Utilization of Health Services and RCH Status in Uttar Pradesh (original) (raw)
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This study examined the effect of reproductive and child health (RCH) services on fertility and child mortality in the districts of Uttar Pradesh. It specifically measured the effect of antenatal care, medical assistance at birth, child immunization and use of modern methods of contraception on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and Under-five Morality Rate (U5MR) before and after the National Rural Health Mission (NRHM) period. Data from the 2002-04 District Level Household Survey (DLHS-2), 2012-13 Annual Health Survey (AHS) and the 2001 and 2011 Censuses of India were used. The TFR and U5MR were estimated from the Census of India with district as the unit of analysis. Descriptive statistics, composite indices, random-and fixed-effects models and difference-in-difference models were used to understand the effect of RCH services on the reduction in TFR, IMR and the U5MR. The results suggest large inter-district variations in the coverage of RCH services in the state. During the post-NRHM period, improvement was highest in safe delivery followed by immunization coverage and antenatal care and least for contraceptive use in most districts. The relative ranking of districts has not changed much over time. In 2002-04, the RCH Index was highest in Lucknow (0.442) followed by Ballia and least in Kaushambi (0.115). By 2012-13, it was highest in Jhansi (0.741) and lowest in Shrawasti (0.241). The districts of Kaushambi, Unnao, Mahoba, Banda and Hardoi performed better in the RCH Index over time, while Ballia, Gautam Buddha Nagar, Kanpur Nagar, Pratapgarh and Sonbhadra remained poor. The RCH service coverage and demographic outcomes were poor in seven districts, particularly those in eastern and western Uttar Pradesh. The regression analyses suggest that the RCH Index exerts greater influence on the reduction in IMR and U5MR, while female literacy exerts greater influence on the reduction in TFR. The results of the hybrid model suggest that a 10% change in RCH 1 Corresponding author.
Utilization of Health Services and RCH Status In Madhya Pradesh: A District Level Analysis
rmrct.org
The study attempts to explore the pattern of utilization of RCH services viz. antenatal care, safe deliveries, child immunization and reproductive and child health status (complications during pregnancy, delivery and post-delivery etc.) in the districts of Madhya Pradesh. The linkages of different socioeconomic and demographic indicators with utilization of services and RCH status are also studied. The study elicits district wise reproductive health status indices. Further some indices namely; index of social development, health facilities, utilization of services, reproductive morbidities and index of quality of care has been computed for all districts. As a final point, the correlation of these indices with indices of reproductive and child health has been illustrated. The study reveals that utilization of health services and social development depicts strong negative relation with reproductive morbidities.
ABSTRACT: Reproductive and Child Health (RCH) Services are an essential service in the promotion of women and child health. Besides this, their services are of utmost significance in promoting a healthy society. This paper is an outcome of a study that was conducted with the objectives of understanding the organisation of RCH care services in Northeast India and to analyse the pattern of utilization of RCH care services in this region. In addition to this, an attempt was also made to examine the socio-economic determinants of RCH services utilization. It is this latter objective that is the main focus of this paper. A descriptive research design was adopted, using non-probability sampling method and non-proportional quota sampling, wherein the four states of Assam, Manipur, Meghalaya and Sikkim were identified for the study. Then one representative institution from each level of healthcare in each state was identified for the purpose of collecting information regarding how the RCH care services are organised and delivered to the people in these states. Besides this, multistage sampling was used to collect information from the users' perspective. A total of 800 households were surveyed. This paper tries to establish the fact that woman's education, husband's education, and family income continue to be very significant determinants in promoting an effective utilization of RCH care services. Besides religion and caste, other significant socio-economic indicators such as source of drinking water, type of housing, numbers of rooms, separate kitchen, type of fuel used for cooking, type of toilet were recorded to understand the socio-economic class and how they influence utilisation of RCH services. Significant RCH indicators such as pregnancy registration, ANC utilisation, IFA consumption, type and place of delivery, availing of JSY, PNC services were also studied.
Clinical Epidemiology and Global Health
This study aims to address the spatial variation in the availability of public health facilities and utilization of Maternal and Child Health (MCH) services at district level in India. Methods: Two nationally representative secondary data sources such as the National Family Health Survey 2015-16 and Census of India, 2011 were used to identify districts, which are lagging behind in terms of the availability and utilization of MCH services. Mapping and spatial clustering analyses was performed to identify underperforming districts in India. Further, Ordinary least square and spatial autoregressive models were used to determine the predictor for utilization of MCH services at the district level. Results: Significantly, less availability of public health facilities and utilization of MCH services were observed in districts of Jharkhand,
rmrct.org
The study attempts to explore the pattern of utilization of RCH services viz. antenatal care, safe deliveries, child immunization and reproductive and child health status (complications during pregnancy, delivery and post-delivery etc.) in the districts of Madhya Pradesh. The linkages of different socio-economic and demographic indicators with utilization of services and RCH status are also studied. The study elicits district wise reproductive health status indices. Further some indices namely; index of social development, health facilities, utilization of services, reproductive morbidities and index of quality of care has been computed for all districts. As a final point, the correlation of these indices with indices of reproductive and child health has been illustrated. The study reveals that utilization of health services and social development depicts strong negative relation with reproductive morbidities.
