Utilization of maternal health services and its determinants

a cross-sectional study among women in rural Uttar Pradesh, India

Ranjana Singh, Sutapa B. Neogi, Avishek Hazra, Laili Irani, Jenny Ruducha, Danish Ahmad, Sampath Kumar, Neelakshi Mann, Dileep Mavalankar

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Proper utilization of antenatal and postnatal care services plays an important role in reducing the maternal mortality ratio and infant mortality rate. This paper assesses the utilization of health care services during pregnancy, delivery and post-delivery among rural women in Uttar Pradesh (UP) and examines its determinants. METHODS: Data from a baseline survey of UP Community Mobilization (UPCM) project (2013) was utilized. A cross-sectional sample of currently married women (15 to 49 years) who delivered a baby 15 months prior to the survey was included. Information was collected from 2208 women spread over five districts of UP. Information on socio-demography characteristics, utilization of antenatal care (ANC), delivery and postnatal care (PNC) services was collected. To examine the determinants of utilization of maternal health services, the variables included were three ANC visits, institutional delivery and PNC within 42 days of delivery. Separate multilevel random intercept logistic regressions were used to account for clustering at a block and gram panchayat level after adjusting for covariates. RESULTS: Eighty-three percent of women had any ANC. Of them, 61% reported three or more ANC visits. Although 68% of women delivered in a health facility, 29% stayed for at least 48 h. Any PNC within 42 days after delivery was reported by 26% of women. In the adjusted analysis, women with increasing number of contacts with the health worker during the antenatal period, women exposed to mass-media and non-marginalized women were more likely to have at least three ANC visits during pregnancy. Non-marginalized women and women with at least three ANC visits were more likely than their counterparts to deliver in an institution. Contacts with health worker during pregnancy, marginalization, at least three ANC visits and institutional delivery were the strong determinants for utilization of PNC services. Self-help group (SHG) membership had no association with the utilization of maternal health services. CONCLUSIONS: Utilization of maternal health services was low. Contact with the health worker and marginalization emerged as important factors for utilization of services. Although not associated with the utilization, SHGs can be used for delivering health care messages within and beyond the group.

Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalJournal of health, population, and nutrition
Volume38
Issue number1
DOIs
Publication statusPublished - 27 May 2019

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Maternal Health Services
rural women
prenatal care
cross-sectional studies
health services
Prenatal Care
India
Cross-Sectional Studies
Postnatal Care
health care workers
pregnancy
Pregnancy
Health
women's health
infant mortality
mass media
infants
Mass Media
demography
Maternal Mortality

Cite this

Singh, Ranjana ; Neogi, Sutapa B. ; Hazra, Avishek ; Irani, Laili ; Ruducha, Jenny ; Ahmad, Danish ; Kumar, Sampath ; Mann, Neelakshi ; Mavalankar, Dileep. / Utilization of maternal health services and its determinants : a cross-sectional study among women in rural Uttar Pradesh, India. In: Journal of health, population, and nutrition. 2019 ; Vol. 38, No. 1. pp. 1-12.
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Utilization of maternal health services and its determinants : a cross-sectional study among women in rural Uttar Pradesh, India. / Singh, Ranjana; Neogi, Sutapa B.; Hazra, Avishek; Irani, Laili; Ruducha, Jenny; Ahmad, Danish; Kumar, Sampath; Mann, Neelakshi; Mavalankar, Dileep.

In: Journal of health, population, and nutrition, Vol. 38, No. 1, 27.05.2019, p. 1-12.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Utilization of maternal health services and its determinants

T2 - a cross-sectional study among women in rural Uttar Pradesh, India

AU - Singh, Ranjana

AU - Neogi, Sutapa B.

