International Institute for Population Sciences, Deonar, Mumbai, India.
PLoS One. 2012;7(2):e31666. doi: 10.1371/journal.pone.0031666. Epub 2012 Feb 15.
Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed.
METHODOLOGY/PRINCIPAL FINDINGS: Using the data from third wave of National Family Health Survey (2005-06), available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15-19 years) in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994), selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions.
The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start targeting household with married adolescent women belonging to poor and specific sub-groups of the population in rural areas to address the unmet need for maternal healthcare service utilization.
印度的少女怀孕问题，加上产妇死亡人数最多，已成为当务之急，因为少女结婚年龄早，避孕措施使用率低。印度农村已婚青少年利用产妇保健服务的相关因素尚未得到充分讨论。
方法/主要发现：本文利用公共领域可用于研究人员使用的第三次国家家庭健康调查（2005-06 年）的数据，研究了印度农村已婚青少年（15-19 岁）利用产妇保健服务的相关因素。产妇保健服务利用的三个组成部分进行了衡量：完全产前护理、安全分娩以及调查前五年内分娩的妇女在分娩后 42 天内进行的产后护理。考虑到 Thaddeus 和 Maine（1994 年）提出的产妇死亡原因框架，选择了影响结果事件的选定社会经济、人口和文化因素作为预测变量。应用了双变量分析，包括卡方检验以确定比例差异，以及逻辑回归以了解预测变量对选定结果的净效应。研究结果表明，教育程度、经济状况和居住地区对选定产妇保健服务利用的差异具有统计学意义。穆斯林妇女以及属于在册种姓、在册部落和其他落后阶层的妇女获得安全分娩服务的可能性较低。此外，南部地区的青少年妇女利用产妇保健服务的比例高于其他地区。
本研究记录了一些影响印度农村青少年妇女利用产妇保健服务的社会经济和文化因素。正在进行的医疗保健计划应开始针对属于贫困和农村地区特定人群亚群的有已婚青少年妇女的家庭，以满足产妇保健服务利用方面的未满足需求。
