全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用：99美元
投递稿件

查看量下载量

相关文章

更多...
PLOS ONE  2013 

Socioeconomic Disparities in Maternity Care among Indian Adolescents, 1990–2006

DOI: 10.1371/journal.pone.0069094

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15–19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15–19) in India during 1990–2006. Methods and Findings Data from three rounds of the National Family Health Survey of India conducted during 1992–93, 1998–99, and 2005–06 were analyzed. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends were applied, respectively, to understand the trend in the proportion of adolescent mothers utilizing select maternity care services during 1990–2006. Using pooled multivariate logistic regression models, the probability of select maternal healthcare utilization among women by key socioeconomic characteristics was appraised. After adjusting for potential socio-demographic and economic characteristics, the likelihood of adolescents accessing full antenatal care increased by only 4% from 1990 to 2006. However, the probability of adolescent women availing themselves of professional attendance at delivery increased by 79% during the same period. The study also highlights the desolate disparities in maternity care services among adolescents across the most and the least favoured groups. Conclusion Maternal care interventions in India need focused programs for rural, uneducated, poor adolescent women so that they can avail themselves of measures to delay child bearing, and for better antenatal consultation and delivery care in case of pregnancy. This study strongly advocates the promotion of a comprehensive ‘adolescent scheme’ along the lines of ‘Continuum of Maternal, Newborn and Child health Care’ to address the unmet need of reproductive and maternal healthcare services among adolescent women in India.

