Utilization of maternal health services and determinants of skilled care during delivery in slums of Gujarat, India
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Date
2015-07
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Obstetrics & Gynecology
Abstract
Background: In India one in three women is delivering without skilled care. This is
happening even after the Safe Motherhood Initiative began two decades ago. Aim &
Objective: The aim of the present paper is to assess utilization of maternal health services
and factors affecting skilled delivery care among urban slum women. Method: We selected
562 women delivered two year prior to survey using two stage clusters sampling for a
community based cross sectional study. Using a pre-tested structured interview schedule,
information was collected on demographics, socioeconomic status, use of maternal health
services, and reasons for non-utilization of health services. Univariate and multivariate
analysis were performed. Result: Majority (92%) of women received at least one antenatal
care during pregnancy, while only 4 out of five women sought skilled care during the last
delivery. Women of educationally and socially backward classes (OR=0.46, 95% CI 0.23-
0.94), women live in a distance more than two kilometers from maternity health facility
(OR=0.38, 95% CI 0.22-0.65), and women been on their second pregnancy (OR=0.44, 95%
CI 0.21-0.94) utilized less of skilled care during delivery compared to their counterparts.
Increase in education level of women and number of Antenatal care received were tending
more utilization of skilled care during delivery. Minimal sense of need, cost, social barriers
and perceptions about care were found to be the reasons for not seeking care. Poor
attitude of providers, poor quality of services and long waiting time were found to be the
reasons for non-utilization of public health facilities. Conclusion: The factors determine
skilled delivery care were caste affiliation, education, service availability, parity, perceived
utility of services and health seeking behaviors. Government institutions were lying
underutilized as women do not prefer them for delivery
Description
Keywords
Maternal Health services, Antenatal care (ANC), Skilled delivery care, Health Seeking behavior, Urban Slum, Gujarat, India
Citation
Bhanderi MN, Srinivasan K. Utilization of maternal health services and determinants of skilled care during delivery in slums of Gujarat, India. Obstetrics & Gynecology: An International Journal. 2015. doi: 10.5171/2015.293492