maternal health care services
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2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Sumirtha Gandhi ◽  
Umakant Dash ◽  
M. Suresh Babu

Abstract Background Continuum of Maternal Health Care Services (CMHS) has garnered attention in recent times and reducing socio-economic disparity and geographical variations in its utilisation becomes crucial from an egalitarian perspective. In this study, we estimate inequity in the utilisation of CMHS in India between 2005 and 06 and 2015-16. Methods We used two rounds of National Family Health Survey (NFHS) - 2005-06 and 2015-16 encompassing a sample size of 34,560 and 178,857 pregnant women respectively. The magnitude of horizontal inequities (HI) in the utilisation of CMHS was captured by adopting the Erreygers Corrected Concentration indices method. Need-based standardisation was conducted to disentangle the variations in the utilisation of CMHS across different wealth quintiles and state groups.  Further, a decomposition analysis was undertaken to enumerate the contribution of legitimate and illegitimate factors towards health inequity. Results The study indicates that the pro-rich inequity in the utilisation of CMHS has increased by around 2 percentage points since the implementation of National Rural Health Mission (NRHM), where illegitimate factors are dominant. Decomposition analysis reveals that the contribution of access related barriers plummeted in the considered period of time. The results also indicate that mother’s education and access to media continue to remain major contributors of pro-rich inequity in India. Considering, regional variations, it is found that the percentage of pro-rich inequity in high focus group states increased by around 3% between 2005 and 06 and 2015-16. The performance of southern states of India is commendable. Conclusions Our study concludes that there exists a pro-rich inequity in the utilisation of CMHS with marked variations across state boundaries. The pro-rich inequity in India has increased between 2005 and 06 and high focus group states suffered predominantly. Decentralisation of healthcare policies and  granting greater power to the states might lead to equitable distribution of CMHS.


2021 ◽  
Vol 11 (10) ◽  
pp. 88-98
Author(s):  
Sharmila Ranabhat ◽  
Suman Baskota ◽  
Rama Thapa

Maternal health care services should be accessible to all women during pregnancy, delivery, and the postpartum period. The majority of maternal deaths can be prevented if women utilize maternal health care services appropriately. This study aimed to assess the utilization of maternal health services and explore the barriers in accessing maternal health care services. This descriptive cross-sectional study was conducted among 48 mothers over the age of 18 with one or more children. The data was obtained by interview and focus group discussion using the structured questionnaires and checklists, which included socio-demographic characteristics, and utilization of antenatal care, delivery practice, and postnatal care services. Among 48 mothers, only 35.41% used complete antenatal care services, 66.66% received TT vaccine during pregnancy, 54.16% delivered their last child at the hospital, and only 27.08% received postnatal services as recommended by the World Health Organization. The antenatal care services and delivery services were utilized suboptimally, and postnatal care visits were significantly lower. Socio-economic factors such as family income and education of women correlated considerably with maternal health care utilization. Women with higher education levels and higher family income were more likely to go for frequent antenatal check-ups, have TT vaccinations, deliver in hospitals, and visit more postnatal check-ups than women with lower education levels and lower family income. The findings indicate that there are unmet needs of maternal health care access to women living in the squatters of Nepal. It is therefore important to implement targeted incentive programs and maternal health awareness campaigns to increase the utilization of maternal health services among women living in squatter settlements in Nepal. Key words: Antenatal, Delivery, Postnatal, Maternal health services, Squatter.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Anguach Shitie ◽  
Zelalem Nigussie Azene

Abstract Background Maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skilled birth attendant (SBA), and postnatal care (PNC) within 48 h of delivery. It is one of the essential strategies for reducing maternal and newborn morbidity and mortality. Therefore, this study aimed to assess the prevalence and factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam zone, Ethiopia. Methods A community-based cross-sectional study was conducted among six hundred twenty-one (621) women who gave birth in the last one year in Enemay district from February 25 to March 10, 2019. A simple random sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable binary logistic regression. Results In this study, around 61% of women had antenatal care follow-up. Out of those women having ante natal care follow-up, about 77.5% (95% CI 73, 81.7%) had continued to receiving skilled birth delivery service. Age (AOR = 1.7 95% CI: (1.0, 2.88)), marital status (AOR = 1.6, 95% CI: (1.01, 2.76)), women’s educational status (AOR = 2.9, 95% CI: (1.30, 6.72)), autonomy for health care decision-making (AOR = 3.71, 95%CI: (2.36, 6.02)), exposure to media (AOR = 2.8, 95% CI: (1.78, 4.6)), wanted pregnancy (AOR = 3.6 95% CI: (2.2, 5.95)), and parity (AOR = 0.34, 95%CI: (0.16, 0.71)) were statistically significant variables associated with initiation of antenatal care, whereas educational status of women (AOR = 4.65, 95% CI: (1.37, 15.7)), autonomy for health care decision making (AOR = 2.62, 95% CI:(1.0, 6.82)), and had counseled during antenatal care (AOR = 2.88 95% CI: (1.21, 6.83)) were statistically significant variables associated with the continuation of maternal health care services. Conclusions This study demonstrated that the initiation and continuity of maternal health care services are low in the study area. Age, marital status, residence, women’s educational status, health care decision-making autonomy, exposure to media, wanted pregnancy, and parity were factors significantly affecting the initiation of antenatal care. Whereas, women’s educational status, health care decision-making autonomy, and counseling during antenatal care were predictors influencing the continuation of maternal health care services (antenatal care to skilled birth delivery).


