Purohit Neha
Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Family Med Prim Care. 2021 Sep;10(9):3374-3380. doi: 10.4103/jfmpc.jfmpc_426_21. Epub 2021 Sep 30.
A traditional African phrase, 'A pregnant woman has one foot in the grave' expresses the immense health risks associated with pregnancy and childbirth. Antenatal care (ANC) is considered an important determinant to alleviate mortalities and morbidities associated with maternal health.
The study aimed to identify the utilization pattern of ANC services by pregnant women in a remote, tribal, and hilly district of Himachal Pradesh and to understand their healthcare needs during antenatal period.
A community based descriptive, cross-sectional study was carried out in 41 far-flung villages of Lahaul and Spiti district in Himachal Pradesh, India, using a mixed-method approach of data collection. Purposive sampling was done to select 103 females who had experienced delivery in the past 2 years and were residents of Lahaul for minimum of 3 years. The participants were interviewed using a semi-structured questionnaire and the data were analysed by SPSS-20.
The study revealed high utilization of ANC services by indigenous women, but it was accompanied by physical, psychological, and financial hardships. The triple challenge of inadequacy of quality antenatal services, transport facilities, and unfavourable weather conditions compelled women to leave their communities in Lahaul and relocate to adjoining districts during the maternity period.
Pregnancy is still a stressful event that disrupts the link between families and communities in such underserved areas. The study recommends the establishment of programs that promote availability of quality ANC services within the rural and remote communities.
非洲有一句传统谚语，“孕妇一只脚踏入坟墓”，表达了与怀孕和分娩相关的巨大健康风险。产前保健（ANC）被认为是减轻孕产妇健康相关死亡率和发病率的一个重要决定因素。
本研究旨在确定印度喜马偕尔邦一个偏远、部落聚居且多山地区孕妇对产前保健服务的利用模式，并了解她们在孕期的医疗保健需求。
在印度喜马偕尔邦拉胡尔和斯皮提地区的41个偏远村庄开展了一项基于社区的描述性横断面研究，采用混合方法收集数据。采用目的抽样法选取了103名在过去2年中分娩且在拉胡尔居住至少3年的女性。使用半结构化问卷对参与者进行访谈，并通过SPSS-20对数据进行分析。
研究表明，当地女性对产前保健服务的利用率很高，但同时也伴随着身体、心理和经济上的困难。优质产前服务不足、交通设施不完善以及恶劣天气条件这三大挑战迫使女性在孕期离开她们在拉胡尔的社区，搬到相邻地区。
在这些服务匮乏的地区，怀孕仍然是一个压力巨大且会破坏家庭与社区联系的事件。该研究建议制定相关项目，以促进农村和偏远社区提供优质的产前保健服务。