International Journal of Integrative Medical Sciences, 2019
Background: Maternal mortality remains a biggest setback in developing nations like India. Almost 90% of maternal deaths can be prevented by timely intervention, antenatal care acts as an effective tool to reduce both maternal and infant mortality. The objective of this study is to assess the utilization of antenatal care services in two divisions of Uttarakhand: Kumaun and Garhwal. Materials and Methods: The study was carried out using secondary data source i.e. NFHS-4 data of Uttarakhand which is divided into two regions, Garhwal and Kumaun. Statistical test i.e. Z-test is used for the comparison between two regions and within inter districts of Uttarakhand. Result: The results of this study indicates that between the two regions i.e Kumaun has better utilization of maternal health care facilities. Nainital district recorded best and Pithoragarh district recorded the least utilization of ANC services in Kumaun division. In Garhwal division, district Chamoli and Dehradun recorded highest utilization of maternal health care services whereas Rudraprayag and Tehri-Garhwal had discouraging statistics. Conclusion: Uttarakhand has immensely progressed in terms of maternal health in recent times; still there are some key areas that require immediate attention. Certain districts in both Garhwal and Kumaun division need assistance to improve maternal health care seeking behavior amongst the mother and the family. Dissemination of information and benefits regarding the utilization of ANC services should be encouraged to achieve a reduction in maternal mortality.
EPRA International Journal of Research & Development (IJRD)
The objective of this present study is to the analysis of inter-district variation in the health status of Odisha with a special reference to Healthcare. Health is an important view of health care. One needs good health to lead an economical life. The health of individuals and communities depends upon various socio-economic, demographic and environmental components. To understand the situation of health care an analysis of indicators such as infant mortality rate, death rate, birth rate, life expectancy, Sex ratio, Doctor per thousand of population, medical in hospital per thousand of population, Beds per thousand of population, and literacy rate have been employed through various quantitative techniques like composite index, Descriptive Statistics, Correlation etc. The study depends entirely on secondary data. The relevant secondary data have been collected from various dependable sources. Although the level of health status in Odisha has shown substantial improvement over the year...
Objectives: To examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India. Design: Data for the present study are taken from the Annual Health Survey (AHS), 2010–2013 and Census of India, 2011. Settings: This study used secondary data from states having higher mortality and fertility rates, termed as high focus states in India. Participants: District-level information regarding children aged 12–23 months and ever married women aged 15–49 years has been extracted from the AHS (2010–2013), and household amenities, female literacy and main workforce information has been obtained from the Census of India 2011. Measures: 2 summary indexes were calculated first for maternal and child health services and another for socioeconomic and development status, using data from AHS and Census. Cronbach’s α was used to assess the internal consistency of the items used in the index. Results: The result shows that the coverage gap is highest in Uttar Pradesh (37%) and lowest in Madhya Pradesh (21%). Converge gap and socioeconomic development are negatively correlated (r=−0.49, p=0.01). The average coverage gap was highest in the lowest quintile of socioeconomic development. There was an absolute change of 1.5% per year in coverage gap during 2009–2013. In regression analysis, the coefficient of determination was 0.24, β=−30.05, p=0.01 for a negative relationship between socioeconomic development and coverage gap. Conclusions: There is a significant disparity in the usage of maternal and child healthcare services in the districts of India. Resource-rich people (urban residents and richest quintile) are way ahead of marginalised people (rural residents a
Factors influencing the Utilization of Maternal Health Care Services in Uttarakhand
The National Family Health Survey (NFHS-III 2005-06) provided a gloomy picture of the status of maternal health indicators of Uttarakhand. The state has witnessed a higher proportion of high risk pregnancies. A large number of births take place outside the health system (67.4 percent), the majority being attended by untrained dais (midwives). These have resulted in higher maternal morbidity and mortality. Therefore, the present paper attempts to find out the possible factors influencing the use of maternal health care services, using the data from NFHS III. Both bi-variate and multivariate analysis have been carried out for the study by taking antenatal care and delivery care as dependant variables. The result reveals that the educational level of women, birth order and wealth index are significant predictors in explaining antenatal and delivery care. Controlling the effect of other variables, the predictive power of women's educational level, wealth index have been positively associated with antenatal care and also delivery care.
A Study of Spatial Variation of Maternal Health Care Services in West Bengal
IJIRMPS, 2018
In this study we identify the inter-district disparity of maternal health care use in West Bengal. We use data from the National Family Health Survey (NFHS) carried out during 2015-16 across most district in India. This study focuses on the utilization of delivery and post delivery services especially antenatal and postnatal check-up and institutional services. We have used the ArcGIS software to show the utilization of maternal health care services across the districts. We also measure the maternal health care index on the basis of four or more ANC, institutional services and PNC for showing of district wise safe motherhood status. The study indicates of maternal health care services are not same across the districts. The performance of utilization of maternal health care services is highest in Kolkata followed by Howrah, Darjeeling and Nadia and the worst performance districts are Uttar Dinajpur, Maldah, Murshidabad. The inter-district differences in utilization are likely due to differences in availability and accessibility of services among the districts. The challenge is how to make safe motherhood strategies in the future more successful. To implement evidence-based strategies and micro-level programmes planning are needed for the safe pregnancy and maternal health outcome.