2021 ◽  
Vol 23 (3) ◽  
pp. 470-481
Author(s):  
Sohini Paul

India launched the National Rural Health Mission (NRHM) in 2005 to improve maternal and child health by providing good quality health services to all, especially deprived sections of society, to reduce inequality in access to health services. With the backdrop of NRHM, we analysed the extent to which the utilisation of maternal health care services (MHCSs) in the three stages of the continuum of care—antenatal care (ANC), care during child delivery and postnatal care (PNC)—–has improved among the poor vis-à-vis the rich in India, and the corresponding narrowing down in inequality in the period 2006–2016. Data from the 3rd round of the National Family Health Survey (NFHS) in 2005–2006, capturing the pre-NRHM period and the 4th round of NFHS 2015–2016, capturing the post-NRHM era ten years after the implementation of the flagship programme, are used for the analysis. We estimated absolute as well as relative measures of inequality, absolute gap and coverage ratio between the poor and rich, slope index of inequality and concentration index. Our findings show that maternal health care coverage increased significantly among the poor for all components of MHCSs. Even so, the extent of utilisation of services remains significantly lower among the poor in 2015–2016 compared to the coverage among the rich in 2005–2006. Although inequality declined at the national level over the decade, it still persists. High equity has been achieved in using skilled birth attendance during child delivery and institutional delivery during 2015–2016, however, inequality continues to be higher for ANC indicators including consumption of iron and folic acid supplements for at least 100 days, receipt of four or more antenatal check-ups and comprehensive health check-ups at least once during antenatal visits and receipt of first check-up in the first trimester.


2021 ◽  
Vol 13 (1-2) ◽  
Author(s):  
S. Banerjee

ABSTRACT The aim of the present study was to investigate the maternal healthcare services in Eastern Indian States (West Bengal, Odisha, Jharkhand, Bihar). The present study also tried to understand the effect of socio-economic and demographic factors in the utilization of maternal health care services in the above mentioned states of India, using NFHS-4 data. The present study considered only those women who conceived baby within last five years. All the study women were married and the age range was 15-49 years. Total sample size consisted of 170995 of ever married women. For statistical analysis, Pearson Chi-squre test and Binary logistic regression were performed. The present study revealed that statistically significant difference in utilization of maternal health care services were present among women of different Eastern Indian states.The present study also depicted that residential pattern, caste, religion, respondent’s occupation, respondent’s age, respondent’s educational attainments, Wealth Index had significant association with maternal health care services


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249214
Author(s):  
Kababa Temesgen ◽  
Negash Wakgari ◽  
Bikila Tefera Debelo ◽  
Belay Tafa ◽  
Getu Alemu ◽  
...  

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization amidst the COVID-19 pandemic in West Shoa zone, Central Ethiopia. A community-based cross-sectional study was conducted among 844 pregnant women or those who gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interviews using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and an adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR = 2.16, 95%CI: 1.29–3.60), secondary (AOR = 1.97, 95%CI: 1.13–3.44), and college and above education (AOR = 2.89, 95%CI: 1.34–6.22) than those who could not read and write. Besides, mothers who did travel 30–60 minutes (AOR = 0.37, 95%CI: 0.23–0.59) and 60-90minutes (AOR = 0.10, 95%CI: 0.05–0.19) to reach the health facility had a lower odds of maternal health service utilization than those who did travel <30 minutes. Moreover, mothers who earn 1000–2000 (AOR = 3.10, 95%CI: 1.73–5.55) and > 2000 birrs (AOR = 2.66 95%CI: 1.52–4.64) had higher odds of maternal health service utilization than those who earn <500 birrs. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR = 2.79, 95%CI: 1.85–4.20), who had not had to request permission from husband to visit the health facility (AOR = 7.24, 95%CI: 2.65–19.75), who had practicedCOVID-19 prevention measure (AOR = 5.82, 95%CI: 3.87–8.75), and used face mask (AOR = 2.06, 95% CI: 1.28–3.31) than their counterpart. Empowering mothers and creating awareness on COVID-19 preventionis recommended to improve maternal health service utilization during the COVID-19 pandemic.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pooja Singh ◽  
Kaushalendra Kumar Singh ◽  
Pragya Singh

