ABSTRACT
Background: About 0.76 million neonates die every year in India, the highest for any country in the world. Globally antenatal care (ANC) and postnatal care (PNC) of the new born is being promoted as a strategy to reduce neonatal deaths. This paper examines the association of PNC and advice given to women about care of neonates with neonatal mortality in India.Methods: Used DLHS-4 data (2012-13), 319965 ever married women aged 15-49 years from 21 States/UTs of India were covered. Overall 89876 (96.46%) live births were reported from last pregnancy. Bivariate and multiple logistic regression were used to examine associations between exposure and outcome variables.Results: Almost 50% of mothers did not receive advices about neonate care. Children whose mothers did not advised for breastfeeding were 1.42 time more likely to die (CI= 1.16-1.75, p<0.001) than those who received this advice. Crude odds ratio for advice on keeping the neonate warm was 1.43 (CI=1.19-1.71, p<0.001), for advice on cleanliness was 1.55 (CI=1.25-1.93, p<0.001), for better nutrition for mother and child was 1.28 (CI=1.04-1.57, p=0.022). Neonates whose weight were not measured were 1.63 times (CI=0.94-1.67) more likely to die than those whose weight were measured, though this result was not statistically significant. The odds ratios were not much different when the socioeconomic and demographic characteristics were adjusted in the model.Conclusions: Neonatal mortality was high among those who did not receive advices during ANC for new born care and PNC check-up for neonates. Though Government of India launched a number of interventions their implementation needs to be strengthened.
ABSTRACT
Assessment of the status of health and nutrition of a population is imperative to design and implement sound public health policies and programmes. The various extensive national health and nutrition surveys provide national-level information on different domains of health. These provide vital information and statistics for the country, and the data generated are used to identify the prevalence and risk factors for the diseases and health challenges faced by a country. This review describes the various national health and nutrition surveys conducted in India and also compares the information generated by each of these surveys. These include the National Family Health Survey, District Level Household Survey, Annual Health Survey, National Nutrition Monitoring Bureau Survey, Rapid Survey on Children and Comprehensive National Nutrition Survey.
ABSTRACT
Universal Health coverage (UHC) is required for fulfilment of Health for All. Currently World Health Organization has proposed indicators for tracing coverage of UHC. This study aimed to find the current status of the UHC in India and Indian States. Material and Methods: Data were collected from the national data portals, national surveys and annual reports of ministry. In case of non-availability, numerator and denominator were used from different sources. Data were entered in to Microsoft excel and analysed using Stata-12. Results: Coverage indicators for Non Communicable diseases and cataract surgery were not available in any national survey or national report of ministry. Coverage of none of the health system indicators were found to be 100%. Few indicators like Skilled attendance at birth, TB cure rate, Preventive chemotherapy against filariasis, access to improved water source had a coverage of 80%. Across the states and union territories the coverage was variable but no significant difference was observed between the EAG and Non EAG states. Very few states have achieved the minimum coverage of 80% in various coverage indicators. Conclusion: There is non-availability of some data and some data were collected in duplication. Because of the lack of data, it is not yet possible to compare the UHC service coverage index across key dimensions of inequality. Until these data gaps are overcome, inequalities in service coverage cannot be assessed.
ABSTRACT
Background & objectives: Despite various efforts by the Government of India, utilization of antenatal care (ANC) services continues to be low among women from rural areas particularly those belonging to the Scheduled Tribes. The present study was undertaken to examine the factors associated with the utilization of ANC services among women in four States including Rajasthan, Odisha, Chhattisgarh and Madhya Pradesh which constitute a good share of tribal population of the country. Methods: Data from third round of District Level Household and Facility Survey, 2007-08 (DLHS-3) have been used. Bivariate and multivariate analyses (logistic regression model) were used to study the association between the utilization of ANC services and the independent variables at individual, household and village levels along with the motivational factors (motivation by health workers and family members). Results: The utilization of ANC services among Scheduled Tribes women varied from about 4 per cent in Madhya Pradesh and Rajasthan to 10-14 per cent in Chhattisgarh and Odisha. Utilization was highest among those women with level of education 9th class and above (15-28%) and those women who visited health facility for pregnancy confirmation test (9-27%). Across the States, women who visited health facility for pregnancy testing (adjusted odds ratio, AOR = 1.5-2.5; P<0.001) except in Madhya Pradesh; registration of pregnancy (AOR = 2.1-4.5; P<0.01) and sought treatment of pregnancy related problems (AOR = 1.5-1.8; P<0.06) except in Rajasthan, were more likely to avail complete ANC services than their counterparts. Interpretation & conclusions: The utilization of antenatal care among Scheduled Tribe women across four States was very poor. The reasons behind non-utilisation include both socio-economic and health system factors. For improving ANC utilization among tribes, these factors need to be addressed with special emphasis on woman’s educational attainment of high school and above. In addition, the study highlighted the need to create awareness among both pregnant tribal women as well as her family members on the importance of early ANC care.