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 2012

Socio-Economic Inequalities in the Use of Postnatal Care in India

DOI: 10.1371/journal.pone.0037037

Abhishek Singh, Sabu S. Padmadas, Udaya S. Mishra, Saseendran Pallikadavath, Fiifi A. Johnson, Zoe Matthews

Full-Text Cite this paper Add to My Lib

Abstract:

Objectives First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. Methods and Findings Rich–poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007–08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. Conclusions PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions.

References

[1]	Sines E, Syed U, Wall S, Worley H (2007) Postnatal care: A critical opportunity to save mothers and newborns. Washington DC: Population Reference Bureau.
[2]	Martines J, Paul VK, Bhutta ZA, Koblinsky M, Soucat A, et al. (2005) Neonatal survival: a call for action. The Lancet 365: 1189–1197.
[3]	Baqui AH, Ahmed S, El Arifeen S, Darmstadt GL, Rosecrans AM, et al. (2009) Effect of timing of first postnatal care home visit on neonatal mortality in Bangladesh: a observational cohort study. British Medical Journal 339: b2826.
[4]	Lawn JE, Cousens S, Zupan J (2005) 4 million neonatal deaths: When? Where? Why? The Lancet 365: 891–900.
[5]	Ronsman C, Graham W J (2006) Maternal mortality: Who, when, where, and why? pp. 13–23. The Lancet, Maternal Survival Series.
[6]	Rasaily R (2008) Age profile of neonatal deaths. Indian Pediatrics 45: 991–994.
[7]	International Institute for Population Sciences (IIPS) (2010) District Level Household Survey (DLHS-3), 2007–08: India. Mumbai: IIPS.
[8]	World Health Organization (1998) Postpartum care of the mother and newborn: a practical guide. Geneva: World Health Organization.
[9]	World Health Organization (2005) The World Health Report 2005. Geneva: World Health Organization.
[10]	RGI (2010) Compendium of India’s Fertility and Mortality Indicators, 1971–2007. New Delhi: Registrar General and Census Commissioner of India.
[11]	International Institute for Population Sciences (IIPS) and Macro International (2007) National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS.
[12]	RGI (2011) Special bulletin on maternal mortality in India 2007–09. New Delhi: Office of the Registrar General and Census Commissioner of India.
[13]	MoHFW (1997) Reproductive and Child Health Programme: Schemes for Implementation. New Delhi: Department of Family Welfare, MoHFW.
[14]	Dhakal S, Chapman GN, Simkhada PP, van Teijlingen ER, Stephens J, et al. (2007) Utilization of postnatal care among rural women in Nepal. BMC Pregnancy and Childhealth 7: 1–9.
[15]	Iqbal Anwar ATM, Killewo J, Chowdhury MK, Dasgupta SK (2004) Bangladesh: inequalities in utilization of maternal health care services – evidence from MATLAB. HNP Discussion Paper. Washington, DC: The World Bank.
[16]	Halder AK, Saha UR, Kabir M (2007) Inequalities in reproductive healthare utilization: evidence from Bangladesh Demographic and Health Survey 2004. World Health & Population 9: 48–63.
[17]	Jat TJ, Ng N, Sebastian MS (2011) Factors affecting the use of maternal health services in Madhya Pradesh state of India: a multilevel analysis. International Journal for Equity in Health 10: 59. doi:10.1186/1475–9276–10–59.
[18]	Mistry R, Galal O, Lu M (2009) Women’s autonomy and pregnancy care in rural India: a contextual analysis. Social Science and Medicine 69: 926–933.
[19]	Bhatia JC, Cleland J (1995) Determinants of maternal care in a region of South India. Health Transition Review 5: 127–142.
[20]	Montgomery MR, Gragnolati M, Burke KA, Paredes E (2000) Measuring living standards with proxy variables. Demography 37: 155–174.
[21]	Filmer D, Pritchett LH (2001) Estimating wealth effects without expenditure data–or tears: an application to educational enrolments in states of India. Demography 38: 115–132.
[22]	Rutstein SO, Johnson K (2004) The DHS wealth index. DHS comparative reports no. 6. Calverton, Maryland: ORC Macro, MEASURE DHS.
[23]	Vyas S, Kumaranayake L (2006) Constructing socio-economic status indices: how to use principal components analysis. Health Policy and Planning 21: 459–468.
[24]	Gwatkin DR, Rutstein S, Johnson K, Suliman E, Wagstaff A, et al. (2007) Socio-economic differences in health, nutrition, and population within developing countries: an overview. Country Reports on HNP and Poverty. Washington, DC: World Bank.
[25]	O’Donnell O, van Doorslaer E, Wagstaff A, Lindelow M (2008) Analyzing health equity using household survey data a guide to techniques and their implementation. In: Washington WBIlearningresourcesseries, editor. D.C.: World Bank.
[26]	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: 871–77.
[27]	Wagstaff A, van Doorslaer E (2004) Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations. Health Economics 13: 297–301.
[28]	Kakwani N, Wagstaff A, van Doorslaer E (1997) Socioeconomic inequalities in health: Measurement, computation, and statistical inference. Journal of Econometrics 77: 87–103.
[29]	Van Doorslaer E, Wagstaff A, Calonge S, Christiansen T, Gerfin M, et al. (1992) Equity in the delivery of health care: some international comparisons. Journal of Health Economics 11: 389–411.
[30]	Dilip TR, Mishra US (2009) Social divide in maternal health care use in rural India: the relative impact of education and economic status. Paper presented in the International Population Conference of the IUSSP, Marrakech, Morocco, 27 September to 03 October 2009. 12: Available: http://iussp2009.princeton.edu/download.？aspx?submissionId=90364. Accessed 2011 Dec.
[31]	Sunil TS, Rajaram S, Zottarrelli LK (2006) Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach. Social Science and Medicine 62: 1943–1957.
[32]	Pallikadavath S, Foss M, Stones RW (2004) Antenatal care; provision and inequality in rural north India. Social Science and Medicine 59: 1147–1158.
[33]	Navaneetham K, Dharmalingam A (2002) Utilization of maternal health care services in southern India. Social Science and Medicine 55: 1849–1869.
[34]	Grover A (2010) Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of health. Office of the United Nations High Commissioner for Human Rights, United Nations General Assembly. 29: Available: http://www.ohchr.org/EN/Issues/Health/Pa？ges/SRRightHealthIndex.aspx. Accessed 2012 Apr.
[35]	Ram F, Ram U, Singh A (2006) Maternal mortality: is Indian programme prepared to meet the challenges. Journal of Health and Development 2: 67–80.
[36]	Ramarao S, Celeb L, Khan ME, Townsend JW (2001) Safer maternal health in rural Uttar Pradesh: do primary health services contribute? Health Policy and Planning; 16: 256–263.
[37]	Mavlankar DV (1999) Promoting safe motherhood: issues and challenges. In Pachauri S (ed). Implementing a Reproductive Health Agenda in India. New Delhi: Population Council.
[38]	Lim SS, Dandona L, Hoisington JA, James SL, Hogan MC, et al. (2010) India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. The Lancet 375: 2009–2023.
[39]	Patel V, Rodrigues M, DeSouza N (2002) Gender, poverty and postnatal depression: a study of mothers in Goa, India. American Journal of Psychiatry 159: 43–47.
[40]	Mavalankar D, Vora K, Prakasamma M (2008) Achieving Millenium Development Goal 5: is India serious? Bulletin of World Health Organization 86: 243–244.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133