Does engagement with frontline health workers improve maternal and child healthcare utilisation and outcomes in India?

Abstract

Background Poor Maternal and Child Health (MCH) outcomes pose challenges to India’s ability to attain Goal-3 of the Sustainable Development Goals (SDGs). The government of India strengthened the existing network of Frontline Health Workers (FHWs), under its National Rural Health Mission in 2005 and subsequent National Urban Health Mission in 2013 as a strategy to mitigate the shortage of skilled health workers and to provide affordable healthcare services. However, there is a lack of robust national-level empirical analysis on the role of maternal engagement with FHWs in influencing the level of maternal and child health care utilisation and child health outcomes in India. Methods Using data from the nationally representative Indian National Family Health Survey (NFHS) 2015-16, this paper aims to investigate the intensity of engagement of FHWs with married women of child-bearing age (15-49 years), its influence on utilisation of maternal and child healthcare services, and child health outcomes. Our empirical analyses use multivariate regression analyses, focusing on five maternal and child health indicators: antenatal care visits (ANC) (4 or >4 times), institutional delivery, full-immunisation of children, postnatal care (PNC) (within 2 days of delivery), and child survival. Results Our analysis finds that maternal engagement with FHWs is statistically significant and a positive predictor of maternal and child health care utilisation, and child survival. Further, the level of engagement with FHWs is particularly important for women from economically poor households. Our robustness checks across sub-samples of women who delivered only in public health institutions and those from rural areas provides an additional confidence in our main results. Conclusions From a policy perspective, our findings highlight that strengthening the network of FHWs in the areas where they are in shortage which can help in further improving the utilisation of maternal and child healthcare services, and health outcomes.

Factors influencing, SWOT analysis and emerged strategies for improving the use of digital data platforms in immunisation program by frontline health care providers: a study from rural Eastern India

“…In India's healthcare delivery system, their role is critical in disseminating information about the government's flagship healthcare programmes among eligible beneficiaries such as pregnant women, mothers, and their children. 4 Digital health is a multidisciplinary concept that intermingles technology and healthcare for better service provision. 5 In recent years, digital healthcare platforms are getting better utilised in all different aspects of health care.…”