Skip to main content
Erschienen in: The Journal of Obstetrics and Gynecology of India 3/2019

21.08.2018 | Original Article

Why Institutional Deliveries are Low in Balrampur District Uttar Pradesh: A Cross-Sectional Quantitative and Qualitative Exploration

verfasst von: Jaya Srivastava, Alex Joseph

Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

The rate of institutional deliveries in India is 78.5%. Kerala and Tamil Nadu (99.8%) had the highest numbers of institutional deliveries in 2010–13, but still it is less than 60% in about 170 districts in the country. Balrampur (Uttar Pradesh) has recorded the least institutional deliveries in the country.

Objectives

To assess the factors associated with low utilization of healthcare institutions for delivery in rural Balrampur district, Uttar Pradesh.

Methods

A community-based cross-sectional survey was conducted among mothers between the ages of 15–49 who gave birth 12 months before the study in Balrampur district, Uttar Pradesh. Both qualitative and quantitative methods were used for the study. Multistage random sampling was used to select the participants for the quantitative study. Qualitative data collection was done using in-depth interview among 10 women.

Results

Mothers who were not desirous of having more children had a 2.7 times greater chance of delivering at home compared to mothers who were desirous of having more children (OR 2.705, CI 95% 1.189–6.155). Women who married before 18 years of age had a greater chance of home delivery than women who married later (OR 2.381, CI 95% 1.034–5.482). Respondents living far away from home (more than 30 min–1 h travel) were more likely to deliver at home compared to those living close by (OR 2.385, CI 95% 2.357–8.028). Women who were unaware of complications of pregnancy were more like to deliver at home compared to their counterparts who were well aware (OR 2.355, CI 95% 1.677–3.309). Qualitative data showed that cultural beliefs, financial problems, lack of decision making power by the pregnant women were significant determinants of non-utilization of institutional deliveries.

