DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20205670

Barriers in utilization of maternal and child health services among Musahar in Dudhauli Municipality of Sindhuli district, Nepal

Laxmi Gautam, Jwala Subedi

Abstract


Background: Maternal and Child Health remains a public health challenge in Nepal. This study explored information regarding barriers in the utilization of Maternal and Child Health services among women of Musahar community.

Methods: A cross-sectional study was carried out in Dudhauli Municipality, Sindhuli using qualitative and quantitative methods. Qualitative data were obtained from, In Depth Interview among health workers and a Focus Group Discussion among FCHVs of Musahar community. Interview was carried out using questionnaire for quantitative study among 121 mothers of under 5 children. The data was analyzed using SPSS software version 21. Chi Square test was applied to test the associations while p value <0.05 was considered significant.

Results: The average age and age at marriage of respondents were 24.6±5.7 years and 16.22±2.8 respectively, 76% were illiterate, 93.2% lies below poverty line and 73.6% were home maker. Among them, 29.8 did not have ANC while 47.1 had 4 or more ANC visits, 64.5% institutional delivery and 29.8% PNC visit. Social barriers and lack of information are major barriers contributing to more than half of no ANC visit and which contribute to >60% in case of PNC. Home delivery for first child was 56.2% while for last child was 33.9%. Almost 1/5th of the children were not vaccinated. Qualitative study identified social factors like negligence, family pressure, shyness, and unhealthy financial decisions as important barriers.

Conclusions: Utilization of maternal and child health services was poor among Musahar mothers and children which indicates a serious public health concern.


Keywords


Barriers, Maternal and child health, Musahar, Utilization

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References


Bhattarai P, Jo NHRC. Factors associated with use of maternal health services in Nepal: analysis of the 2016. Nepal Demographic Health Survey. 2019;17(3):301-7.

Shah S, Shetty S, Singh D, Mathias J, Upadhaya A, Pandit RJMPH. Prevalence of undernutrition among musahar children aged between 12 to 59 months in Urban Siraha District, Nepal. MOJ Public Health. 2016;4(5):00093.

World Bank Data Help Desk. Available at https://datahelpdesk.worldbank.org/knowledgebase/articles/193310-how-is-the-global-poverty-line-derived-how-is-it. Accessed on 12 July 2020.

Paudel M, Javanparast S, Newman L, Dasvarma GJJ. Population, nutrition health system barriers influencing perinatal survival in mountain villages of Nepal: implications for future policies and practices. Biomed Central. 2018;37(1):16.

Nepal demographic health survey. 2016. Available at https:// dhsprogram. com/ pubs/ pdf/ FR336/ FR336.pdf. Accessed on 12 July 2020.

Bank TW. The World Bank In Nepal: The World Bank; 2018. Available at https:// www. worldbank.org/en/country/nepal/overview. Accessed on 02 August 2020.

Annual Report 2074-75. Available at https:// dohs. gov.np/ annual-report-2074-75/. Accessed on 5 July 2020.

Poudel R. Utilization of maternal health care services among dalit women of Palpa District. Available at https:// www. academia. edu/ 7897959 /Utilization_of_Maternal_Health_Care_Services_Among_Dalit_Women_of_Palpa_District?auto=download. Accessed on 20 August 2020.

Onta S, Choulagai B, Shrestha B, Subedi N, Bhandari GP, Krettek AJG. Perceptions of users and providers on barriers to utilizing skilled birth care in mid-and far-western Nepal: a qualitative study. Glob Health Action. 2014;7(1):24580.

Lama S, Krishna AKIJKUMJ. Barriers in utilization of maternal health care services: perceptions of rural women in Eastern Nepal. Kathmandu Univ Med J. 2014;12(4):253-8.

Khanal V, Bhandari R, Adhikari M, Karkee R, Joshi CJI. Utilization of maternal and child health services in western rural Nepal: a cross-sectional community-based study. Indian J Public Health. 2014;58(1):27.

Tesfahun F, Worku W, Mazengiya F, Kifle MJM. Knowledge, perception and utilization of postnatal care of mothers in Gondar Zuria District, Ethiopia: a cross-sectional study. Matern Child Health. 2014;18(10):2341-51.

Probandari A, Arcita A, Kothijah K, Pamungkasari EPJBhsr. Barriers to utilization of postnatal care at village level in Klaten district, central Java Province, Indonesia. BMC Health Serv Res. 2017;17(1):541.

Sumankuuro J, Crockett J, Wang SJB. Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings. BMJ Open. 2018;8(11):e021223.

Sanjel S, Ghimire R, Pun KJKUMJ. Antenatal care practices in Tamang community of hilly area in central Nepal. Kathamndu Med Uni. 2011;9(2):57-61.

Abbas AA, Walker GJJIJ. Determinants of the utilization of maternal and child health services in Jordan. Int J Epidemol. 1986;15(3):404-7.

Nzioki JM, Onyango RO, Ombaka JHJAJ. Socio-demographic factors influencing maternal and child health service utilization in Mwingi: a rural semi-arid district in Kenya. Am J Public Health Res. 2015;3(1):21-30.

Kaphle HP, Gupta N, Shrestha N. Determinants for the utilization of antenatal care in Nepal. Int J Med Pharm Sci. 2015;8(5):7-18.

Deo KK, Paudel YR, Khatri RB, Bhaskar RK, Paudel R, Mehata S, et al. Barriers to utilization of antenatal care services in Eastern Nepal. Front Public Health. 2015;3:197.