DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20202014

Study of utilization of antenatal care services and its determinants among pregnant women admitted in a tertiary care hospital in Mangaluru, Karnataka, India

Hemant Kumar, Iybu V. Chacko, Seema Mane, Narayanan N. Govindan, Sneha Prasanth

Abstract


Background: Globally only 64% of women receive antenatal (prenatal) care four or more times throughout their pregnancy. National family health survey (NFHS) -4, brings out that in India, 21% of pregnant women utilized full ANC, ranging from 2.3-65.9% across the states. Quality health care during pregnancy and childbirth can prevent many pregnancy related deaths. The objective of the present study was to examine utilization of antenatal care services among the study subjects and find out its determinants, including out of pocket expenditure incurred on management of the pregnancies.

Methods: The study was conducted in a tertiary care teaching hospital among full term pregnant mothers and those who had recently delivered. Purposive sampling method was used and sample size of 368 was calculated.

Results: The study brought out that 100% women had their registration, 75.5% of them within 12 weeks of pregnancy. Majority of the women (69.5%) preferred private health care facility clinic for antenatal check-up. However, the utilization of various government schemes in place for the benefit of pregnant mothers were underutilized (26.6%).The study also revealed that 16.0% of the families suffered catastrophic expenditure as the cost of treatment on antenatal care and treatment went beyond household budget and they had to borrow money for the treatment.

Conclusions: A significant association was found between number of antenatal visits and increasing age, higher socio-economic status, higher educational status, Hindu religion, place of residence (urban), nuclear type of family and early registration.


Keywords


Antenatal care, Catastrophic expenditure, Early registration, Pregnancy

Full Text:

PDF

References


World Health Organization. Maternal mortality. Key facts. 2019. Available at: https://www.who.int/news-room/ fact-sheets / detail / maternal-mortality. Accessed on 22 February 2020.

UNICEF. Maternal mortality. Maternal mortality declined by 38 per cent between 2000 and 2017. Available at: https: //data.unicef.org/topic/maternal-health/maternal-mortality/. Accessed on 22 February 2020.

Maternal and Adolescent Healthcare. Annual Report -2018. Ministry of Health and Family welfare. Available at: https://mohfw.gov.in/sites/default/files /03%20ChapterAN2018-19.pdf. Accessed on 22 February 2020.

NFHS-4. Key findings. Available at: http://rchiips.org/nfhs/factsheet_nfhs-shtml. Accessed on 22 February 2020.

Rode SJ. Effect of complete antenatal care on birth weight of children in india: evidence from National family health survey (NFHS) Data. J Women's Health Care. 2018;7(1):1-12.

Ministry of Health and Family Welfare. NHM components. Quality Antenatal care. National Health mission. Government of India. Available at: http://nrhm.gov.in/nrhm‑components /rmnch‑a/ maternal‑health /background.html. Accessed on 22 February 2020.

National Family Health Survey (NHSF -4) India- 2015-16. Available at: Karnataka. https:// rural India online.org/media/ documents/National_Family _ Health_Survey_NFHS-4_2015- 16_Karnataka.pdf. Accessed on 22 February 2020.

World Health Organization. Child birth care. Available at: https://www.who.int/pmnch/ media / publications/aonsectionIII_3.pdf. Accessed on 24 February 2020.

WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization 2016. Available at: https://apps.who.int/iris/bitstream/handle/ 10665/ 250796 / 9789241549912-eng.pdf;jsessionid=8F3F7 BF9F2BA498430509 EA5B3714447? sequence=1. Accessed on 24 February 2020.

UNICEEF. Antenatal care. There are wide disparities in antenatal care across countries. Available at: https://data.unicef.org/topic/maternal-health/antenatal-care/. Accessed on 24th February 2020.

Jogia PD, Lodhiya KK. A cross sectional study for utilisation of antenatal care services and its association to birth weight of babies in a tertiary care centre in Western India. Int J Community Med Public Health. 2018;5(8):3519-25.

Roy MP, Mohan U, Singh SK, Singh VK, Srivastava AK. Determinants of utilization of antenatal care services in rural Lucknow, India. J Fam Med Primary Care. 2013;2:55-9.

Dorji T, Das M, Van den Bergh R. If we miss this chance, it's futile later on - late antenatal booking and its determinants in Bhutan: a mixed-methods study. BMC Preg Childbirth. 2019;19(1):158.

Sruthi MV, Bablu R. A cross-sectional study on utilization and content of antenatal services among pregnant women in a coastal area of Thrissur district. Int J Community Med Public Health. 2017;4(6):2094-100.

Mausumi B, Chatterjee S, Roy S, Chowdhury G. Utilization of ante natal care services and it’s determinants by women admitted in a tertiary care hospital of Kolkata. Saudi J Health Sci. 2015;4(2):92-8.

Banerjee B. Maternal care rendered at an urban health centre of a Metropolitan city. Indian J Community Med. 2006;31:183‑4.

Javali R, Wantamutte AS, Mallapur MD. Sociodemographic factors influencing utilization of Antenatal Health Care Services in a rural area - A cross-sectional study. Int J Med Sci Public Health. 2014; 3:308-12.

Sugumaran A, Subramanian R, Tharumaraj M, Vaithiyalingam S. Pattern of utilization of antenatal care services in a rural area of Tamil Nadu: acommunitybasedcross-sectionalstudy. Int J Community Med Public Health. 2019;6(5):1933-7.

Ghosh-Jerath S, Devasenapathy N, Singh A, Shankar A, Zodpey S. Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study. Reprod Health. 2015;12:20.

Jallow IK, Chou YH, Liu TL, Huang N. Women’s perception of antenatal care services in public and private clinics in the Gambia. Inter J Qual Health Care. 2012;24(6):595-600.

Angadi N, Davalgi S, Raghavendra SK. Determinants of utilization of maternity benefit schemes among mothers in urban slums of Davangere city, Karnataka, India. Int J Community Med Public Health. 2016;3(3):651-7.

Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, central Ethiopia. BMC Health Serv Res. 2013;13-256:1-10.

Qi Z, Huang ZJ, Yang S, Pan J, Smith B, Xu B. The utilization of antenatal care among rural-to-urban migrant women in Shanghai: a hospital- based cross-sectional study. BMC Public Health. 2012;12:1012.

John AE, Nilima A, Binu VS, Unnikrishnan B. Determinants of antenatal care utilization in India: a spatial evaluation of evidence for public health reforms. Public Health. 2019;66:57-64.

Kakati R, Barua K, Borah M. Factors associated with the utilization of antenatal care services in rural areas of Assam, India. Int J Community Med Public Health. 2016;3(10):2799-805.