 References

[1]  Machel G, Tutu D (2012) Opinions: Early marriage robs children of their opportunities. Washington Post August 1, 2012. Available:., 2012.
[2]  Rai RK, Singh PK, Kumar C, Parasuraman S (2013) Teenage childbearing: a growing public health concern in need of urgent policy and program action. Journal of Public Health, doi: 10.1007/s10389-012-0551-6.
[3]  United Nations (2011) World Fertility Policies 2011. ST/ESA/SER.A/303, Sales No. E.11.XIII.5. UN, Department of Economic and Social Affairs, Population Division.
[4]  James KS (2011) India’s demographic change: opportunities and challenges. Science 333: 576–580.
[5]  Raj A, Saggurti N, Balaiah D, Silverman JG (2009) Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study. Lancet 373: 1883–1889.
[6]  Hampton T (2010) Child marriage threatens girls’ health. JAMA 304: 509–510.
[7]  World Health Organization (2012) Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates. Geneva, Switzerland: WHO.
[8]  Government of India (2011) Maternal Mortality in India 2007–09: Special Bulletin. New Delhi, India: Sample Registration System, Office of the Registrar General, Ministry of Home Affairs, Government of India.
[9]  Dangal G (2005) An update on teenage pregnancy. Internet Journal of Gynecology and Obstetrics 5(1): 13–46.
[10]  LeGrand TK, Mbacke CSM (1993) Teenage pregnancy and child health in urban Sahel. Studies in Family Planning 24(3): 137–149.
[11]  Jensen R, Thornton R (2003) Early female marriage in the developing world. Gender and Development 11: 9–19.
[12]  Singh L, Rai RK, Singh PK (2012) Assessing the utilization of maternal and child health care among married adolescent women: evidence from India. Journal of Biosocial Science 44: 1–26.
[13]  Singh PK, Rai RK, Alagarajan M, Singh L (2012) Determinants of maternity care services utilization among married adolescents in rural India. PLoS ONE 7: e31666.
[14]  World Health Organization, United Nations Children’s Fund (2012) Countdown to 2015, Maternal, Newborn and Child Survival: Building a Future for Women and Children, The 2012 Report. Geneva: WHO and UNICEF.
[15]  Paxton A, Wardlaw T (2011) Are we making progress in maternal mortality? NEJM 364: 1990–1993.
[16]  Rai RK, Tulchinsky TH (2012) Addressing the sluggish progress in reducing maternal mortality in India. Asia Pacific Journal of Public Health. doi: 10.1177/1010539512436883.
[17]  Mavalankar D, Rosenfield A (2005) Maternal mortality in resource-poor settings: policy barriers to care. American Journal of Public Health 95: 200–203.
[18]  Paul VK, Sachdev HS, Mavalankar D, Ramachandran P, Sankar MJ, et al. (2011) Reproductive health, and child health and nutrition in India: meeting the challenge. Lancet 377: 332–349.
[19]  Bhutta ZA, Cabral S, Chan CW, Keenan WJ (2012) Reducing maternal, newborn, and infant mortality globally: An integrated action agenda. International Journal of Gynecology & Obstetrics. doi: 10.1016/j.ijgo.2012.04.001.
[20]  Government of India (2006) Jananai Surkasha Yojana (JSY: Features). Ministry of Health and Family Welfare, New Delhi.
[21]  International Institute for Population Sciences (1995) National Family Health Survey India, 1992–93 NFHS-1. Mumbai: IIPS.
[22]  International Institute for Population Sciences, ORC Macro (2000) National Family Health Survey India, 1998–99 NFHS-2. Mumbai: IIPS.
[23]  International Institute for Population Sciences, ORC Macro (2007) National Family Health Survey India, 2005–06 NFHS-3. Mumbai: IIPS.
[24]  World Health Organization (2006) Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Standards for Maternal and Neonatal care (1.6), Department of Making Pregnancy Safer, Geneva, Switzerland. Available: http://www.who.int/making_pregnancy_safe？r/publications/Standards1.6N.pdf. Accessed July 3, 2012.
[25]  Rai RK, Singh PK, Singh L (2012) Utilization of maternal health care services among married adolescent women: insights from the Nigeria Demographic and Health Survey, 2008. Women’s Health Issues 22: e407–e414.
[26]  Singh PK, Singh L, Kumar C, Rai RK (2013) Correlates of maternal health care service utilisation among adolescent women in Mali: analysis of a nationally representative cross-sectional survey, 2006. Journal of Public Health 21: 15–27.
[27]  Vyas S, Kumaranayake L (2006) Constructing socio-economic status indices: how to use principal component analysis. Health Policy and Planning 21: 459–468.
[28]  Howe LD, Hargreaves JR, Gabrysch S, Huttly SRA (2009) Is the wealth index a proxy for consumption expenditure? A systematic review. Journal of Epidemiology and Community Health 63: 871–877.
[29]  Mishra V, Roy TK, Retherford RD (2004) Sex differentials in childhood feeding, health care, and nutritional status in India. Population and Development Review 30: 269–295.
[30]  Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV (2010) Socioeconomic Inequalities in Childhood Undernutrition in India: Analyzing Trends between 1992 and 2005. PLoS ONE 5: e11392.
[31]  Corsi D, Finlay JE, Subramanian SV (2012) Weight of communities: A multilevel analysis of body mass index in 32,814 neighborhoods in 57 low- to middle-income countries (LMICs). Social Science and Medicine 75: 311–322.
[32]  Kumar C, Singh PK, Rai RK, Singh L (2013) Early neonatal mortality in India: 1990–2006. Journal of Community Health 38: 120–130.
[33]  Armitage P, Berry G, Matthews JNS (2002) Statistical Methods in Medical Research. 4th ed. Oxford, UK: Blackwell Science.
[34]  Rao JNK, Scott AJ (1984) On chi-square tests for multiway contingency tables with cell proportions estimated from survey data. Annals of Statistics 12: 46–60.
[35]  Korn EL, Graubard BI (1990) Simultaneous testing of regression coefficients with complex survey data: Use of Bonferroni t statistics. American Statistician 44: 270–276.
[36]  Statacorp (2007) Stata statistical software: Release 10. College Station: Statacorp LP.
[37]  Viegas AM, Noronha K, Singh A, Rodrigues CG, Padmadas SS (2012) Antenatal care use in Brazil and India: scale, outreach and socioeconomic inequality. Health & Place 18: 942–950.
[38]  Singh PK, Rai RK, Singh L (2012) Examining the effect of household wealth and migration status on safe delivery care in urban India, 1990–2006. PLoS ONE 7: e44901.
[39]  Pallikadavath S, Foss M, Stones RW (2004) Antenatal care: provision and inequality in rural north India. Social Science & Medicine 59: 1147–1158.
[40]  Ronsmans C, Graham WJ (2006) Lancet Maternal Survival Series steering group (2006) Maternal mortality: who, when, where, and why. Lancet 368: 1189–1200.
[41]  Fotso JC (2006) Child health inequities in developing countries: difference across urban and rural areas. International Journal for Equity in Health 5: 9.
[42]  Fotso JC (2007) Urban-rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health & Place 13: 205–223.
[43]  Ministry of Health and Family Welfare (2010) Rural Health Statistics in India - 2010. New Delhi: Government of India. Available: http://nrhm-mis.nic.in/UI/RHS/RHS%202010？/Rural%20Health%20Statistics%202010.htm. Accessed July 3, 2012.
[44]  Navaneetham K, Dharmalingam A (2002) Utilization of maternal health care services in southern India. Social Science & Medicine 55: 1849–1869.
[45]  Ogunlesi TA, Ogunlesi FB (2012) Family socio-demographic factors and maternal obstetric factors influencing appropriate health-care seeking behaviours for newborn Jaundice in Sagamu, Nigeria. Maternal & Child Health Journal 16: 677–684.
[46]  Agha S, Carton TW (2011) Determinants of institutional delivery in rural Jhang, Pakistan. International Journal for Equity in Health 10: 31.
[47]  International Institute for Population Sciences (2010) District Level Household and Facility Survey (DLHS-3), 2007–08. India. Mumbai: IIPS.
[48]  Amin R, Shah NM, Becker S (2010) Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A crosssectional analysis. International Journal for Equity in Health 9: 9.
[49]  Reddy KS (2012) Universal health coverage in India: the time has come. The National Medical Journal of India 25: 65–67.
[50]  Singh PK, Kumar C, Rai RK, Singh L (2013) Factors associated with maternal healthcare service utilization in nine high focus states in India: a multilevel analysis based on 14385 communities in 292 districts. Health Policy and Planning. doi: 10.1093/heapol/czt039.
[51]  Santhya KG, Jejeebhoy SJ, Ghosh S (2008) Early Marriage and Sexual and Reproductive Health Risks: Experiences of Young Women and Men in Andhra Pradesh and Madhya Pradesh, India. Population Council, New Delhi.
[52]  Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization.
[53]  World Health Organization (2012) Rio Political Declaration on Social Determinants of Health. Geneva: World Health Organization. Available: http://www.who.int/sdhconference/declara？tion/en/index.html. Accessed July 3, 2012.
[54]  Government of India (2007) The Prohibition of Child Marriage ACT, 2006, No.6 of 2007, the Gazette of India, New Delhi. Ministry of Law and Justice, Government of India.
[55]  Planning Commission (2011) High Level Expert Group Report on Universal Health Coverage for India. Government of India, New Delhi.
[56]  Jeffrey C (2001) ‘A Fist Is Stronger than Five Fingers’: Caste and Dominance in Rural North India. Transactions of the Institute of British Geographers, New Series 26(2): 217–236.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133