Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20183097Keywords:
Utilization pattern, Antenatal care, Out of pocket expenditure, Public health facilityAbstract
Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Factors like education, economic status and out of pocket (OOP) expenditure can affect utilization of maternal health services. Hence this study aims to assess the utilization pattern of maternal health care and the out of pocket expenditure for delivery services in a public maternity hospital.
Methods: A cross sectional study was conducted using primary data from women who delivered in public maternity hospital, Mangaluru during January –February 2018. Study respondents were interviewed using pre-tested, interview schedule. The data was analysed using SPSS 20.0 version.
Results: 78.3% of the respondents visited the health care provider during first trimester of pregnancy. 97.3% of the mothers attended ≥4 antenatal visits. The time of the first ANC visit, consumption of Iron folic acid (IFA) tablets, choice of provider for ANC are significantly associated with caste, education of the respondents and their husbands. The mean expenditure for delivery care, including indirect expenditure was ₹2875. Expenditure during delivery was significantly associated with respondent’s education and type of delivery.
Conclusions: Socio demographic characteristics like caste and education did seem to have an effect on the utilization of ANC especially consumption of IFA. Education and communication campaigns may aid to improve this. Good implementation of government schemes can help to reduce the direct OOP expenditure for delivery care. The indirect cost associated with maternity care may still be a burden for poor families.
References
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ, editors. Global Burden of Disease and Risk Factors. Washington (DC): World Bank; 2006.
Wycliffe K. Social Factors Influencing Nutrition Status of Expectant Women Admitted At Pumwani Maternity Hospital, Nairobi, Kenya. 2013;4 (10):3.
Maternal Mortality in India. Academike. 2017 Available at: https://www.lawctopus.com/ acade-mike/maternal-mortality-india/. Accessed on 11 April 2018.
WHO. Maternal health. WHO. Available at: http://www.who.int/maternal-health/en/. Accessed on 11 April 2018.
Skordis-Worrall J, Pace N, Bapat U, Das S, More NS, Joshi W, et al. Maternal and neonatal health expenditure in mumbai slums (India): A cross sectional study. BMC Public Health. 2011;11:150.
WHO. New guidelines on antenatal care for a positive pregnancy experience. WHO. Available at: http://www.who.int/reproductivehealth/news/antenatal-care/en. Accessed on 13 April 2018.
Vidler M, Ramadurg U, Charantimath U, Katageri G, Karadiguddi C, Sawchuck D, et al. Utilization of maternal health care services and their determinants in Karnataka State, India. Reprod Health. 2016;13(Suppl1):37.
Griffiths P, Stephenson R. Understanding Users’ Perspectives of Barriers to Maternal Health Care Use In Maharashtra, INDIA. J Biosocial Sci. 2001;33(3):339–59.
Elo IT. Utilization of maternal health-care services in Peru: the role of women’s education. 1992;2(1):20.
Bolam A, Manandhar DS, Shrestha P, Ellis M, Malla K, Costello AM. Factors affecting home delivery in the Kathmandu Valley, Nepal. Health Policy Plan. 1998;13(2):152–8.
Das S, Alcock G, Azad K, Kuddus A, Manandhar DS, Shrestha BP, et al. Institutional delivery in public and private sectors in South Asia: a comparative analysis of prospective data from four demographic surveillance sites. BMC Pregnancy Childbirth. 2016;16.
KA_FactSheet_575_Dakshina Kannada.pdf. Available at: http://rchiips.org/NFHS/FCTS/KA/ KA_FactSheet_575_Dakshina%20Kannada.pdf. Accessed on 4 April 2018.
Wendt A, Stephenson R, Young M, Webb-Girard A, Hogue C, Ramakrishnan U, et al. Individual and facility-level determinants of iron and folic acid receipt and adequate consumption among pregnant women in rural Bihar, India. PLoS ONE. 2015;10(3):1-25.
Imeda CP. Use of Antenatal and Skilled Care during Delivery: A Systematic Review and Meta-analysis of Effectiveness of Interventions Implemented in Developing Countries.:71.
Govil D, Purohit N, Gupta SD, Mohanty SK. Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India. J Health Popul Nutr. 2016;35(1):15.
Hunter BM, Harrison S, Portela A, Bick D. The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review. PLOS ONE. 2017;12(3):e0173068.
Nagarajan S, Paul VK, Yadav N, Gupta S. The National Rural Health Mission in India: its impact on maternal, neonatal, and infant mortality. Semin Fetal Neonatal Med. 2015;20(5):315–20.
Khan A, Zaman S. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan. BMC Pregnancy Childbirth. 2010;10:2.
Douangvichit D, Liabsuetrakul T, McNeil E. Health care expenditure for hospital-based delivery care in Lao PDR. BMC Res Notes. 2012;5:30.
Mohanty SK, Srivastava A. Out-of-pocket expenditure on institutional delivery in India. Health Policy Plan. 2013;28(3):247–62.
Nahar S, Costello A. The hidden cost of “free” maternity care in Dhaka, Bangladesh. Health Policy Plan. 1998;13(4):417–22.
Sahu KS, Bharati B. Out-of-Pocket health expenditure and sources of financing for delivery, postpartum, and neonatal health in urban slums of Bhubaneswar, Odisha, India. Indian J Public Health. 2017;61(2):6773.
