Utilization of Antenatal Care Services in Dalit Communities in Gorkha, Nepal: A Cross-Sectional Study

Abstract

Background and Objective Antenatal care (ANC) is one of the main components of maternal health. Utilization of safe motherhood is deprived in women who belong to low-caste groups like Dalit of Nepal. Low socioeconomic status, poor knowledge and awareness on obstetric complications, lack of decision-making autonomy, and limited health care options lead to underutilization of existing maternal health care service. The aim of this study was to ascertain the utilization of antenatal care services in terms of ANC visits with health personnel, receiving recommended period of iron tablets, consumption of antihelminthes and number of Tetanus Toxoid (TT) vaccines taken among child bearing women in Dalit community. Materials and Methods Descriptive cross-sectional research design was used to conduct the study of 150 child bearing women of reproductive age (15-49 years) having at least one child up to three years of age in a Dalit community of Gorkha from March 2015 to March 2016. The data was collected from each mother by conducting face to face interview with each household by using a questionnaire. Result The study revealed that mean age at marriage of respondents was 17.7 years and mean age at first pregnancy was 18 years. 44.6% of respondents experienced complication during last pregnancy, labour, and postpartum period in their last pregnancy. 59.3% of respondents stated that neighbors, relatives, and traditional healers were the best first contact person during health problem of women. 76.0% of respondents had attended antepartum visit during their last pregnancy whereas 24.0% of respondents did not attend any antepartum clinic. 68.3% of the mothers had consumed Iron/Folates within 45 days after delivery. Only 30.0% of respondents received antihelminthes (albendazole) while 70.0% of respondents had received TT Vaccines during their last pregnancy. Age, type of family, and education of the mothers were significantly associated with utilization of antenatal care services. Conclusion Even though there is reasonable good utilization rate of antenatal service, the study revealed that low education and awareness among mothers, low socioeconomic condition, early marriage and pregnancy, inappropriate antenatal health check-up, and cultural taboos were significant factors affecting the satisfactory utilization of services among the Dalit community. Hence, there is a need to emphasize on raising awareness of Dalit mothers for receiving available prenatal services.

Women’s enlightenment and early antenatal care initiation are determining factors for the use of eight or more antenatal visits in Benin: further analysis of the Demographic and Health Survey

“…Women who married after age 24 years had higher predictive values of at least 8 ANC contacts. This finding is in agreement with the report of a previous study where the majority of the pregnant women who had good utilization of ANC contacts had their marriage after adolescent age [35]. The explanations could be that the delay of timing to marriage may be due to spending more time in educational institution or career development [36], which is a measure of improving women's empowerment.…”

Adequate Antenatal Care Visits among Tribal Women in Bangladesh

“…Another study observed that, with more education, women are most likely to have four or more trips to ANC during pregnancy, confirming findings of earlier study on the effect of women's education on receiving ANC facilities (Islam & Masud, 2018;Awasthi, Awasthi, Thapa, Saud, Pradhan, & Khatry, 2018). In one study in Sindh, the education level was substantially connected with the timing of the first ANC visit among pregnant women; this shows that motherhood education is an important aspect that helps women become more involved with their ANC services (Noh, Kim, Lee, Akram, Shahid, Kwon, & Stekelenburg, 2019).…”

Institutional delivery service use and associated factors among women who delivered during the last 2 years in Dallocha town, SNNPR, Ethiopia

“…This study finding is comparable to a report Pakistan (83.5%) (Noh et al, ). On the other hand, it is higher than the report from Afghanistan (56.2%), Nepal (76%) and Liberia (79.8%) (Awasthi et al, ; Azimi et al, ; Yaya et al, ). This difference might be due to the difference in the literacy level of mothers about the importance of antenatal care and access to service.…”