Conclusion

Despite the cash incentive program, strong cultural and social factors prevent women from accessing institutional deliveries in Balrampur district of UP.
Literatur
1.
Zurück zum Zitat World Health Organization. World health statistics 2015. Geneva: World Health Organization; 2015. World Health Organization. World health statistics 2015. Geneva: World Health Organization; 2015.
2.
Zurück zum Zitat World Health Organization, UNICEF. Trends in maternal mortality: 1990–2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division, 2015. World Health Organization, UNICEF. Trends in maternal mortality: 1990–2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division, 2015.
3.
Zurück zum Zitat Bansal NK. Health services provided under RMNCH+A developing an action plan to improve the effectiveness of the programme. Nurs J India. 2016;107(6):277. Bansal NK. Health services provided under RMNCH+A developing an action plan to improve the effectiveness of the programme. Nurs J India. 2016;107(6):277.
4.
Zurück zum Zitat Registrar General of India. Special bulletin on maternal mortality in India: 2007–09. Sample Regist Syst. 2013;91:1–4. Registrar General of India. Special bulletin on maternal mortality in India: 2007–09. Sample Regist Syst. 2013;91:1–4.
5.
Zurück zum Zitat Filippi V, Chou D, Ronsmans C, et al. Levels and causes of maternal mortality and morbidity. Reprod Matern Newborn Child Health. 2016;11:51. Filippi V, Chou D, Ronsmans C, et al. Levels and causes of maternal mortality and morbidity. Reprod Matern Newborn Child Health. 2016;11:51.
6.
Zurück zum Zitat Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.CrossRef Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.CrossRef
7.
Zurück zum Zitat Dwivedi P. Assessment of Maternal and Child Health under the NRHM frame work. A Study of four Districts of UP Bahraich Balrampur Varanasi and Lucknow, 2015. Dwivedi P. Assessment of Maternal and Child Health under the NRHM frame work. A Study of four Districts of UP Bahraich Balrampur Varanasi and Lucknow, 2015.
8.
Zurück zum Zitat National Rural Health Mission. Guidelines for Janani-Shishu Suraksha Karyakram (JSSK). New Delhi: Government of India, Ministry of Health and Family Welfare, Maternal Health Division; 2011. p. 1–40. National Rural Health Mission. Guidelines for Janani-Shishu Suraksha Karyakram (JSSK). New Delhi: Government of India, Ministry of Health and Family Welfare, Maternal Health Division; 2011. p. 1–40.
9.
Zurück zum Zitat Amano A, Gebeyehu A, Birhanu Z. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2012;12(1):105.CrossRefPubMedPubMedCentral Amano A, Gebeyehu A, Birhanu Z. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2012;12(1):105.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Khanal V, Adhikari M, Karkee R, et al. Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal demographic and health survey 2011. BMC Women’s Health. 2014;14(1):19.CrossRefPubMedPubMedCentral Khanal V, Adhikari M, Karkee R, et al. Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal demographic and health survey 2011. BMC Women’s Health. 2014;14(1):19.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Rai SK, Dasgupta R, Das MK, et al. Determinants of utilization of services under MMJSSA scheme in Jharkhand ‘Client Perspective’: a qualitative study in a low performing state of India. Indian J Public Health. 2011;55(4):252.CrossRefPubMed Rai SK, Dasgupta R, Das MK, et al. Determinants of utilization of services under MMJSSA scheme in Jharkhand ‘Client Perspective’: a qualitative study in a low performing state of India. Indian J Public Health. 2011;55(4):252.CrossRefPubMed
12.
Zurück zum Zitat Adamson PC, Krupp K, Niranjankumar B, et al. Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India. BMC Public Health. 2012;12(1):30.CrossRefPubMedPubMedCentral Adamson PC, Krupp K, Niranjankumar B, et al. Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India. BMC Public Health. 2012;12(1):30.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Nair M, Ariana P, Webster P. What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India. Rural Remote Health. 2012;12(4):2311.PubMed Nair M, Ariana P, Webster P. What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India. Rural Remote Health. 2012;12(4):2311.PubMed
14.
Zurück zum Zitat Mohanty SK, Srivastava A. Out-of-pocket expenditure on institutional delivery in India. Health Policy Plan. 2012;28(3):247–62.CrossRefPubMed Mohanty SK, Srivastava A. Out-of-pocket expenditure on institutional delivery in India. Health Policy Plan. 2012;28(3):247–62.CrossRefPubMed
15.
Zurück zum Zitat Garg R, Shyamsunder D, Singh T, et al. Study on delivery practices among women in rural Punjab. Health Popul Perspect Issues. 2010;33(1):23–33. Garg R, Shyamsunder D, Singh T, et al. Study on delivery practices among women in rural Punjab. Health Popul Perspect Issues. 2010;33(1):23–33.
16.
Zurück zum Zitat Varma DS, Khan ME, Hazra A. Increasing institutional delivery and access to emergency obstetric care services in rural Uttar Pradesh. J Fam Welf. 2010;56(Special issue-2010):23–30. Varma DS, Khan ME, Hazra A. Increasing institutional delivery and access to emergency obstetric care services in rural Uttar Pradesh. J Fam Welf. 2010;56(Special issue-2010):23–30.
17.
Zurück zum Zitat Lim SS, Dandona L, Hoisington JA, et al. India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet. 2010;375(9730):2009–23.CrossRefPubMed Lim SS, Dandona L, Hoisington JA, et al. India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet. 2010;375(9730):2009–23.CrossRefPubMed
18.
Zurück zum Zitat Populations Fund India UN. Concurrent assessment of Janani Suraksha Yojana (JSY) in selected states. New Delhi: UN Population Fund India; 2009. Populations Fund India UN. Concurrent assessment of Janani Suraksha Yojana (JSY) in selected states. New Delhi: UN Population Fund India; 2009.
Metadaten
Titel
Why Institutional Deliveries are Low in Balrampur District Uttar Pradesh: A Cross-Sectional Quantitative and Qualitative Exploration
verfasst von
Jaya Srivastava
Alex Joseph
Publikationsdatum
21.08.2018
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India / Ausgabe 3/2019
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-018-1165-x

Weitere Artikel der Ausgabe 3/2019

The Journal of Obstetrics and Gynecology of India 3/2019 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.