Search

Introduction: Most maternal deaths are preventable because there are proven medical procedures to prevent, diagnose, and treat problems. Basic maternal services help reduce and manage pregnancy complications and reduce preventable deaths. Aim and Objective: To assess the quality and extent of maternal and infant health services provided. Material and Methods: The present cross-sectional study was conducted by the Department of Community Medicine, GSVM Medical College Kanpur, using a multistage random sample including women with children less than one year of age and infants (less than one year of age) born to these women in rural blocks of Kanpur Nagar district to assess maternal and infant care services from February 2021 to September 2022. Results: Weight and height were measured in 86.58% of participants, abdominal examination was performed in 81.52% of participants, and blood pressure was checked in 86.84% of participants. Hb test was done in 91.65% participants, urine test for proteinuria was done in 28.35% participants, majority of the study participants received counseling on danger signs (79.49%), dietary counseling (86.58%), newborn care (94.43%), family planning (87.84%). Similar results to NFHS-5 in rural Uttar Pradesh were found in previous published research. Conclusion: The percentage of 4 ANC visits was found to be low in the present study along with low consumption of iron and folic acid. [ABSTRACT FROM AUTHOR]

Introduction: The birth of a baby through the vaginal route is a traditional way of delivery. But, at times normal vaginal delivery is not desirable due to various reasons. Under such circumstances, Lower section caesarean section (LSCS) is carried out to deliver the baby safely. There are rising concerns about the increasing rate of caesarean sections with wide variations in rates across the globe. Factors that influence the decision to perform a LSCS are often complex and multifactorial. Understanding these complexities is one of many steps to help stop the rise of any unnecessary LSCSs or prevent their overuse. Aim: To find out factors influencing the choice of caesarean delivery among recently delivered mothers through caesarean section and within puerperium. Method: A cross-sectional survey using pretested, self-administered, semistructured questionnaire was done between December 2022 to February 2023 among patients recently delivered through caesarean section and within puerperium. Result: A total of 250 participants were approached over a three-month period. Among them, 211 completed the survey. The majority of participants were in the age group 25 to 30 years, Hindu by religion, and residents of rural areas. Sixty-four participants perceived that LSCS was done for the safety of the baby. Educational status (p<0.001), place of previous delivery (p<0.001), and count of current LSCS (p=0.016) were the factors associated with caesarean delivery satisfaction and it was found to be statistically significant. Conclusion: About one-third of the participants perceived that LSCS was done for the safety of the baby. The majority of participants were satisfied with the decision of LSCS. [ABSTRACT FROM AUTHOR]

Context: Antenatal care (ANC) effectively reduces infant and maternal mortality rates mainly by promoting institutional deliveries. In view of this, the Government of India introduced Janani Suraksha Yojna (JSY) in 2005 and Janani Shishu Suraksha Karyakram (JSSK) in 2011. Aims: To estimate the proportion of home and institutional deliveries in the district, assess the impact of JSK and JSSY on institutional deliveries, and identify the different intranatal care providers. Settings and Design: This cross-sectional study was conducted in the Gaya district, Bihar. A total of 657 females of the reproductive age group (15-49 years) were included in the study. Methods and Material: Predesigned, pre-tested & semi-structured questionnaire was used to collect information on place of delivery, type of delivery, knowledge regarding JSY and JSSK schemes and source of information. Statistical analysis used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods. Results: Out of 519 deliveries, 63% were institutional and 37% were home deliveries. About 91 and 11.4% of respondents were aware of JSY and JSSK schemes. There was a significant association between those who opted for institutional delivery and awareness regarding JSY and JSSK services. Conclusion: Despite awareness and running of various government programs, the percentage of institutional deliveries is still less. An increase in institutional deliveries at primary care level through JSY and JSSK will not only decrease the out of pocket expenditure of the population but also help build faith in the government health facilities. [ABSTRACT FROM AUTHOR]

