sonal Katyal

Background: Despite being a relatively smaller state, Haryana’s per capita Gross State Domestic Product (GSDP) is high. The statistical data on the status of women has a different story to share. Objective: This study analyzes the maternal healthcare situation in Haryana to examine the differential in utilization of maternal health care service i.e. antenatal care on the basis of socio economic and socio demographic indicators such as Women’s age at Birth, Birth order, Education, Residence, Religion, Wealth index and Caste. Methodology: The present study uses the third round of the National Family Health Survey (NFHS) data which is similar to the Demographic and Health Surveys (DHS). DHS collects, disseminates national data on health and population in developing countries. Findings: Indicate that economic status, husband’s education and caste have effect on the utilization of antenatal care services. Conclusion: The present study demonstrates several socio economic and demographic factors affecting the utilization of antenatal care services in Haryana. Efforts need to be taken at community and household level to improve utilization. Abbreviations: NFHS- National Family Health Survey; DHS- Demographic and Health Surveys; MDG- Millennium Development Goals; SC/ST-Scheduled caste/Scheduled tribe; WHO-World Health Organization; MOHFW- Ministry of Health and Family Welfare; ANM – Auxiliary Nurse Midwife; VIF – Variance Inflation Factor; OBC- Other Backward Classes; ANC- Antenatal Care; TBA – Trained Birth Attendant


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gunjan Kumar ◽  
Tarun Shankar Choudhary ◽  
Akanksha Srivastava ◽  
Ravi Prakash Upadhyay ◽  
Sunita Taneja ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pradeep Kumar ◽  
Shekhar Chauhan ◽  
Ratna Patel ◽  
Shobhit Srivastava ◽  
Dhananjay W. Bansod

Abstract Background Malnutrition in mothers as well as in children is a significant public health challenge in most of the developing countries. The triple burden of malnutrition is a relatively new issue on the horizon of health debate and is less explored among scholars widely. The present study examines the prevalence of the triple burden of malnutrition (TBM) and explored various factors associated with the TBM among mother-child pairs in India. Methods Data used in this study were drawn from the fourth round of the National Family Health Survey (NFHS-IV) conducted in 2015–16 (N = 168,784). Bivariate and binary logistic regression analysis was used to quantify the results. About 5.7% of mother-child pairs were suffering from TBM. Results Age of mother, educational status of the mother, cesarean section delivery, birth size of baby, wealth status of a household, and place of residence were the most important correlates for the triple burden of malnutrition among mother-child pairs in India. Further, it was noted that mothers with secondary education level (AOR: 1.15, CI 1.08–1.23) were having a higher probability of suffering from TBM, and interestingly the probability shattered down for mothers having a higher educational level (AOR: 0.90, CI 0.84–0.95). Additionally, mother-child pairs from rich wealth status (AOR: 1.93, CI 1.8–2.07) had a higher probability of suffering from TBM. Conclusion From the policy perspective, it is important to promote public health programs to create awareness about the harmful effects of sedentary lifestyles. At the same time, this study recommends an effective implementation of nutrition programs targeting undernutrition and anemia among children and obesity among women.


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