Predictors of Availing Maternal Health Schemes: A community based study in Gujarat, India

Kranti Suresh Vora, Sandul Yasobant, Dileep Mavalankar

Abstract


Background: India continues to face challenges in improving key maternal health indicators with about 1/3rd of global maternal deaths happening in India. Utilization of health care services is an important issue in India with significant proportion of home deliveries and majority of mothers not receiving adequate antenatal care. Mortality among poor rural women is the highest with lowest utilization. To make maternal healthcare more equitable, numerous schemes such as Janani Suraksha Yojana, Chiranjeevi Yojana, Kasturba Poshan Sahay Yojana have been introduced. Studies suggest that utilization of such schemes by target population is low and there is a need to understand factors affecting maternal health care utilization in the context of these schemes. Current community based study was done in rural Gujarat to understand characteristics of women who utilize such schemes and predictors of utilization. Methodology: Data collection was done in two districts of Gujarat from June to August, 2013 as a pilot phase of MATIND project. Community based cross-sectional study included 827 households and socio-demographic details of 1454 women of 15-49 years age groups were collected. 265 mothers, who had delivered after 1st January, 2013 are included in the regression analyses. The data analysis carried out with R version 3.0.1 software.  Results: The analysis indicates socioeconomic variables such as caste, maternal variables such as education and health system variables such as use of government facility are important predictors of maternal health scheme utilization. Results suggest that socioeconomic and health system factors are the best predictors for availing scheme. Conclusion: Health system variables along with individual level variables are important predictors for availing maternal health schemes. The study indicates the need to examine all levels of predictors for utilizing government health schemes to maximize the benefit for underserved populations such as poor rural mothers.


Keywords


Maternal Health; Availing Scheme; Utilization; Predictors

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References


Vora KS, Mavalankar DV, Ramani KV, Upadhyaya M, Sharma B, Iyengar S, Gupta V, Iyengar K. Maternal health situation in India: a case study. J Health Popul Nutr. 2009 Apr;27(2):184-201. PubMed PMID: 19489415; PubMed Central PMCID: PMC2761784. [PubMED]

Sample Registration System (SRS) Bulletin Report, Volume 46 (1), December, 2011.

Sanneving L, Trygg N, Saxena D, Mavalankar D, Thomsen S. Inequity in India: the case of maternal and reproductive health. Glob Health Action. 2013 Apr 3;6:19145. doi: 10.3402/gha.v6i0.19145. Review. PubMed PMID: 23561028; PubMed Central PMCID: PMC3617912. [PubMed]

Priyanka Saksena et al. Health services utilization and out-of-pocket expenditure at public and private facilities in low-income countries, Background Paper, No 20.World Health Report.2010.

Sonalde Desai et al. Utilization of Maternal Health Care Services in India: Understanding the Regional Differences. India Human Development Survey Report, 2005.

Balabanova D, Mackee M, Pomerleau J, Rose R, Haerpfer C. Health Service Utilization in the Former Soviet Union: Evidence from Eight Countries. Health Services Research 2004; 39:6, Part II.

Elo IT. Utilization of maternal health-care services in Peru: the role of women's education. Health Transit Rev. 1992 Apr;2(1):49-69. PubMed PMID: 10148665. [PubMed]

Goldman N, Pebley AR. Childhood immunization and pregnancy-related services in Guatemala. Health Transit Rev. 1994 Apr;4(1):29-44. PubMed PMID: 10147163. [PubMed]

Raghupathy S. Education and the use of maternal health care in Thailand. Soc Sci Med. 1996 Aug;43(4):459-71. PubMed PMID: 8844947. [PubMed]

Dharmalingam A, Hussain TM, Smith JF: Women's education autonomy and utilization of reproductive health services in Bangladesh. In Reproductive health: programmes and policy changes post-Cairo Edited by: Mundigo AI. Liege, Belgium, International Union for the Scientific Study of Population (IUSSP); 1999.

Twelfth Five Year Plan Report (vol. 3) of Planning Commission, 2012. Accessed from http://planningcommission.gov.in/plans/planrel/12thplan.

Ram F, Singh A. Is antenatal care effective in improving maternal health in rural uttar pradesh? Evidence from a district level household survey. J Biosoc Sci. 2006 Jul;38(4):433-48. PubMed PMID: 16762083. [PubMed]

Saikia N, Singh A. Does type of household affect maternal health? Evidence from India. J Biosoc Sci. 2009 May;41(3):329-53. doi: 10.1017/S0021932008003209. Epub 2008 Nov 27. PubMed PMID: 19036173. [PubMed]

Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS One. 2010 Jun 23;5(6):e11190. doi: 10.1371/journal.pone.0011190. PubMed PMID: 20585646; PubMed Central PMCID: PMC2890410. [PubMed]

Amin R, Shah NM, Becker S (2010) Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: a cross-sectional analysis. International Journal for Equity in Health 9, 9.

Nayar KR. Social exclusion, caste & health: a review based on the social determinants framework. Indian J Med Res. 2007 Oct;126(4):355-63. Review. PubMed PMID: 18032810. [PubMed]

Abosse Z, Woldie M, Ololo S. Factors influencing antenatal care service utilization in hadiya zone. Ethiop J Health Sci. 2010 Jul;20(2):75-82. PubMed PMID: 22434964; PubMed Central PMCID: PMC3275839. [PubMed]

Fenta M: Assessment of Factors Affecting Utilization of Maternal Health Care Services in Ayssaita and Dubti Town, Afar Regional State. North East Ethiopia: A MSc. thesis, Department of Community Health, Medical Faculty, AAU; 2005.

Advancing and sustaining universal coverage; Primary Health Care – Now More Than Ever. The World Health Report 2008.

Akash Acharya. Assessing Gujarat’s ‘Chiranjeevi’ Scheme, A Commentary Report. Economic & Political Weekly (EPW) November 28, 2009 vol xliv no 48.

Bhat R, Mavalankar DV, Singh PV, Singh N. Maternal healthcare financing: Gujarat's Chiranjeevi Scheme and its beneficiaries. J Health Popul Nutr. 2009 Apr;27(2):249-58. PubMed PMID: 19489419; PubMed Central PMCID: PMC2761781. [PubMed]

Digambar A et al. Factors influencing the Utilization of Maternal Health Care Services in Uttarakhand. Ethno Med, 5 (3): 209-216 (2011).

Ravendra K Sharma et al. Utilization of Health Services and RCH status in Madhya Pradesh: A District Level Analysis.

Singh PK, Rai RK, Alagarajan M, Singh L. Determinants of maternity care services utilization among married adolescents in rural India. PLoS One. 2012;7(2):e31666. doi: 10.1371/journal.pone.0031666. Epub 2012 Feb 15. PubMed PMID: 22355386; PubMed Central PMCID: PMC3280328. [PubMed]


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