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Antenatal care: provision and inequality in rural north India

Author

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  • Pallikadavath, Saseendran
  • Foss, Mary
  • Stones, R William

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.

Suggested Citation

  • Pallikadavath, Saseendran & Foss, Mary & Stones, R William, 2004. "Antenatal care: provision and inequality in rural north India," Social Science & Medicine, Elsevier, vol. 59(6), pages 1147-1158, September.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:6:p:1147-1158
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    Cited by:

    1. Kaushal, Kaushalendra Kumar & F Ram, Faujdar Ram & Abhishek, Abhishek Singh, 2013. "Public Spending on Health and Childhood Mortality in India," MPRA Paper 48680, University Library of Munich, Germany.
    2. Sheabo Dessalegn, S., 2017. "Social capital and maternal health care use in rural Ethiopia," Other publications TiSEM bb0ec225-4ec3-4028-90d6-1, Tilburg University, School of Economics and Management.
    3. Chattopadhyay, Sreeparna, 2006. "'Rakter dosh'--corrupting blood: The challenges of preventing thalassemia in Bengal, India," Social Science & Medicine, Elsevier, vol. 63(10), pages 2661-2673, November.
    4. Stein, Alexander J. & Meenakshi, J.V. & Qaim, Matin & Nestel, Penelope & Sachdev, H.P.S. & Bhutta, Zulfiqar A., 2008. "Potential impacts of iron biofortification in India," Social Science & Medicine, Elsevier, vol. 66(8), pages 1797-1808, April.
    5. Mônica Viegas Andrade & Kenya Valéria M. de Souza Noronha & Abhishek Singh & Cristina Guimarães Rodrigues & Sabu S. Padmadas, 2011. "Equidade na utilização dos serviços de saúde no Brasil: um estudo comparativo entre as regiões brasileiras no período 1998-2008," Textos para Discussão Cedeplar-UFMG td446, Cedeplar, Universidade Federal de Minas Gerais.
    6. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, vol. 74(12), pages 1882-1890.
    7. repec:hur:ijarbs:v:7:y:2017:i:9:p:477-520 is not listed on IDEAS
    8. Jeffery, Patricia & Jeffery, Roger, 2010. "Only when the boat has started sinking: A maternal death in rural north India," Social Science & Medicine, Elsevier, vol. 71(10), pages 1711-1718, November.
    9. Gage, Anastasia J., 2007. "Barriers to the utilization of maternal health care in rural Mali," Social Science & Medicine, Elsevier, vol. 65(8), pages 1666-1682, October.
    10. Evan Borkum & Dana Rotz & Anu Rangarajan & Swetha Sridharan & Sukhmani Sethi & Mercy Manoranjini & Lakshmi Ramakrishnan & Lalit Dandona & Rakhi Dandona & Priyanka S. Kochar & G. Anil Kumar & Priyanka , 2014. "Midline Findings from the Evaluation of the Ananya Program in Bihar," Mathematica Policy Research Reports 74ef56ababd9412b82ef906fc, Mathematica Policy Research.
    11. Shroff, Monal R. & Griffiths, Paula L. & Suchindran, Chirayath & Nagalla, Balakrishna & Vazir, Shahnaz & Bentley, Margaret E., 2011. "Does maternal autonomy influence feeding practices and infant growth in rural India?," Social Science & Medicine, Elsevier, vol. 73(3), pages 447-455, August.
    12. Premchand Dommaraju & Victor Agadjanian & Scott Yabiku, 2008. "The Pervasive and Persistent Influence of Caste on Child Mortality in India," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(4), pages 477-495, August.

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