Does owning a bank account improve reproductive and maternal health services utilization and behavior in India? Evidence from the National Family Health Survey 2015-16.
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ABSTRACT:
SUBMITTER: Singh A
PROVIDER: S-EPMC6468192 | biostudies-literature | 2019 Apr
REPOSITORIES: biostudies-literature
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Does owning a bank account improve reproductive and maternal health services utilization and behavior in India? Evidence from the National Family Health Survey 2015-16.
Singh Abhishek A Kumar Kaushalendra K McDougal Lotus L Silverman Jay G JG Atmavilas Yamini Y Gupta Raksha R Raj Anita A
SSM - population health 20190406
•Ownership of a bank account is associated with improved reproductive and maternal health services utilization and behaviour.•Observed associations are strongest in states where the utilization of studied services is far below the national average.•No association is found between women's ownership of a bank account and institutional delivery. ...[more]
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Project description:BackgroundMaternal and child health services, like antenatal care, skilled birth attendance and postnatal care, are crucial to improve maternal and neonatal health outcomes. Numerous studies have been conducted on the distribution of utilization of maternal and child healthcare (MCH) services in India with respect to socioeconomic and demographic characteristics. But no study has analyzed the utilization of MCH services with a focus on the topography of a given region (hilly/plain). The present study analyzes the utilization of MCH services in the hilly-Himalayan region of India in comparison to the rest of the country.MethodsData from India's National Family Health Survey-4 (2015-16), on 190,898 women, was utilized for analysis in the present study. The association between the utilization of MCH services and the topography of the region of residence (hilly/plain) was analyzed by calculating adjusted odds ratios (AOR) with 95% confidence interval (95%CI) and predicted probabilities using a two-level random intercept logistic regression model.ResultsIt was found that the utilization of MCH services was significantly lower in the hilly regions compared to the plain regions. Women living in hilly areas (AOR: 0.42, 95%CI: 0.39-0.45) had 58% lower odds of receiving skilled birth attendance (SBA) than those living in plain areas. Similarly, the odds of receiving PNC, ANC, and full immunization were also lower in the hilly regions compared to the plain regions. The utilization of MCH services was alarmingly low in the rural-hilly regions. The odds of receiving two tetanus injections before birth were 71% lower for women in the rural-hilly areas (AOR: 0.39, 95% CI: 0.36-43) than those in the rural-plain areas. Predicted probabilities also showed that women in the hilly regions were less likely to receive MCH services compared to their counterparts in the plain regions.ConclusionExcept for the consumption of Iron Folic Acid (IFA) and the utilization of AWC services/ICDS (Integrated Child and Development Services), all other MCH services were significantly underutilized in the hilly regions compared to the plain regions. This calls for the attention of and concentrated efforts by policy makers and stakeholders, with a special focus on the rural-hilly regions. We firmly believe that the results of the present study have important policy implications.
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Project description:BackgroundKarnataka State continues to have the highest rates of maternal mortality in south India at 144/100,000 live births, but lower than the national estimates of 190-220/100,000 live births. Various barriers exist to timely and appropriate utilization of services during pregnancy, childbirth and postpartum. This study aimed to describe the patterns and determinants of routine and emergency maternal health care utilization in rural Karnataka State, India.MethodsThis study was conducted in Karnataka in 2012-2013. Purposive sampling was used to convene twenty three focus groups and twelve individual interviews with community and health system representatives: Auxiliary Nurse Midwives and Staff Nurses, Accredited Social Health Activists, community leaders, male decision-makers, female decision-makers, women of reproductive age, medical officers, private health care providers, senior health administrators, District health officers, and obstetricians. Local researchers familiar with the setting and language conducted all focus groups and interviews, these researchers were not known to community participants. All discussions were audio recorded, transcribed, and translated to English for analysis. A thematic analysis approach was taken utilizing an a priori thematic framework as well as inductive identification of themes.ResultsMost women in the focus groups reported regular antenatal care attendance, for an average of four visits, and more often for high-risk pregnancies. Antenatal care was typically delivered at the periphery by non-specialised providers. Participants reported that sought was care women experienced danger signs of complications. Postpartum care was reportedly rare, and mainly sought for the purpose of neonatal care. Factors that influenced women's care-seeking included their limited autonomy, poor access to and funding for transport for non-emergent conditions, perceived poor quality of health care facilities, and the costs of care.ConclusionsRural south Indian communities reported regular use of health care services during pregnancy and for delivery. Uptake of maternity care services was attributed to new government programmes and increased availability of maternity services; nevertheless, some women delayed disclosure of pregnancy and first antenatal visit. Community-based initiatives should be enhanced to encourage early disclosure of pregnancies and to provide the community information regarding the importance of facility-based care. Health facility infrastructure in rural Karnataka should also be enhanced to ensure a consistent power supply and improved cleanliness on the wards.Trial registrationNCT01911494.
