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Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India

Author

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  • Abhishek Singh
  • Saseendran Pallikadavath
  • Faujdar Ram
  • Reuben Ogollah

Abstract

Objectives: Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. Methods and Findings: The District Level Household Survey (2007–08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%–72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. Conclusion: A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of their socioeconomic status.

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  • Abhishek Singh & Saseendran Pallikadavath & Faujdar Ram & Reuben Ogollah, 2012. "Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-8, September.
    • Handle: RePEc:plo:pone00:0044931
    DOI: 10.1371/journal.pone.0044931
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    2. Madhu Gupta & Hans Bosma & Federica Angeli & Manmeet Kaur & Venkatesan Chakrapani & Monica Rana & Onno C P van Schayck, 2017. "Impact of a Multi-Strategy Community Intervention to Reduce Maternal and Child Health Inequalities in India: A Qualitative Study in Haryana," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-23, January.
    3. Isabel Tiago de Oliveira & José G Dias & Sabu S Padmadas, 2014. "Dominance of Sterilization and Alternative Choices of Contraception in India: An Appraisal of the Socioeconomic Impact," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-9, January.
    4. Madhu Gupta & Federica Angeli & Hans Bosma & Monica Rana & Shankar Prinja & Rajesh Kumar & Onno C P van Schayck, 2016. "Effectiveness of Multiple-Strategy Community Intervention in Reducing Geographical, Socioeconomic and Gender Based Inequalities in Maternal and Child Health Outcomes in Haryana, India," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-13, March.
    5. Md Mobarak Hossain Khan & Arina Zanuzdana & Alexander Kraemer, 2013. "Levels, Trends and Disparities in Public-Health-Related Indicators among Reproductive-Age Women in Bangladesh by Urban-Rural and Richest-Poorest Groups, 1993-2011," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.

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