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ASSESSING THE UTILIZATION OF MATERNAL AND CHILD HEALTH CARE AMONG MARRIED ADOLESCENT WOMEN: EVIDENCE FROM INDIA

Published online by Cambridge University Press:  21 September 2011

LUCKY SINGH
Affiliation:
International Institute for Population Sciences (IIPS), Deonar, Mumbai, India
RAJESH KUMAR RAI
Affiliation:
Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
PRASHANT KUMAR SINGH
Affiliation:
International Institute for Population Sciences (IIPS), Deonar, Mumbai, India

Summary

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005–06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban–rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

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References

Adekunle, C., Filippi, V., Graham, W., Onyemunwa, P. & Udjo, E. (1990) Patterns of maternity care among women in Ondo States, Nigeria. In Hill, A. G. (eds) Determinants of Health and Mortality in Africa. Issue 10. Demographic and Health Survey Further Analysis Series. Population Council, New York, pp. 145.Google Scholar
Adhikari, R. K. (2003) Early marriage and childbearing: risks and consequences. In Bott, S., Jejeebhoy, S., Shah, I. & Puriet, C. (eds) Towards Adulthood: Exploring the Sexual and Reproductive Health of Adolescents in South Asia. World Health Organization, pp. 6266.Google Scholar
Ahmed, S., Creanga, A. A., Gillespie, D. G. & Tsui, A. O. (2010) Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS ONE 5(6), e11190.CrossRefGoogle ScholarPubMed
Akin, A. & Munevver, B. (1996) Contraception, Abortion and Maternal Health Services in Turkey: Results of Further Analysis of the 1993 Turkish Demographic and Health Survey. Ministry of Health [Turkey] and Macro International Inc, Calverton, MD.Google Scholar
Amin, R., Shah, N. M. & Becker, S. (2010) Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: a cross-sectional analysis. International Journal for Equity in Health 9(1), 9.CrossRefGoogle ScholarPubMed
Barua, A. & Kurz, K. (2001) Reproductive health-seeking by married adolescent girls in Maharashtra, India. Reproductive Health Matters 9(17), 5362.CrossRefGoogle ScholarPubMed
Barua, A., Waghmare, R. & Venkiteswaran, S. (2003) Implementing reproductive and child health services in rural Maharashtra, India: a pragmatic approach. Reproductive Health Matters 11(21), 140149.CrossRefGoogle ScholarPubMed
Basu, A. M. (1992) Culture, the Status of Women, and Demographic Behaviour: Illustrated with the Case of India. Oxford University Press, Oxford.Google Scholar
Bhatia, J. C. & Cleland, J. (1995) Determinants of maternal care in a region of South India. Health Transition Review 5(2), 127142.Google Scholar
Bhutta, Z. A., Chopra, M., Axelson, H., Berman, P., Boerma, T., Bryce, J. et al. (2010) Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. Lancet 375(9730), 20322044.CrossRefGoogle ScholarPubMed
Bhutta, Z. A., Gupta, I., de'Silva, H., Manandhar, D., Awasthi, S., Hossain, S. M. & Salam, M. A. (2004) Maternal and child health: is South Asia ready for change. British Medical Journal 328 (7443), 816819.CrossRefGoogle ScholarPubMed
Bloom, S. S., Wypij, D. & Dasgupta, M. (2001) Dimensions of women's autonomy and the influence on maternal health care utilization in a north Indian city. Demography 38(1), 6778.CrossRefGoogle Scholar
Boerma, J. T., Sommerfelt, A. E., Rutstein, S. O. & Rojas, G. (1990) Immunization: Levels, Trends and Differentials. Institute for Resource Development/Macro Systems, Columbia, MD.Google Scholar
Celik, Y. & Hotchkiss, D. R. (2000) The socioeconomic determinants of maternal health care utilization in Turkey. Social Science & Medicine 50(12), 17971806.CrossRefGoogle ScholarPubMed
Chanana, K. (1996) Education attainment, status production and women's autonomy: a study of two generations of Punjabi women in New Delhi. In Jeffery, R. & Basu, A. M. (eds) Girls' Schooling, Women's Autonomy and Fertility Change in South Asia. Sage Publications, New Delhi, pp. 107132.Google Scholar
Dangal, G. (2005) An update on teenage pregnancy. Internet Journal of Gynecology and Obstetrics 5(1), 1346.Google Scholar