AU - Hazra, Avishek

AU - Irani, Laili

AU - Ruducha, Jenny

AU - Ahmad, Danish

AU - Kumar, Sampath

AU - Mann, Neelakshi

AU - Mavalankar, Dileep

PY - 2019/5/27

Y1 - 2019/5/27

N2 - BACKGROUND: Proper utilization of antenatal and postnatal care services plays an important role in reducing the maternal mortality ratio and infant mortality rate. This paper assesses the utilization of health care services during pregnancy, delivery and post-delivery among rural women in Uttar Pradesh (UP) and examines its determinants. METHODS: Data from a baseline survey of UP Community Mobilization (UPCM) project (2013) was utilized. A cross-sectional sample of currently married women (15 to 49 years) who delivered a baby 15 months prior to the survey was included. Information was collected from 2208 women spread over five districts of UP. Information on socio-demography characteristics, utilization of antenatal care (ANC), delivery and postnatal care (PNC) services was collected. To examine the determinants of utilization of maternal health services, the variables included were three ANC visits, institutional delivery and PNC within 42 days of delivery. Separate multilevel random intercept logistic regressions were used to account for clustering at a block and gram panchayat level after adjusting for covariates. RESULTS: Eighty-three percent of women had any ANC. Of them, 61% reported three or more ANC visits. Although 68% of women delivered in a health facility, 29% stayed for at least 48 h. Any PNC within 42 days after delivery was reported by 26% of women. In the adjusted analysis, women with increasing number of contacts with the health worker during the antenatal period, women exposed to mass-media and non-marginalized women were more likely to have at least three ANC visits during pregnancy. Non-marginalized women and women with at least three ANC visits were more likely than their counterparts to deliver in an institution. Contacts with health worker during pregnancy, marginalization, at least three ANC visits and institutional delivery were the strong determinants for utilization of PNC services. Self-help group (SHG) membership had no association with the utilization of maternal health services. CONCLUSIONS: Utilization of maternal health services was low. Contact with the health worker and marginalization emerged as important factors for utilization of services. Although not associated with the utilization, SHGs can be used for delivering health care messages within and beyond the group.

AB - BACKGROUND: Proper utilization of antenatal and postnatal care services plays an important role in reducing the maternal mortality ratio and infant mortality rate. This paper assesses the utilization of health care services during pregnancy, delivery and post-delivery among rural women in Uttar Pradesh (UP) and examines its determinants. METHODS: Data from a baseline survey of UP Community Mobilization (UPCM) project (2013) was utilized. A cross-sectional sample of currently married women (15 to 49 years) who delivered a baby 15 months prior to the survey was included. Information was collected from 2208 women spread over five districts of UP. Information on socio-demography characteristics, utilization of antenatal care (ANC), delivery and postnatal care (PNC) services was collected. To examine the determinants of utilization of maternal health services, the variables included were three ANC visits, institutional delivery and PNC within 42 days of delivery. Separate multilevel random intercept logistic regressions were used to account for clustering at a block and gram panchayat level after adjusting for covariates. RESULTS: Eighty-three percent of women had any ANC. Of them, 61% reported three or more ANC visits. Although 68% of women delivered in a health facility, 29% stayed for at least 48 h. Any PNC within 42 days after delivery was reported by 26% of women. In the adjusted analysis, women with increasing number of contacts with the health worker during the antenatal period, women exposed to mass-media and non-marginalized women were more likely to have at least three ANC visits during pregnancy. Non-marginalized women and women with at least three ANC visits were more likely than their counterparts to deliver in an institution. Contacts with health worker during pregnancy, marginalization, at least three ANC visits and institutional delivery were the strong determinants for utilization of PNC services. Self-help group (SHG) membership had no association with the utilization of maternal health services. CONCLUSIONS: Utilization of maternal health services was low. Contact with the health worker and marginalization emerged as important factors for utilization of services. Although not associated with the utilization, SHGs can be used for delivering health care messages within and beyond the group.

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KW - Delivery

KW - Marginalization

KW - Postnatal care

KW - Self-help group (SHG)

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