Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada

Abstract

Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Factors like education, economic status and out of pocket (OOP) expenditure can affect utilization of maternal health services. Hence this study aims to assess the utilization pattern of maternal health care and the out of pocket expenditure for delivery services in a public maternity hospital. Methods: A cross sectional study was conducted using primary data from women who delivered in public maternity hospital, Mangaluru during January -February 2018. Study respondents were interviewed using pre-tested, interview schedule. The data was analysed using SPSS 20.0 version. Results: 78.3% of the respondents visited the health care provider during first trimester of pregnancy. 97.3% of the mothers attended ≥4 antenatal visits. The time of the first ANC visit, consumption of Iron folic acid (IFA) tablets, choice of provider for ANC are significantly associated with caste, education of the respondents and their husbands. The mean expenditure for delivery care, including indirect expenditure was ₹2875. Expenditure during delivery was significantly associated with respondent's education and type of delivery. Conclusions: Socio demographic characteristics like caste and education did seem to have an effect on the utilization of ANC especially consumption of IFA. Education and communication campaigns may aid to improve this. Good implementation of government schemes can help to reduce the direct OOP expenditure for delivery care. The indirect cost associated with maternity care may still be a burden for poor families.

Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey

“…The median OOP expenditure for child delivery care in India was INR 1000 ($15.6) with an average cost of INR 5985 ($93.3). This finding was similar to some of the small‐scale studies conducted in various parts of India like Odisha (INR 1100), Mangalore (INR 1150), and Lucknow (INR 1406) . However, a previous large‐scale survey conducted in India (District Level Household Survey‐3) showed significantly lesser OOP expenses ($44) for delivery services when compared with the current study findings .…”

“…Only 36.4% of mothers utilized the JSY scheme . Although several small scale studies have been conducted to determine OOP expenditure on health, little information is available on the cost incurred for maternal health services and its determinants at the national level . Hence, this study aims at finding the costs incurred for child delivery care and determinants of OOP payments made toward the same in India.…”

Antenatal service utilization among women in South India: a community based cross sectional study

“…Current study revealed that 91.5% had the minimum 4 antenatal visits, similarly, Tellis SB et al, found that 97.3% had the minimum number of visits. 13 Adequate IFA supplementation was received by 83.1% of the women in this study, which was similar to the other study in the district (82.2% consumed all the IFA tablets). 13 Also a study by Pai DV et al, reported, IFA consumption as 85.6% at udupi.…”

“…13 Adequate IFA supplementation was received by 83.1% of the women in this study, which was similar to the other study in the district (82.2% consumed all the IFA tablets). 13 Also a study by Pai DV et al, reported, IFA consumption as 85.6% at udupi. 14 Injection TT coverage was 98.6% in this study and 99% received Injection TT in Tellis SB et al, study.…”

“…11,12 Study by Tellis SB et al, in the same district reported that 78.3% had early registration, similar to our study. 13 However, the early registration was higher in Mysore (98.5%) and lower in Pondicherry (60%) compared to the present study.…”