Das, N. P., Gandotra, M. M., Pandey, D. & Shah, U. (2002) Status of Women and Reproductive Behavior. Hindustan Publishing Corporation, New Delhi.Google Scholar
Dyson, T. & Moore, M. (1983) On kinship structure, female autonomy, and demographic behaviour in India. Population and Development Review 9(1), 3560.CrossRefGoogle Scholar
Elo, I. T. (1992) Utilization of maternal health care services in Peru: the role of women's education. Health Transition Review 2(1), 4969.Google ScholarPubMed
Fatusi, A. O. & Hindin, M. J. (2010) Adolescents and youth in developing countries: health and development issues in context. Journal of Adolescence 33(4), 499508.CrossRefGoogle ScholarPubMed
Filippi, V., Ronsmans, C., Campbell, O. M., Graham, W. J., Mills, A., Borghi, J., Koblinsky, M. & Osrin, D. (2006) Maternal health in poor countries: the broader context and a call for action. Lancet 368(9546), 15351541.CrossRefGoogle Scholar
Fotso, J. C., Ezeh, A. & Oronje, R. (2008) Provision and use of maternal health services among urban poor women in Kenya: what do we know and what can we do? Journal of Urban Health 85(3), 428442.CrossRefGoogle Scholar
Furuta, M. & Salway, S. (2006) Women's position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspectives 32(1), 1727.CrossRefGoogle ScholarPubMed
Gage, A. J. (1998) Premarital childbearing, unwanted fertility and maternity care in Kenya and Namibia. Population Studies 52(1), 2134.CrossRefGoogle Scholar
Gage, A. J. & Calixte, M. G. (2006) Effects of the physical accessibility of maternal health services on their use in rural Haiti. Population Studies 60(3), 271288.CrossRefGoogle ScholarPubMed
Government of India (2006) Jananai Surkasha Yojana (JSY: Features). Ministry of Health and Family Welfare, New Delhi.Google Scholar
Government of India (2007) The Prohibition of Child Marriage Act, 2006. Gazette of India No. 6. Ministry of Law and Justice, Government of India, New Delhi.Google Scholar
Government of India (2009) Maternal Mortality in India 2004–06. Special Bulletin. Sample Registration System. Office of the Registrar General, Ministry of Home Affairs, New Delhi.Google Scholar
Hampton, T. (2010) Child marriage threatens girls' health. Journal of the American Medical Association 304(5), 509510.CrossRefGoogle ScholarPubMed
Hussein, J., Newlands, D., D'Ambruoso, L., Thaver, I., Talukder, R. & Besana, G. (2010) Identifying practices and ideas to improve the implementation of maternal mortality reduction programmes: findings from five south Asian countries. BJOG 117(3), 304313.CrossRefGoogle ScholarPubMed
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) (2007) Consequences of early marriage on female schooling in rural Bangladesh. Health and Science Bulletin 5(4), 1318.Google Scholar
International Council for Research on Women (2007) New Insights on Preventing Child Marriage: A Global Analysis of Factors and Programs. URL: http://www.icrw.org/docs/2007-new-insights-preventing-childmarriage.pdf (accessed 4th July 2010).Google Scholar
International Institute for Population Sciences (IIPS) & Macro International (2007) National Family Health Survey (NFHS-3), 2005–06: India. Volume I. IIPS, Mumbai.Google Scholar
Jafarey, S., Kamal, I., Qureshi, A. F. & Fikree, F. (2008) Safe motherhood in Pakistan. International Journal of Gynecology and Obstetrics 102(2), 179185.CrossRefGoogle ScholarPubMed
Jejeebhoy, S. J. (2002) Convergence and divergence in spouses' perspectives on women's autonomy in rural India. Studies in Family Planning 33(4), 299308.CrossRefGoogle ScholarPubMed
Jensen, R. & Thornton, R. (2003) Early female marriage in the developing world. Gender and Development 11(2), 919.CrossRefGoogle Scholar
Kamal, S. M. M. (2009) Factors affecting utilization of skilled maternity care services among married adolescent in Bangladesh. Asian Population Studies 5(2), 153170.CrossRefGoogle Scholar
Kandel, D. B., Kiros, G. E., Schaffran, C. & Hu, M. C. (2004) Racial/ethnic differences in cigarette smoking initiation and progression to daily smoking: a multilevel analysis. American Journal of Public Health 94(1), 128135.CrossRefGoogle ScholarPubMed
Klingberg-Allvin, M., Graner, S., Phuc, H. D., Höjer, B. & Johansson, A. (2010) Pregnancies and births among adolescents: a population-based prospective study in rural Vietnam. Sexual & Reproductive Healthcare 1(1), 1519.CrossRefGoogle ScholarPubMed
