scholarly journals Measurement and Mapping of Maternal Health Service Coverage Through a Novel Composite Index: A Sub-National Level Analysis in India

2022 ◽  
Author(s):  
Tanvi Kiran ◽  
KP Junaid ◽  
Vineeth Rajagopal ◽  
Madhu Gupta ◽  
Divya Sharma
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Geometric Mean ◽  
National Level ◽  
Composite Index ◽  
Arithmetic Mean ◽  
Maternal Health Service ◽  
Series Data ◽  
Targeted Interventions ◽  
Service Coverage

Abstract Background: Expansion of maternal health service coverage is crucial for the survival and wellbeing of both mother and child. To date, limited literature exists on the measurement of maternal health service coverage at the sub-national level in India. The prime objectives of the study were to comprehensively measure the maternal health service coverage by generating a composite index; map India by categorizing it into low, medium and high zones and examine its incremental changes over time. Methods: Utilising a nationally representative time series data of 15 key indicators spread across three domains of antenatal care, intranatal care and postnatal care, we constructed a novel ‘Maternal Health Service Coverage Index’ (MHSI) for 29 states and 5 union territories of India for the base (2017-18) and reference (2019-20) years. Following a rigorous procedure, MHSI scores were generated using both arithmetic mean and geometric mean approach. We categorized India into low, medium and high maternal health coverage zones and further generated geospatial maps to examine the extent and transition of maternal health service coverage from base to reference year.Results: India registered the highest mean percentage coverage (93.66%) for ‘institutional delivery’ and lowest for ‘treatment for obstetric complications’ (9.25%) among all the indicators. Depending on the usage of arithmetic mean and geometric mean approach, the maternal health service coverage index score for India exhibited marginal incremental change (between 0.015- 0.02 index points) in the reference year. West zone exhibited an upward transition in the coverage of maternal health service indicators, while none of the zones recorded a downward movement. States of Mizoram (east zone), Puducherry (south zone) showed a downward transition. Union territories of Dadra & Nagar Haveli (west zone) and Chandigarh (north zone) along with the states of Maharashtra (west zone), Assam, as well as Jharkhand (both from the east & north east zone), showed upward transition.Conclusion: Overall, maternal health service coverage is increasing across India. Our study offers a novel summary measure to comprehensively quantify the coverage of maternal health service, which can momentously help India to identify lagged indicators and low performing regions, thereby warranting the targeted interventions and concentrated programmatic efforts to bolster the maternal health service coverage at the sub-national level.

scholarly journals Understanding variation in maternal health service coverage and maternal health outcomes among districts in Rwanda

2019 ◽  
Author(s):  
Felix Sayinzoga ◽  
Tetui Moses ◽  
Koos van der Velden ◽  
Jeroen van Dillen ◽  
Leon Bijlmakers
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Outcomes ◽  
Health Workers ◽  
Text Messages ◽  
Maternal Health Service ◽  
Poor People ◽  
District Hospitals ◽  
Maternal Health Outcomes ◽  
Service Coverage

AbstractObjectiveTo identify factors that explain variations between districts in maternal health service coverage and maternal health outcomes.MethodsIndividual key informant interviews and focus group discussions using structured topic lists were conducted in May 2015 in four purposively selected districts.ResultsThe solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization. Geographical factors, in particular location close to borders with mobile populations and migrants, and large populations with sparsely distributed health infrastructure, exacerbated by hilly topography and muddy roads were identified as barriers. Shortages of skilled health providers at the level of district hospitals were cited as contributing to poor maternal health outcomes.ConclusionThere is a need to take into account disparities between districts when allocating staff and financial resources in order to achieve universal coverage for high-quality maternal health services and better outcomes. Local innovations such as the use of SMS and WhatsApp text messages by health workers and financial protection schemes for poor patients improve solidarity and are worth to be scaled up.

scholarly journals Understanding how distance to facility and quality of care affect maternal health service utilization in Kenya and Haiti: A comparative geographic information system study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xing Gao ◽  
David Wayne Kelley
Keyword(s):  
Quality Of Care ◽  
Maternal Health ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Geographic Information ◽  
Maternal Health Service ◽  
Rural Regions ◽  
Urban Regions

In 2000, the United Nations established eight Millennium Development Goals (MDG) to combat worldwide poverty, disease, and lack of primary education. Goal number five aimed to reduce the maternal mortality ratio by three quarters and provide universal access to reproductive healthcare services by 2015. While there has been some progress, MDG 5 fell far short of target goals, highlighting the necessity of further improvement in global maternal health. Using Geographic Information Systems (GIS), this study aims to understand how distance to facility and quality of care, which are components of access, affect maternal service utilization in two of the world’s poorest countries, Haiti and Kenya. Furthermore, this study examines how this relationship may change or hold between urban and rural regions. Data from the United States Agency for International Development Demographic and Health Survey and Service Provision Assessment were linked spatially in a GIS model, drawing comparisons among distance to facility, quality of care, and maternal health service utilization. Results show that in both rural and urban regions, access to maternal health service and maternal health service utilization share a similar spatial pattern. In urban regions, pockets of maternal health disparities exist despite close distance to facility and standard quality of care. In rural regions, there are areas with long distances to facilities and low quality of care, resulting in poor maternal service usage. This study highlights the usefulness of GIS as a tool to evaluate disparities in maternal healthcare provision and usage.

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