Abstract Background Maternal deaths among young women (15–24 years) shares 38% of total maternal mortality in India. Utilizing maternal health care services can reduce a substantial proportion of maternal mortality. However, there is a paucity of studies focusing on young women in this context. This paper, therefore, aimed to examine the trends and determinants of full antenatal care (ANC) and skilled birth attendance (SBA) utilization among young married women in India. Methods The study analysed data from the four rounds of National Family Health Surveys conducted in India during the years 1992–93, 1998–99, 2005–06 and 2015–16. Young married women aged 15–24 years with at least one live birth in the 3 years preceding the survey were considered for analysis in each survey round. We used descriptive statistics to assess the prevalence and trends in full ANC and SBA use. Pooled multivariate logistic regression was conducted to identify the demographic and socioeconomic determinants of the selected maternity care services. The significance level for all analyses was set at p ≤ 0.05. Results The use of full ANC among young mothers increased from 27 to 46% in India, and from 9 to 28% in EAG (Empowered Action Group) states during 1992–2016. SBA utilization was 88 and 83% during 2015–16 by showing an increment of 20 and 50% since 1992 in India and EAG states, respectively. Findings from multivariate analysis revealed a significant difference in the use of selected maternal health care services by maternal age, residence, education, birth order and wealth quintile. Additionally, Muslim women, women belonging to scheduled caste (SC)/ scheduled tribe (ST) social group, and women unexposed to mass media were less likely to utilize both the maternal health care services. Concerning the time effect, the odds of the utilization of full ANC and SBA among young women was found to increase over time. Conclusions In India coverage of full ANC among young mothers remained unacceptably low, with a wide and persistent gap in utilization between EAG and non-EAG states since 1992. Targeted health policies should be designed to address low coverage of ANC and SBA among underprivileged young mothers and increased efforts should be made to ensure effective implementation of ongoing programs, especially in EAG states.


2021 ◽  
Author(s):  
Pooja Singh ◽  
Kaushalendra Kumar Singh ◽  
Pragya Singh

Abstract Background: Maternal deaths among young women (15-24 years) shares 38% of total maternal mortality in India. Utilizing maternal health care services can reduce a substantial proportion of maternal mortality. However, there is a paucity of studies focusing on young women in this context. This paper therefore aimed to examine the trends and determinants of full antenatal care (ANC) and skilled birth attendance (SBA) utilization among young married women in India.Methods: The study analysed data from the four rounds of National Family Health Surveys conducted in India during the years 1992–93, 1998–99, 2005–06 and 2015–16. Young married women aged 15-24 years with at least one live birth in the three years preceding the survey were considered for analysis in each survey round. We used descriptive statistics to assess the prevalence and trends in full ANC and SBA use. Pooled multivariate logistic regression was conducted to identify the demographic and socioeconomic determinants of the selected maternity care services.Results: The use of full ANC among young mothers increased from 27% to 46% in India, and from 9% to 28% in EAG (Empowered Action Group) states during 1992-2016. SBA utilization was 88% and 83% during 2015-16 by showing an increment of 20% and 50% since 1992 in India and EAG states, respectively. Findings from multivariate analysis revealed significant difference in the use of selected maternal health care services by maternal age, residence, education, birth order and wealth quintile. Additionally, Muslim women, women belonging to scheduled caste (SC)/ scheduled tribe (ST) social group, and women unexposed to mass media were less likely to utilize both the maternal health care services. Concerning the time effect, the odds of the utilization of full ANC and SBA among young women was found to increase over time.Conclusions: Utilization of full ANC remained unacceptably low, specifically in EAG states. Programmatic interventions, targeting women residing in EAG states, adolescents, illiterate, poor and Muslim and SC/ST women would help to increase full ANC utilization and to maintain the increasing trend of SBA use.


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