Trends and determinants in the utilization of maternal healthcare services in West Bengal, India: Findings from the 3rd and 4th round National Family and Health Survey.

BACKGROUND: Proper utilization of recommended healthcare services during the pregnancy is considered as critically important for better pregnancy outcomes, as well as a good health status of the mother. OBJECTIVE: The aim of the current study was to trace the trend in progress, and what are factors associated with the attendance at four Antenatal Care (ANC) visits, receive full ANC and institutional delivery in the study area. RESEARCH DESIGN/SETTING: The study has used a cross-sectional secondary data of the 3rd and 4th round National Family and Health Survey (NFHS) for India conducted in 2005-06 and 2015-2016 respectively. For West Bengal, a total of 6794 in 2005-06 and 17,668 in 2015-2016 ever-married women aged 15-49 who had experienced at least one live birth in the past five years preceding the survey were covered in this study. To analyze the data, the chi-square test was performed as it allows researcher to assess the association between outcome variables and independent variables. The univariate descriptive and multivariate statistical tools have been applied to analyse the data in this study. RESULTS: Our study indicated that the progress rate in attending at least four antenatal care visits, institutional delivery considerably good, but a noticeable gap exists across the different socio-economic groups. The coverage of full ANC services has remained very poor and unchanged over the decade. It was concluded that the wealth status of the households significant predictor of the attendance at least four ANC visits, full ANC and Institutional delivery in West Bengal. Other statistically significant socio-economic and demographic factors include level of women education, age of women, exposure to mass media, place of residence, and number of parities of birth. CONCLUSION: The present study suggests that the increasing strength in the coverage of all maternal healthcare services could be a significant focus during the program implementation in West Bengal. For strengthening and ascertaining the universal coverage of maternal healthcare services, there is an urgent need to reduce socioeconomic inequity in uses of the recommended maternal healthcare services. Moreover, our study found that the socio-economic and demographic factors play a significant role in utilization of maternal healthcare services. Thus the promotion of women education, empowerment and autonomy, and the frequent social marketing of government schemes and programs on maternal healthcare through the various types of mass media should be the unique future steps for achieving the universal coverage of maternal service in West Bengal.

Factors associated with delay in treatment-seeking behaviour for fever cases among caregivers of under-five children in India: Evidence from the National Family Health Survey-4, 2015-16.

BACKGROUND: Fever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India. METHODS: A cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015-2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman's Questionnaire, Man's Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children. RESULTS: In India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a 'big problem' (AOR: 1.16; 95% CI: 1.09, 1.23). CONCLUSION: The study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.

Exploring the strategies for upgrading the rural unqualified health practitioners in West Bengal, India: A knowledge, attitude and practices assessment-based approach.

Introduction: Rural Unqualified Health Practitioners (RUHPs) are more common in the village health system in India and other developing countries. They only provides primary care to patients with diarrhea, cough, malaria, dengue, ARI/pneumonia, skin diseases, etc. As they are unqualified so their quality of health practices is substandard and inappropriate to practices. Objective and contribution: The intention of this work was to assess the Knowledge, Attitude, and Practices (KAP) of diseases among RUHPs and proposing a blueprint of potential intervention strategies for improving their knowledge and practice. Materials and methods: The study has used a cross-sectional primary data and adopted quantitative approach. For assessment purpose, a composite KAP Score was constructed for two diseases (malaria and dengue). Results: The study observed that the KAP Score amongst the RUHPs are on average (about 50%) in most of the individual variables and composite scores for malaria and dengue in West Bengal, India. Their KAP score increased with age, level of education, working experiences, type of practitioners, using android mobile, work satisfaction, organization membership, attending RMP/Government workshop, heard WHO/IMC treatment protocol. Conclusion: The study suggested multistage interventions includes targeting young practitioners, allopathic and homeopathic quack, launching ubiquitous app-based medical-learning, and government-sponsored workshop should be significant interventions to improve the level of knowledge, change positive attitudes, and adhere to standard health practice.