Ladusingh, L. & Singh, C. H. (2007) Rich–poor gap in maternal care. Asian Population Studies 3(1), 7994.CrossRefGoogle Scholar
LeGrand, T. K. & Mbacke, C. S. M. (1993) Teenage pregnancy and child health in urban Sahel. Studies in Family Planning 24(3), 137149.CrossRefGoogle ScholarPubMed
Lloyd, C. B. & Mensch, B. S. (2006) Marriage and Childbirth as Factors in School Exit: An Analysis of DHS Data from Sub-Saharan Africa. Policy Research Division Working Paper No. 219. Population Council, New York.Google Scholar
Mekonnen, Y. & Mekonnen, A. (2002) Utilization of Maternal Health Care Services in Ethiopia. ORC Macro, Calverton, MD.Google Scholar
Mensch, B. S., Bruce, J. & Greene, M. E. (1998) The Uncharted Passage: Girls' Adolescence in the Developing World. Population Council, New York.CrossRefGoogle Scholar
Ministry of Health and Family Welfare (2011) Service Providers' Manual: Understanding Health Management Information Systems. Volume I. New Delhi.Google Scholar
Mistry, R., Galal, O. & Lu, M. (2009) Women's autonomy and pregnancy care in rural India: a contextual analysis. Social Science & Medicine 69(6), 926933.CrossRefGoogle ScholarPubMed
Mohanty, S. K. & Pathak, P. K. (2009) Rich–poor gap in utilization of reproductive and child health services in India, 1992–2005. Journal of Biosocial Science 41(3), 381398.CrossRefGoogle ScholarPubMed
Mumtaz, Z. & Salway, S. (2005) ‘I never go anywhere’: extricating the links between women's mobility and uptake of reproductive health services in Pakistan. Social Science & Medicine 60(8), 17511765.CrossRefGoogle ScholarPubMed
Navaneetham, K. & Dharmalingam, A. (2002) Utilization of maternal health care services in southern India. Social Science & Medicine 55(10), 18491869.CrossRefGoogle ScholarPubMed
Nayar, K. R. (2007) Social exclusion, caste & health: a review based on the social determinants framework. Indian Journal of Medical Research 126(4), 355363.Google Scholar
Obermeyer, C. M. & Potter, J. E. (1991) Maternal health care utilization in Jordan: a study of patterns and determinants. Studies in Family Planning 22(3), 177187.CrossRefGoogle Scholar
Omar, K., Hasim, S., Muhammad, N. A., Jaffar, A., Hashim, S. M. & Siraj, H. H. (2010) Adolescent pregnancy outcomes and risk factors in Malaysia. International Journal of Gynecology and Obstetrics 111(3), 220223.CrossRefGoogle ScholarPubMed
Onah, H. E., Ikeako, L. C. & Iloabachie, G. C. (2006) Factors associated with the use of maternity services in Enugu, southeastern Nigeria. Social Science & Medicine 63(7), 18701878.CrossRefGoogle ScholarPubMed
Pathak, P. K. & Mohanty, S. K. (2010) Does the safe-motherhood programme reach the poor in Uttar Pradesh, India? Asian Population Studies 6(2), 173191.CrossRefGoogle Scholar
Pebley, A. R., Goldman, N. & Rodriguez, G. (1996) Prenatal and delivery care and childhood immunization in Guatemala: do family and community matter? Demography 33(2), 231247.CrossRefGoogle ScholarPubMed
Prakash, A., Swain, S. & Negi, K. S. (1994) Who decides? Indian Pediatrics 31(8), 978980.Google ScholarPubMed
Raj, A., Saggurti, N., Balaiah, D. & Silverman, J. G. (2009) Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in india: a cross-sectional, observational study. Lancet 373(9678), 18831889.CrossRefGoogle ScholarPubMed
Ram, F. & Singh, A. (2006) Is antenatal care effective in improving maternal health in rural Uttar Pradesh: evidence from a district level household survey. Journal of Biosocial Science 38(4), 433448.CrossRefGoogle ScholarPubMed
Rao, K. S., Selvaraju, S., Nagpal, S. & Sakthivel, S. (2005) Financing and Delivery of Health Care Services in India. National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare, Government of India, New Delhi.Google Scholar
Rasheed, S., Abdelmonem, A. & Amin, M. (2011) Adolescent pregnancy in Upper Egypt. International Journal of Gynecology and Obstetrics 112(1), 2124.CrossRefGoogle ScholarPubMed
Reynolds, H. W., Wong, E. L. & Tucker, H. (2006) Adolescents' use of maternal and child health services in developing countries. International Family Planning Perspectives 32(1), 616.CrossRefGoogle ScholarPubMed
