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EFFECT OF INDIVIDUAL AND COMMUNITY FACTORS ON MATERNAL HEALTH CARE SERVICE USE IN INDIA: A MULTILEVEL APPROACH

Published online by Cambridge University Press:  05 March 2015

AWDHESH YADAV  and
RANJANA KESARWANI
AWDHESH YADAV*
Affiliation:
International Institute for Population Sciences (IIPS), Deonar, Mumbai, India
RANJANA KESARWANI
Affiliation:
Public Health Foundation of India (PHFI), Gurgaon, Haryana, India
*
1Corresponding author. Email: awdhesh.stat@gmail.com
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Summary

This study aimed to assess empirically the influence of individual and community (neighbourhood) factors on the use of maternal health care services in India through three outcomes: utilization of full antenatal care (ANC) services, safe delivery and utilization of postnatal care services. Data were from the third round of the National Family Health Survey (2005–06). The study sample constituted ever-married women aged 15–49 from 29 Indian states. Multilevel logistic regression analysis was performed for the three outcomes of interest accounting for individual- and community-level factors associated with the use of maternal health care services. A substantial amount of variation was observed at the community level. About 45%, 51% and 62% of the total variance in the use of full ANC, safe delivery and postnatal care, respectively, could be attributed to differences across the community. There was significant variation in the use of maternal health care services at the individual level, with socioeconomic status and mother's education being the most prominent factors associated with the use of maternal health care services. At the community level, urban residence and poverty concentration were found to be significantly associated with maternal health care service use. The results suggest that an increased focus on community-level interventions could lead to an increase in the utilization of maternal health care services in India.

Type
Articles
Information
Journal of Biosocial Science , Volume 48 , Issue 1 , January 2016 , pp. 1 - 19
Copyright
Copyright © Cambridge University Press 2015 

