Poor coverage of quality-adjusted antenatal care services: a population-level assessment by visit and source of antenatal care services in Bihar state of India

Dandona, Rakhi; Kumar, G Anil; Majumder, Moutushi; Akbar, Md; Prasad Dora, S Siva; Dandona, Lalit

doi:10.1016/j.lansea.2023.100332

The Lancet Regional Health - Southeast Asia

2024

DOI: 10.1016/j.lansea.2023.100332

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Poor coverage of quality-adjusted antenatal care services: a population-level assessment by visit and source of antenatal care services in Bihar state of India

Rakhi Dandona,

G Anil Kumar,

Moutushi Majumder

et al.

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Cited by 3 publications

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Turning the tide with better data to address stillbirths in India

Dandona,

Kumar,

Mahapatra

2024

The Lancet Regional Health - Southeast Asia

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Turning the tide with better data to address stillbirths in India

Dandona,

Kumar,

Mahapatra

2024

The Lancet Regional Health - Southeast Asia

View full text Add to dashboard Cite

Population-level trends over a decade in geographical inequality for opportunity in access to maternal care services: a cross-sectional analysis from the National Family Health Surveys in India

Dandona,

Majumder,

Kumar

2024

BMJ Open

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ObjectivesThe objective of this study is to examine the trends in geographical inequality of opportunity in maternal health services in India considering the Every Newborn Action Plan (ENAP) 2025 coverage targets.SettingIndia.ParticipantsWomen in the National Family Health Survey (NFHS)—NFHS-4 (2014–2015) and NFHS-5 (2019–2021).Primary and secondary measuresDistrict-level coverages of 4+antenatal care (ANC) visits, institutional delivery with skilled birth attendant, postnatal care (PNC) services within 48 hours of delivery, continuum of care (CoC) services for women with most recent live births were considered. Human Opportunity Index (HOI) documented the opportunities for equitable access to these services, ranging from 0 (high inequality) to 100 (universal access). HOI was compared between the survey rounds and wealth index (WI) quintiles that the women belonged to.ResultsCoverages of 4+ANC visits, institutional delivery, PNC and CoC in India increased by 22.8% (95% CI 22.1% to 23.5%), 12.6% (95% CI 12.2% to 12.9%), 28.5% (95% CI 28.0% to 29.0%) and 38.6% (95% CI 37.6% to 39.6%) between NFHS-4 and NFHS-5, respectively. The HOI for 4+ANC visits was 48.4 in NFHS-5, ranging from 11.3 to 92.4 in states and from 31.1 to 70.5 for WI I–V. The HOI for institutional delivery was 80.4 in NFHS-5, ranging from 37.4 to 99.7 in the states and from 21.0 to 100 for WI I–V. The HOI for PNC services was 73.5 in NFHS-5, ranging from 37.5 to 95.6 in the states and from 61.2 to 88.3 for WI I–V. The HOI for CoC was 37.1, ranging from 6.5 to 88.8 in the states and from 19.8 to 62.7 for WI I–V for CoC in NFHS-5.ConclusionThough significant improvements in the geographical inequity of maternal health services have been made in India, the geographical inequity for 4+ANC visits coverage lags significantly behind resulting in CoC coverage inequity to achieve the ENAP targets for these services.

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Socio-cultural practices and experience of mothers’ post stillbirth and newborn death: a population-based perspective from India

Majumder,

Kumar,

Ali

et al. 2024

BMC Pregnancy Childbirth

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Introduction We report on post stillbirth and newborn death socio-cultural experience of women from a population-based representative sample in the Indian state of Bihar. Methods A state-representative sample of 7,270 births between July 2020 and June 2021 was sampled, including 582 stillbirths and 831 newborn deaths. Detailed confidential interviews were conducted with the consenting women with stillbirth and newborn death to understand their post-birth experience. Results A total of 501 (86.1% participation) women with stillbirth and 717 (86.3% participation) with neonatal death provided interview. Able to talk to someone about their baby and receiving support to cope with their loss were reported by 369 (74.2%) and 398 (80.2%) women with stillbirth; these proportions were 76.7% and 77.3% for women with newborn deaths, respectively. More than 80% of these women reported spouses as their main source of support. At least one negative experience was reported by 150 (30.9%) and 233 (32.5%) women with stillbirth and newborn death, respectively. The most commonly reported negative experience was receiving insensitive/hurtful comments about the baby (18.6% for stillbirth and 20.4% for newborn deaths), followed by being blamed for the baby’s death (14.3% for stillbirths and 15.0% for newborn deaths). The majority of women reported being verbally abused by the mother-in-law for both stillbirth (24, 63.2%) and newborn death (49, 64.5%); while 48 (67.6%) and 66 (61.7%) women were blamed by the mother-in-law for stillbirth and neonatal death, respectively. Most women with stillbirth (72.7%) and with neonatal death (77.1%) were asked to forget about their babies as a means to cope with their loss. Naming, seeing, and holding the stillborn were reported by 56 (11.2%), 229 (45.9%), and 64 (12.8%) women with a stillborn. Conclusion With one-third women with adverse birth outcome reporting negative experience, this translates into a significant number of women in India as it accounts for high numbers of stillbirths and newborn deaths globally. These population-based data can facilitate in designing interventions to improve post-partum experience for women with adverse birth outcomes in India.

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Poor coverage of quality-adjusted antenatal care services: a population-level assessment by visit and source of antenatal care services in Bihar state of India

Cited by 3 publications

References 57 publications

Turning the tide with better data to address stillbirths in India

Turning the tide with better data to address stillbirths in India

Population-level trends over a decade in geographical inequality for opportunity in access to maternal care services: a cross-sectional analysis from the National Family Health Surveys in India

Socio-cultural practices and experience of mothers’ post stillbirth and newborn death: a population-based perspective from India

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