Accessibility and Utilization of Emergency Obstetric Care in Rural Settings of Wardha District- Beneficiaries Perspective

ABSTRACT

In India, Emergency Obstetric Care services were started under RCH-II with the goal to reduce MMR to less than 100/lakh live births, and increase institutional deliveries to 80% by 2010. Strategy was to enhance availability and access to EmOC, for averting unpredictable death during pregnancy and childbirth. We wanted to determine the perception of beneficiary women about accessibility and utilization pattern of EmOC at peripheral health care facilities. METHODSThe present qualitative study was conducted in one of the eight blocks of Wardha (Maharashtra) from May to October-2017. Data was collected by in-depth interview of service users (21 beneficiaries). Notes were transcribed and then translated into English. Respondents’ verbatim that are significant and illustrative as per theme of study were used for analysis.RESULTSFacilitators for EmOC were found to be birth preparedness, promotion of institutional delivery, registration for JSY/JSSK through health workers along with provision of some EmOC services. Socio-cultural beliefs, leading to delay in recognition of danger signals to access care, transportation delay due to poor access of ambulance and identified vehicles along with insufficient coverage of JSSK program, were the main barriers. Beneficiaries who required EmOC were dissatisfied due to frequent referral & travelling, expenditure on transport & food, loss of daily wages, managing dependent family members and domestic work.