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References

Adekunle, C., Filippi, V., Graham, W., Onyemunva, P. & Udjo, E. (1990) Pattern of maternity care among women in Ondo states, Nigeria. In Hill, A. G. (ed.) Determinants of Health and Mortality in Africa. Demography and Health Survey Further Analysis Series No. 10. Population Council, New York, pp. 1–45.Google Scholar
Agha, S. & Carton, T. W. (2011) Determinants of institutional delivery in rural Jhang, Pakistan. International Journal for Equity in Health 10(31).CrossRefGoogle ScholarPubMed
Akin, A. & Munevver, B. (1996) Contraceptive, Abortion and Maternal Health Services in Turkey: Results of Further Analysis of the 1993 Turkish Demographic and Health Survey. Ministry of Health [Turkey] and Macro International Inc., Calverton, MD, USA.Google Scholar
Andersen, R. M. & Newman, J. F. (1973) Social and individual determinants of medical care utilization in the United States. Milbank Memorial Quarterly 51, 95–124.Google Scholar
Babalola, S. & Fatusi, A. (2009) Determinants of use of maternal health services in Nigeria: looking beyond individual and household factors. BMC Pregnancy and Child Birth 9, 43.Google Scholar
Bajpai, N., Dholkia, R. & Towel, M. (2013) Increasing the availability of skilled birth attendance in rural India. SA Working Paper No. 9. Paper prepared for the International Advisory Panel of the National Rural Health Mission, Ministry of Health & Family Welfare, Government of India, Columbia Global Centres, South Asia.Google Scholar
Basu, A. M. (1992) Culture: The Status of Women and Demographic Behaviour: Illustrated with the Case of India. Oxford University Press, Oxford.Google Scholar
Berker, S., Peters, D. H., Gray, R. H., Gultiano, C. & Blake, R. E. (1993) The determinants of use of maternal and child health services in metro Cebu, the Philippines. Health Transition Review 3, 77–89.Google Scholar
Bhatia, J. C. & Cleland, J. (1995) Determinant of maternal care in a region of south India. Health Transition Review 5(2), 127–142.Google Scholar
Bloom, S. S., Wypij, D. & Dasgupta, M. (2001) Dimensions of women's autonomy and the influence on maternal health care utilization in a north India city. Demography 38(1), 67–78.Google Scholar
Carroli, G., Rooney, C. & Villar, J. (2001) How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatric and Perinatal Epidemiology 15 (supplement 1), 1–42.Google Scholar
Celik, Y. & Hotchkiss, D. R. (2000) The socio-economic determinant of maternal health care utilization in Turkey. Social Science & Medicine 27(12), 1357–1368.Google Scholar
CSO (2013) SAARC Development Goals, India Country Report 2013. Central Statistics Office, Ministry of Statistics and Program Implementation, Government of India.Google Scholar
Das, N. P., Gandotra, M. M., Pandey, D. & Shah, U. (2002) Status of Women and Reproductive Behaviour. Hindustan Publishing Corporation, New Delhi.Google Scholar
Gage, A. (1998) Premarital childbearing, unwanted fertility and maternity care in Kenya and Namibia. Population Studies 52, 21–34.Google Scholar
Gertler, P., Rahman, O., Feifer, C. & Ashley, D. (1993) Determinants of pregnancy outcomes and targeting of maternal health care services in Jamaica. Social Science & Medicine 37, 99–211.Google Scholar
IIPS & Macro International (2007) National Family Health Survey (NFHS-3), 2005–06: India. Volume I. IIPS, Mumbai.Google Scholar
Islam, M. R. & Odland, J. O. (2011) Determinant of antenatal and postnatal care visit among indigenous people in Bangladesh: a study of the Mru community. Rural and Remote Health 10.Google Scholar
Jat, T. R., Ng, N. & Sebastian, M. S. (2011) Factor affecting the use of maternal health services in Madhya Pradesh state of India: a multilevel analysis. International Journal of Equity in Health 10, 59.Google Scholar
Kalaivani, K. (2009) Prevalence and consequences of anemia in pregnancy. Indian Journal of Medical Research 130(5), 627–633.Google Scholar
Leslie, J. & Gupta, G. R. (1989) Utilization of Formal Services for Maternal Nutrition and Health Care. International Center for Research on Women, Washington, DC.Google Scholar
Magadi, M., Diamond, I. & Nascimento Rodrigues, N. (2000) The determinants of delivery care in Kenya. Social Biology 47, 164–188.Google Scholar
Mekonnen, Y. (1998) Barriers to the utilization of maternity care services in southern Ethiopia: analysis of the services and users factors. MSc thesis, Addis Ababa University, Ethiopia.Google Scholar
Mistry, R., Galal, O. & Lu, M. (2009) Women's autonomy and pregnancy care in rural India: a contextual analysis. Social Science & Medicine 69(6), 926–933.Google Scholar
Mohanty, S. K. & Pathak, P. K. (2009) Rich–poor gap in utilization of reproductive and child health services in India, 1992–2005. Journal of Biosocial Science 41(3), 381–398.Google Scholar
Montgomery, A. L., Ram, U., Kumar, R., Jha, P. et al (2013) Maternal mortality in India: cause and health care service use based on nationally representative survey. PLoS One 9(1), e83331. doi:10.1371/journal.pone.0083331 Google Scholar
Navneetham, K. & Dharmalingum, A. (2002) Utilization of maternal health care services in southern India. Social Science & Medicine 55, 1849–1869.Google Scholar
Obermeyer, C. M. (1993) Culture, maternal health care, and women status: a comparison of Morocco and Tunisia. Studies in Family Planning 24(6), 354–365.CrossRefGoogle ScholarPubMed
Obermeyer, C. M. & Potter, J. E. (1991) Maternal health care utilization in Jordan: a study of patterns and determinants. Studies in Family Planning 22, 177–187.Google Scholar
Pathak, P. K. & Mohanty, S. K. (2010) Does the safe-motherhood programme reach the poor in Uttar Pradesh, India? Asian Population Studies, 6(2), 173–191.Google Scholar
Raghupathy, S. (1996) Education and the use of maternal health care in Thailand. Social Science & Medicine 43(4), 459–471.Google Scholar
Registrar General of India (2011) Special Bulletin on Maternal Mortality in India, June 2011. URL: http://planningcommission.nic.in/data/datatable/0904/tab_145.pdf (accessed 5th December 2013).Google Scholar
Sagna, M. L. & Sunil, T. S. (2012) Effect of individual and neighbourhood factors on maternal care in Cambodia. Health & Place 18, 415–423.Google Scholar
Sarin, A. R. (1997) Underutilization of maternal health services. World Health Forum 18, 67–68.Google Scholar
Singh, A., Hazra, A. & Ram, F. (2007) Women's autonomy and sex differential in child mortality in India. Genus LXIII (3–4), 55–75.Google Scholar
Singh, L., Rai, R. K. & Singh, P. R. (2011) Assessing the utilization of maternal and child health care among married adolescent women: evidence from India. Journal of Biosocial Science 44(1), 1–26.Google Scholar
StataCorp (2009) Stata Statistical Software: Release 11. StataCorp LP, College Station, TX.Google Scholar
Stephenson, R. & Tsui, A. O. (2002) Contextual influences on reproductive health services use in Uttar Pradesh, India. Studies in Family Planning 33(4), 309–320.Google Scholar
Stewart, K. & Sommerfelt, A. E. (1991) Utilization of maternity care services: a comparative study using DHS data. Proceeding of the Demographic and Health Surveys World Conference, Washington, DC. Volume III. Columbia, MD, pp. 1645–1668.Google Scholar
Thind, A., Mohani, A., Banerjee, K. & Hagigi, F. (2008) Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health 8, 29–36.CrossRefGoogle ScholarPubMed
Tinker, A., Hoope, P. B., Azfar, S., Bustreo, F. & Bell, R. (2005) A continuum of care to save newborn lives. Lancet 365(9462), 822–825.Google Scholar
Toteja, G. S. & Singh, P. (2004) Micronutrient Profile of Indian Population. Indian Council of Medical Research, New Delhi.Google Scholar
Vadm, S. & Arora, P. (2005) Maternal mortality – Indian scenario. Medical Journal Armed Forces India 61(3), 214–215.Google Scholar
WHO (1996) Care in Normal Birth: A Practical Guide. WHO/FRH/MSM 96-24, Geneva.Google Scholar
WHO (2006) Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Standard for Maternal and Neonatal Care (1.6). Department of Making Pregnancy Safer, WHO, Geneva, Switzerland. URL: http://www.who.int/making_pregnacy_safer/publications/Standards1.6N.pdf (accessed 28th June 2013).Google Scholar
WHO (2012) Maternal Mortality. Fact Sheet May 2012. URL: http://www.who.int/mediacentre/factsheets/fs348/en/ (accessed 5th December 2013).Google Scholar
WHO, UNICEF, UNFPA & World Bank (2012) Trends in Maternal Mortality: 1990–2010. URL: http://www.unfpa.org/sites/default/files/resource-pdf/EN-SRH%20fact%20sheet-LifeandDeath.pdf Google Scholar
WHO (2013) WHO Recommendations on Postnatal Care of the Mother and Newborn. WHO, Geneva. URL: http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf (accessed 7th February 2014).Google Scholar