Long-Term Trend in Inequalities by Socioeconomic Status and Residence Type and Geographic Variation in the Utilization of Antenatal Care Service in India: Result from the National Family Health Survey 1998-2015

2019 ◽  
Author(s):  
Hwa-Young Lee ◽  
Juhwan Oh ◽  
Rockli Kim ◽  
S. V. Subramanian
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 ◽  
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 ◽  
Vol 19 (1) ◽  
Author(s):  
Gunjan Kumar ◽  
Tarun Shankar Choudhary ◽  
Akanksha Srivastava ◽  
Ravi Prakash Upadhyay ◽  
Sunita Taneja ◽  
...  

Author(s):  
Mohankumar Raju

Background: The sustainable development goal emphasises on reduction in mothers dying due to pregnancy. Recommended care for the pregnant mothers will help achieve this goal. Tamil Nadu is one of the best performing state in maternal and child health care. Author analysed the full antenatal care coverage of pregnant mothers of the districts of Tamil Nadu by using National Family Health Survey (NFHS)-4 data. Methods: Author did a secondary data analysis of NFHS 4 data for the districts of Tamil Nadu for understanding the MCH coverage. Results: Tamil Nadu showed 45% full AN coverage with 46.3% in urban and 43.8% in rural population, among 32 districts, Krishnagiri (65.5%) is the best performing and Virudhunagar (13.7%) is the poorest performing district of Tamil Nadu. Full AN coverage includes at least 4 AN check-up, vaccination of tetanus toxoid and consumption of 100 IFA tablets in last pregnancy. Tamil Nadu showed 81.1% of at-least 4 AN visit, 71% with vaccination for TT and 64% on consumption of 100 IFA tables. Similar coverage trend among the components of full ANC coverage is seen among all the districts of Tamil Nadu. Conclusion: Focusing on the coverage of IFA tablet consumption and also showing special interest among the rural population will increase the coverage. A detailed assessment for understanding the reasons for poor performance among the districts of Tamil Nadu is needed for better evidence-based practices.


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.


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


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Anktia Shukla

Abstract Background In recent years India has made groundbreaking progress in achieving universal institutional deliveries however the country failed to mirror this success in the postnatal period too. Method Data is utilized from nationally representative survey National Family Health Survey (2015-16). A quantitative analysis of available information is presented here. Results According to National family health survey (2015-16), 83% women received antenatal care (ANC) at least once, 79% had institutional delivery and only 65% had post-natal check-up. Surprisingly, postnatal-checkup was not universal even among mothers who had c-sections, around 10-15% women who had c-section did not receive post-natal check. The PNC coverage was worse in the states with high maternal mortality- Assam, Uttar Pradesh, Rajasthan and Madhya Pradesh. PNC was lowest among home deliveries followed by deliveries in sub-center health facilities. Conclusion Though a pool of data is available on coverage and quality of care on different components of antenatal care and child-delivery very little evidence is available on the frequency of contact and quality of postnatal care. One of the major contributor of maternal deaths in India is postpartum hemorrhage. Yet it is the postpartum period when coverage and programs are at their lowest along the continuum of care. Key messages Above mentioned evidence calls for focus on comprehensive PNC package, evidence generation on PNC care and improving linkages between deliveries at home/lower levels facilities and PNC.


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