The University of Southampton
University of Southampton Institutional Repository

Antenatal care: provision and inequality in rural north India

Antenatal care: provision and inequality in rural north India
Antenatal care: provision and inequality in rural north India
The objectives of this paper are to examine factors associated with use of antenatal care in rural areas of north India, to investigate access to specific critical components of care and to study differences in the pattern of services received via health facilities versus home visits. We used the 1998–1999 Indian National Family Health Survey of ever-married women in the reproductive age group and analysed data from the states of Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh (n=11,369). Overall, about three-fifths of rural women did not receive any antenatal check-up during their last pregnancy. Services actually received were predominantly provision of tetanus toxoid vaccination and supply of iron and folic acid tablets. Only about 13% of pregnant women had their blood pressure checked and a blood test done at least once. Women visited by health workers received fewer services compared to women who visited a health facility. Home visits were biased towards households with a better standard of living. There was significant under-utilisation of nurse/midwives in the provision of antenatal services and doctors were often the lead providers. The average number of antenatal visits reported in this study was 2.4 and most visits were in the second trimester. Higher social and economic status was associated with increased chances of receiving an antenatal check-up, and of receiving specific components including blood pressure measurement, a blood test and urine testing but not the obstetric physical examination, which was however linked to ever-use of family planning and the education of women and their husbands. Thus, pregnant women from poor and uneducated backgrounds with at least one child were the least likely to receive antenatal check-ups and services in the four large north Indian states. Basic antenatal care components are effective means to prevent a range of pregnancy complications and reduce maternal mortality. The findings indicate substantial limitations of the health services in overcoming socio-economic and cultural barriers to access.
antenatal care, health services, socio-economic status, india
0277-9536
1147-1158
Pallikadavath, Saseendran
8b97eff3-f8d9-4346-bdc0-55578ceb477f
Foss, Mary
ec004239-30ef-442a-8cc6-54646c343919
Stones, R. William
cc80809c-04a3-4dc0-8771-820de97c312d
Pallikadavath, Saseendran
8b97eff3-f8d9-4346-bdc0-55578ceb477f
Foss, Mary
ec004239-30ef-442a-8cc6-54646c343919
Stones, R. William
cc80809c-04a3-4dc0-8771-820de97c312d

Pallikadavath, Saseendran, Foss, Mary and Stones, R. William (2004) Antenatal care: provision and inequality in rural north India. Social Science & Medicine, 59 (6), 1147-1158. (doi:10.1016/j.socscimed.2003.11.045).

Record type: Article

Abstract

The objectives of this paper are to examine factors associated with use of antenatal care in rural areas of north India, to investigate access to specific critical components of care and to study differences in the pattern of services received via health facilities versus home visits. We used the 1998–1999 Indian National Family Health Survey of ever-married women in the reproductive age group and analysed data from the states of Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh (n=11,369). Overall, about three-fifths of rural women did not receive any antenatal check-up during their last pregnancy. Services actually received were predominantly provision of tetanus toxoid vaccination and supply of iron and folic acid tablets. Only about 13% of pregnant women had their blood pressure checked and a blood test done at least once. Women visited by health workers received fewer services compared to women who visited a health facility. Home visits were biased towards households with a better standard of living. There was significant under-utilisation of nurse/midwives in the provision of antenatal services and doctors were often the lead providers. The average number of antenatal visits reported in this study was 2.4 and most visits were in the second trimester. Higher social and economic status was associated with increased chances of receiving an antenatal check-up, and of receiving specific components including blood pressure measurement, a blood test and urine testing but not the obstetric physical examination, which was however linked to ever-use of family planning and the education of women and their husbands. Thus, pregnant women from poor and uneducated backgrounds with at least one child were the least likely to receive antenatal check-ups and services in the four large north Indian states. Basic antenatal care components are effective means to prevent a range of pregnancy complications and reduce maternal mortality. The findings indicate substantial limitations of the health services in overcoming socio-economic and cultural barriers to access.

This record has no associated files available for download.

More information

Published date: 2004
Keywords: antenatal care, health services, socio-economic status, india

Identifiers

Local EPrints ID: 34794
URI: http://eprints.soton.ac.uk/id/eprint/34794
ISSN: 0277-9536
PURE UUID: 72882375-10c1-4f1c-8136-2d9cedbe8ba3

Catalogue record

Date deposited: 16 May 2006
Last modified: 15 Mar 2024 07:49

Export record

Altmetrics

Contributors

Author: Saseendran Pallikadavath
Author: Mary Foss
Author: R. William Stones

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×