Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
BMC Pregnancy Childbirth. 2021 Feb 10;21(1):122. doi: 10.1186/s12884-021-03607-w.
Maternal deaths among young women (15-24 years) shares 38% of total maternal mortality in India. Utilizing maternal health care services can reduce a substantial proportion of maternal mortality. However, there is a paucity of studies focusing on young women in this context. This paper, therefore, aimed to examine the trends and determinants of full antenatal care (ANC) and skilled birth attendance (SBA) utilization among young married women in India.
The study analysed data from the four rounds of National Family Health Surveys conducted in India during the years 1992-93, 1998-99, 2005-06 and 2015-16. Young married women aged 15-24 years with at least one live birth in the 3 years preceding the survey were considered for analysis in each survey round. We used descriptive statistics to assess the prevalence and trends in full ANC and SBA use. Pooled multivariate logistic regression was conducted to identify the demographic and socioeconomic determinants of the selected maternity care services. The significance level for all analyses was set at p ≤ 0.05.
The use of full ANC among young mothers increased from 27 to 46% in India, and from 9 to 28% in EAG (Empowered Action Group) states during 1992-2016. SBA utilization was 88 and 83% during 2015-16 by showing an increment of 20 and 50% since 1992 in India and EAG states, respectively. Findings from multivariate analysis revealed a significant difference in the use of selected maternal health care services by maternal age, residence, education, birth order and wealth quintile. Additionally, Muslim women, women belonging to scheduled caste (SC)/ scheduled tribe (ST) social group, and women unexposed to mass media were less likely to utilize both the maternal health care services. Concerning the time effect, the odds of the utilization of full ANC and SBA among young women was found to increase over time.
In India coverage of full ANC among young mothers remained unacceptably low, with a wide and persistent gap in utilization between EAG and non-EAG states since 1992. Targeted health policies should be designed to address low coverage of ANC and SBA among underprivileged young mothers and increased efforts should be made to ensure effective implementation of ongoing programs, especially in EAG states.
在印度，15-24 岁的年轻女性的孕产妇死亡占总孕产妇死亡人数的 38%。利用孕产妇保健服务可以降低相当一部分孕产妇死亡。然而，针对这一背景下的年轻女性，相关研究却很少。因此，本文旨在探讨印度年轻已婚妇女充分利用产前护理（ANC）和熟练接生（SBA）的趋势和决定因素。
本研究分析了 1992-1993 年、1998-1999 年、2005-2006 年和 2015-2016 年期间在印度进行的四轮全国家庭健康调查的数据。每个调查轮次都考虑了年龄在 15-24 岁之间、在调查前 3 年内至少有一次活产的年轻已婚妇女。我们使用描述性统计方法评估了充分利用 ANC 和 SBA 的流行率和趋势。进行了汇总多变量逻辑回归分析，以确定选定产妇保健服务的人口统计学和社会经济决定因素。所有分析的显著性水平均设定为 p≤0.05。
1992-2016 年期间，印度年轻母亲充分利用 ANC 的比例从 27%增加到 46%，EAG（赋权行动小组）邦从 9%增加到 28%。2015-2016 年期间，SBA 的利用率为 88%和 83%，与 1992 年相比，印度和 EAG 邦分别增加了 20%和 50%。多变量分析结果显示，产妇年龄、居住地、教育程度、出生顺序和财富五分位数等因素对选定的产妇保健服务的利用存在显著差异。此外，穆斯林妇女、属于在册种姓（SC）/在册部落（ST）社会群体的妇女以及未接触大众媒体的妇女利用这两种产妇保健服务的可能性较低。关于时间效应，发现年轻妇女利用充分 ANC 和 SBA 的几率随着时间的推移而增加。
在印度，年轻母亲充分利用 ANC 的比例仍然低得令人无法接受，自 1992 年以来，EAG 和非 EAG 邦之间在利用方面存在着广泛而持续的差距。应该制定有针对性的卫生政策，解决贫困年轻母亲中 ANC 和 SBA 覆盖率低的问题，并加大力度确保正在实施的方案得到有效执行，特别是在 EAG 邦。
