Bengaluru Dr. B.R. Ambedkar School of Economics, Bengaluru, Karnataka, India.
Dayal Singh, College, Delhi University, New Delhi, India.
BMC Health Serv Res. 2022 May 5;22(1):602. doi: 10.1186/s12913-022-07876-9.
Utilisation of continuum of maternal health care services is crucial for a healthy pregnancy and childbirth and plays an important role in attaining Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) related to maternal and child health. This paper aims to assess the percentage of dropouts across various stages of utilization of continuum of maternal health services (CMHS) in India and also investigates the factors hindering the utilization of these services.
We used recent data from National Family Health Survey(NFHS) encompassing a total sample of 1,70,937 pregnant women for the period 2015-16. The percentage of women dropping out while seeking maternal health care is measured using descriptive statistics. While, the factors impeding the utilization of maternal health services is estimated using a Multinomial Logistic Regression Model, where dependent variable (CMHS) is defined as complete care, incomplete care and no care.
Only17% of pregnant women availed the utilisation of complete care and 83% either did not seek any care or dropped after seeking one or two services. For instance, it is found that 79% of women who registered for antenatal care services (ANC) did not avail the same adequately. An empirical investigation of determinants of inadequate utilization of CMHS revealed that factors like individual characteristics, for instance- access to media (RRR: 2.06) and mother's education play (RRR: 3.61) a vital role in the uptake of CMHS. It is also found that the interaction between wealth index and place of residence plays a pivotal role in seeking complete care. Lastly, the results revealed that male participation (RRR: 2.69) and contacting multi-purpose worker (MPW) (RRR: 2.33) are also at play.
The study suggests that the major determinants of utilisation of CMHS are access to media, mother's education, affordability barriers and male participation. Hence, policy recommendations should be oriented towards strengthening these dimensions and the utilisation of adequate ANC has to be considered as the need of the hour.
利用连续的母婴保健服务对于健康怀孕和分娩至关重要，对于实现全民健康覆盖（UHC）和与母婴健康相关的可持续发展目标（SDGs）也起着重要作用。本文旨在评估印度在利用母婴保健服务连续体（CMHS）的各个阶段的辍学率，并调查阻碍这些服务利用的因素。
我们使用了最近来自国家家庭健康调查（NFHS）的数据，涵盖了 2015-16 年期间的 170937 名孕妇的总样本。使用描述性统计方法衡量在寻求母婴保健时妇女辍学的百分比。而，使用多项逻辑回归模型来估计阻碍母婴保健服务利用的因素，其中因变量（CMHS）定义为完全护理、不完全护理和无护理。
只有 17%的孕妇利用了完全护理，83%的孕妇要么根本不寻求任何护理，要么在寻求一到两项服务后就停止了。例如，发现有 79%的妇女登记了产前护理服务（ANC）但没有充分利用。对 CMHS 利用不足的决定因素的实证研究表明，个人特征等因素，例如接触媒体的机会（RRR：2.06）和母亲的教育程度（RRR：3.61）在 CMHS 的利用中起着至关重要的作用。还发现，财富指数和居住地之间的相互作用在寻求完全护理方面起着关键作用。最后，结果表明，男性参与（RRR：2.69）和联系多用途工人（MPW）（RRR：2.33）也在起作用。
该研究表明，CMHS 利用的主要决定因素是接触媒体、母亲的教育程度、负担能力障碍和男性参与。因此，政策建议应侧重于加强这些方面，并且必须考虑到充分利用适当的 ANC。
