ABSTRACT
Background: Postnatal period is a vulnerable time, because most maternal and new born deaths occur during this period, especially immediately after childbirth. Postnatal care in the first hours and days after childbirth could prevent the great majority of these deaths. The objective of study was to assess the utilization of post-natal care and associated factors for low utilization in urban area of Jabalpur district.Methods: A community based cross-sectional study was carried 360 mothers who delivered in last one year in urban area of Jabalpur district. Sampling method was multistage sampling method. A total 36 wards with 10 mothers from each ward was selected. The questionnaire included information related to mode of delivery, post-natal checkups and visits of health care providers.Results: Among 360 mothers, 93.9% mothers received first postnatal check-up within 24 hrs. 1.11% of mothers between 2-3 days and 1.67% of mothers received first postnatal check-up between 4-7 days while 3.33% of mothers didn’t receive any postnatal check-up. Regarding number of post-natal visits, 58.33% mothers received 3 or more postnatal visits, 35% of mother received 2 PNC visits, while 3.3% did not receive a single postnatal visit. The education of mothers, joint type of family, high socioeconomic status, early registration of pregnancy, minimum 4 ANC visits and institutional deliveries were found significantly associated with utilization of postnatal check-up.Conclusions: Utilization of postnatal services is still poor in the urban areas even though the physical accessibility was adequate. In the present study, it was concluded that the role of education, especially of female education, is important contributing factor associated with utilization of postnatal care.
ABSTRACT
Background: As part of the Sustainable Development Goal 3, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births globally by 2030. Antenatal care (ANC) is an important determinant of maternal mortality and ANC visit is an important component of maternal health care. This study was carried out to assess the utilization of antenatal care services and to understand the factors associated with utilization of antenatal care services in tribal area of Madhya Pradesh.Methods: Community based cross-sectional study carried in tribal dominated district of Madhya Pradesh. A total of 210 mothers who delivered in last one year were selected for study by cluster sampling technique and mothers were interviewed using structured questionnaire after obtaining informed consent.Results: Present study 94.8% antenatal mothers registered and received at least one antenatal check-up and 51.4% mother were registered during first trimester while only 43.4% mothers received four or more ANC visits. Completely utilization of ANC services was found in 39.5% mother. Education of the mother, occupation of mother, income, education of the husband, knowledge of mother about the needs of antenatal care and early ANC registration were found to be significant factors associated with full utilization of ANC services.Conclusions: This study revealed that education of mother and knowledge of mother about the needs of ANC were important contributing factors associated with full utilization of ANC services in tribal area. The education is related with the economic status, awareness of mother about utilization health services, empowerment and decisions making capacity of mothers.
ABSTRACT
The Government of India initiated a cash incentive scheme—Janani Suraksha Yojana (JSY)—to promote institutional deliveries with an aim to reduce maternal mortality ratio (MMR). An observational study was conducted in a tertiary-care hospital of Madhya Pradesh, India, before and after implementation of JSY, with a sample of women presenting for institutional delivery. The objectives of this study were to: (i) determine the total number of institutional deliveries before and after implementation of JSY, (ii) determine the MMR, and (iii) compare factors associated with maternal mortality and morbidity. The data were analyzed for two years before implementation of JSY (2003-2005) and compared with two years following implementation of JSY (2005-2007). Overall, institutional deliveries increased by 42.6% after implementation, including those among rural, illiterate and primary-literate persons of lower socioeconomic strata. The main causes of maternal mortality were eclampsia, pre-eclampsia and severe anaemia both before and after implementation of JSY. Anaemia was the most common morbidity factor observed in this study. Among those who had institutional deliveries, there were significant increases in cases of eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage (APH), postpartum haemorrhage (PPH), and malaria after implementation of JSY. The scheme appeared to increase institutional delivery by at-risk mothers, which has the potential to reduce maternal morbidity and mortality, improve child survival, and ensure equity in maternal healthcare in India. The lessons from this study and other available sources should be utilized to improve the performance and implementation of JSY scheme in India.