Trends, Differentials, and Social Determinants of Maternal Health Care Services Utilization in Rural India: An Analysis from Pooled Data

Abstract

Background: Millennium development goal 5 aimed at reduction of maternal deaths by three-quarters from 1990 to 2015: a target India commendably achieved, but this milestone remains overshadowed by inequalities in utilization of health services that are driven by determinants both at community and at individual level. Materials and Methods: We studied the utilization trends using descriptive statistics and analyzed the relative contribution of various socioeconomic predictors on the use of maternal health care services in rural India using binary logistic regression analysis on pooled data from three rounds of National Family Health Survey. Outcome variables included four or more antenatal care visits, skilled birth attendance, and postnatal care. Results: Although utilization of maternal health care services showed an upward trend from 1998-1999 to 2015-2016, factors such as illiteracy, female age ‡40 years, having five and more children, belonging to scheduled tribes, rural residence, and not possessing a health card were associated with significantly low utilization of maternal health care services. However, partner's education, good economic status, women's autonomy, and infrastructure at village level were associated with better odds of availing these services. Conclusions: The study generates evidence on the role of various socioeconomic determinants in maternal health care utilization and identifies gaps that must be strategically addressed to reach sustainable developmental goal maternal mortality target of 70 deaths per 100,000 live births by 2030. It reemphasizes the need for ensuring convergence among different stakeholders while structuring maternal health policies so that health reforms can be accomplished effectively at all levels of health care.

A cross-sectional study on utilization of maternal health services and its determinants among rural population of district Sitapur, Uttar Pradesh

“…10,13,15 In contrast to our study, no significant association was found between birth order of the women and maternal health care service utilization. 14 The result of the study are in congruence with the notion that higher SLI increased the utilization of all three indicators of maternal health services in a significant manner, which is in tune with other findings. [13][14][15] However couple's age showed no significant association with utilization of maternal health care services.…”

“…14 The result of the study are in congruence with the notion that higher SLI increased the utilization of all three indicators of maternal health services in a significant manner, which is in tune with other findings. [13][14][15] However couple's age showed no significant association with utilization of maternal health care services. In contrast to our findings, various author shave been observed that mother's age was negatively associated with utilization of maternal health care services.…”

“…In contrast to our findings, various author shave been observed that mother's age was negatively associated with utilization of maternal health care services. 10,14 Our analysis also suggested that there were no considerable differences between maternal health care services and women's occupation as almost all the females were homemaker in our study whereas significant association was found in a study conducted in Mwingi, a rural district in Kenya. 10…”

“…Women and their partner's literacy were found to have significant association with all the indicators of maternal health care services and the findings are consistent with the results of previous studies. [13][14][15] Similarly, mother's education was found to be strong predictors for the utilization of maternal health care services by various authors. 10,13,16 This clearly indicates that education directly translates into better maternal health service utilization.…”

Perinatal Grief Among Poor Rural and Urban Women in Central India

“…Populations living in urban slums and poor populations in rural areas have less access to maternal and reproductive health services compared to their non-poor counterparts living in the same areas. 42 , 45 A recent analysis of the India Demographic and Health Survey 2015–16 found that rural women were more likely to experience spontaneous perinatal loss than urban women, while urban women were more likely to have had an abortion than their rural counterparts. 46…”