Ronsmans, C., Chowdhury, M. E., Koblinsky, M. & Ahmed, A. (2010) Care seeking at time of childbirth, and maternal and perinatal mortality in Matlab, Bangladesh. Bulletin of the World Health Organization 88(4), 289296.CrossRefGoogle ScholarPubMed
Rosenfield, A., Charo, R. A. & Chavkin, W. (2008) Moving forward on reproductive health. New England Journal of Medicine 359(18), 18691871.CrossRefGoogle ScholarPubMed
Saikia, N. & Singh, A. (2009) Does type of household affect maternal health? Evidence from India. Journal of Biosocial Science 41(3), 329353.CrossRefGoogle ScholarPubMed
Salam, A. & Siddiqui, S. A. (2006) Socioeconomic inequalities in use of delivery care services in India. Journal of Obstetrics Gynecology of India 56(2), 123127.Google Scholar
Santhya, K. G., Jejeebhoy, S. J. & Ghosh, S. (2008) Early Marriage and Sexual and Reproductive Health Risks: Experiences of Young Women and Men in Andhra Pradesh and Madhya Pradesh, India. Population Council, New Delhi.Google Scholar
Santow, G. (1995). Social roles and physical health: the case of female disadvantage in poor countries. Social Science & Medicine 40(2), 147161.CrossRefGoogle ScholarPubMed
Saroha, E., Altarac, M. & Sibley, L. M. (2008) Caste and maternal health care service use among rural Hindu women in Maitha, Uttar Pradesh, India. Journal of Midwifery & Women's Health 53(5), e4147.CrossRefGoogle ScholarPubMed
Shawky, S. & Milaat, W. (2001) Cumulative impact of early maternal marital age during the childbearing period. Paediatric and Perinatal Epidemiology 15(1), 2733.CrossRefGoogle ScholarPubMed
Singh, A., Hazra, A. & Ram, F. (2007) Women's autonomy and sex differential in child mortality in India. Genus LXIII (3–4), 5575.Google Scholar
SPSS (2006) Statistical Package for the Social Sciences. SPSS Inc., Chicago.Google Scholar
Stephenson, R. & Tsui, A. O. (2002) Contextual influences on reproductive health service use in Uttar Pradesh, India. Studies in Family Planning 33(4), 309320.CrossRefGoogle ScholarPubMed
Stewart, K. & Sommerfelt, A. E. (1991) Utilization of maternity care services: a comparative study using DHS data. In Demographic and Health Surveys World ConferenceWashington, DC, 5–7th August 1991. Proceedings: Institute for Resource Development/Macro International, Demographic and Health Surveys (DHS), Columbia, MD, Vol. 3, pp. 16451667.Google Scholar
Sunil, T. S., Rajaram, S. & Zottarelli, L. K. (2006) Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach. Social Science & Medicine 62(8), 19431957.CrossRefGoogle ScholarPubMed
Suwal, J. V. (2001) The main determinants of infant mortality in Nepal. Social Science & Medicine 53(12), 16671681.CrossRefGoogle ScholarPubMed
Thaddeus, S. & Maine, D. (1994) Too far to walk: maternal mortality in context. Social Science & Medicine 38(8), 10911110.CrossRefGoogle ScholarPubMed
United Nations (2009) UN Millennium Development Goals. URL: http://www.un.org/MillenniumGoals (accessed 16th July 2009).Google Scholar
UNICEF (2011) Progress for Children: A World Fit for Children Statistical Review. Protecting against Abuse, Exploitation and Violence: Child Marriage. URL: http://www.unicef.org/progressforchildren/2007n6/index_41848.htm (accessed 13th March 2011).Google Scholar
Wagle, R., Sabroe, S. & Nielsen, B. B. (2004) Socio-economic and physical distance to the maternity hospital as predictors for place of delivery: an observation study from Nepal. BioMed Central Pregnancy and Childbirth 4(1), 820.CrossRefGoogle Scholar
Wong, E. L., Popkin, B. M., Guilkey, D. K. & Akin, J. S. (1987) Accessibility, quality of care and prenatal use in the Philippines. Social Science & Medicine 24(11), 927944.CrossRefGoogle ScholarPubMed
WHO (1998) Postpartum Care of the Mother and Newborn: A Practical Guide. Maternal and Newborn Health/Safe Motherhood Unit, Division of Reproductive Health (Technical Support), Geneva, Switzerland.Google Scholar
WHO (2006) Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Standards for Maternal and Neonatal care (1.6), Department of Making Pregnancy Safer, Geneva, Switzerland. URL: http://www.who.int/making_pregnancy_safer/publications/Standards1.6N.pdf. (accessed 3rd July 2009).Google Scholar
WHO (2008) Adolescent Pregnancy. Geneva, Switzerland.Google Scholar