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Project description:ObjectivesOfficial data on birth is important to monitor the specific targets of SDGs. About 2.7 million children under age five years do not have official birth registration document in India. Unavailability of birth registration document may deprive the children from access to government-aided essential services such as fixed years of formal education, healthcare, and legal protection. This study examines the effect of socioeconomic, demographic and health care factors on birth registration in India. We also examined the spatial pattern of completeness of birth registration that could be useful for district level intervention.MethodsWe used data from the National Family Health Survey (NFHS-4), 2015-16. We carried out the descriptive statistics and bivariate analysis. Besides, we used multilevel binary logistic regression to identify significant covariates of birth registration at the individual, district, and state levels. We used GIS software to do spatial mapping of completeness of birth registration at district level.ResultsThe birth registration level was lower than national average (80.21%) in the 254 districts. In Uttar Pradesh, 12 out of 71 districts recorded lower than 50% birth registration. Also, some districts from Arunachal Pradesh, J&K, and Rajasthan recorded lower than 50% birth registration. We also found a lower proportion of children are registered among children of birth order three and above (62.83%) and rural resident (76.62%). Children of mothers with no formal education, no media exposure, poorest wealth quintile, OBC and muslims religion have lower level of birth registration. Multilevel regression result showed 25 percent variation in birth registration lie between states while the remaining 75 percent variation lie within states. Moreover, children among illiterate mother (AOR = 0.57, CI [0.54, 0.61], p<0.001), Muslims households (AOR = 0.90, CI [0.87, 0.94], p<0.001), and poorest wealth quintile (AOR = 0.38, CI [0.36, 0.41], p<0.001) showed lower odds for child's birth registration.ConclusionWe strongly suggest linking the birth registration facilities with health institutions.
| S-EPMC8412296 | biostudies-literature
Project description:The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world's largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015-2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0-72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother-child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.
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Project description:BackgroundAdolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent-adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent-adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal.MethodsThis was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15-19 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent-adolescent communication and service utilization.ResultsWe analyzed the data from 594 students. Students with a higher score of parent-adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29-2.23, p<0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65-62.08, p<0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28-6.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02-0.66, p = 0.01).ConclusionStudents with a higher score on parent-adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.
| S-EPMC7894935 | biostudies-literature
Project description:BackgroundVarious countries in the world have achieved promising progress in promoting, protecting and guaranteeing sexual and reproductive health rights (SRHRs) since the 1994 International Conference on Population and Development (ICPD) in Cairo. However, SRHRs have not been recognized to their maximum potential in Ethiopia, despite the domestication of the international instruments related to their successful implementation. This study was intended to determine the magnitude of SRHRs knowledge, reproductive health services utilization and their independent predictors among rural reproductive-age women in the Aleta Wondo District, Ethiopia.MethodsA community-based cross-sectional study was conducted among 833 rural reproductive-age women from April to May 2019. A systematic random sampling technique was employed to select households, and a structured questionnaire was used to gather the data. EPI INFO version 7 was used to enter the data, and SPSS version 23 was used for data analysis. Logistic regression analysis was employed to assess the association between outcomes and explanatory variables. Odds ratios at 95% CI were also computed and reported.ResultsOf 833 respondents, 43.9% had good knowledge of SRHR, and 37% had used at least one sexual and reproductive health (SRH) service. Variables that had a statistically significant association with SRHR knowledge in multivariable analysis were: had formal education, household with the highest income, having information sources for SRH services, and knowing about SRH services and providing institutions. SRH services utilization was associated with: having information sources for SRH services, had formal education, household with the highest income, and knowing about SRH services and providing institutions.ConclusionIn this study demographic and economic factors, such as education and household monthly income were positively identified as independent predictors for knowledge of SRHR and SRH services utilization. Therefore, responsible government sectors and NGOs should design and implement programs to promote women's educational status and household economic status to enhance women's SRHR knowledge and SRH services utilization.
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Project description:UCSF Center for Reproductive Health (CRH) Research Bank
| PRJNA492179 | ENA
Project description:UCSF Center for Reproductive Health (CRH) Research Bank
| PRJNA492180 | ENA