Background: Emergency Obstetrics care is an integrated strategy developed by the WHO, UNFPA and UNICEF that aims to equip health facilities with the capacity to provide evidence based, cost effective interventions to attend the leading causes of maternal mortality. Methods: A community based cross sectional study was conducted between April 2019 - July 2020. A total of 201 women who delivered in the last 6 months and had complications during their pregnancy were interviewed to find out accessibility and quality emergency obstetric Care (EmOC) services. Facility assessment was also done at two health facilities of Chiraigaon block for the assessment EmOC. Results: Findings show that only 41.8% respondents were able to reach the government health facilities in less than half-an-hour. Out of the total respondents who utilized government health facilities for EmOC, only 19% were attended by the health providers within 1 hour. Conclusion: Low percentage of respondents with complications were reaching the health facility within 30 minutes. Therefore, there is a strong need for strengthening of basic EmOC services at health facilities. [ABSTRACT FROM AUTHOR]

Background: Kangaroo Mother Care (KMC) is early, continuous and prolonged skin-to-skin contact between mother and baby, with exclusive breastfeeding. Besides preterm and low birth weight babies, even full-term healthy newborns benefit from KMC. Objective: to assess awareness and experience of KMC for full-term newborns among newly delivered mothers in a rural maternity hospital. Methods: Interventional study with interview schedule to capture awareness of KMC (25 scored items). After one hour of practicing KMC, post-intervention assessment of KMC experience (23 scored items) was done. Bivariate analysis performed to associate awareness and experience of KMC with socio-demographic and obstetric variables. Results: The 100 mothers in our study had low median KMC awareness score of 4(IQR=2,8) and were unaware of benefits of KMC. Median KMC experience score was 21(IQR=19,22), indicating highly positive experience. Mothers reported feeling happy or relaxed, found it easier to breastfeed, easy to practice KMC, and wanted to continue KMC at home. Mothers with caesarean section were more likely to experience abdominal or back pain during KMC (P=0.037) and mothers with previous abortion/stillbirth were more likely to have fear of suffocating the baby during KMC (P=0.005). Conclusion: Though awareness of KMC was found to be low, overall experience of KMC was very positive. Mothers should be educated about benefits of KMC and given an opportunity to practice KMC in hospital. Full-term healthy newborns and their mothers should not be denied the numerous advantages of KMC. There is need to create KMC-friendly hospital culture and promote KMC for all newborns. [ABSTRACT FROM AUTHOR]

Background: The Mother and Child Tracking System (MCTS) portal captures and tracks all pregnant women right from conception up to 42 days after delivery and all children below five years. Objectives: This study was conducted to find out the technical, behavioral and organizational factors that affect the process and performance of MCTS. Material and Methods: This was an exploratory qualitative study conducted in Varanasi district by using multistage random sampling method. Data were collected by in-depth interviews of 48 health care providers. Results: Majority of the ANMs and ASHAs were not aware of the meaning of "Tracking System" and the use of MCTS ID. Inappropriate training of ASHAs, absence of supervision and monitoring by ANMs, overburdened DEOs and ANMs, poor internet connection, slow server speed, software problem and frequent power failures were identified as major factors for poor performance of MCTS. Conclusion: The most effective measure to improve the performance of MCTS would be to properly train grass root level workers so that more efficient data can be fed into MCTS. [ABSTRACT FROM AUTHOR]

Background: Indian Public Health Standards (IPHS) evaluates supply side compliance of Primary Health Centers (PHCs). Patient Satisfaction (PS) on the other hand, assesses the demand side. Objective: Examining the supply side compliance and relating it to PS in the domain of Reproductive Health (RH). Methods: Using multistage stratified sampling, six rural and three urban PHCs in sub-districts, Ramanagara and Channapatna, in District Ramanagara, state of Karnataka, India, were chosen. Information collected using IPHS proforma for PHCs was compared with PS questionnaire (PSQ 18) data, collected from 398 patients visiting these facilities. Results: Using descriptive and inferential analysis, sub-optimal compliance levels in ease of access, physical & human infrastructure, patient data and usage of untied funds was found. Existing behavioral compliance was found to be optimal. These findings were in alignment with PS findings. Conclusion: Results call for PHC capacity building, incentivization and a crucial need to look into PS side, before passing judgement about performance standard. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality and morbidity continues to remain high in India, despite the existence of successive national programs for improving maternal and child health since the 1980s. In 2005, the Government of India launched the National Rural Health Mission to provide accessible, affordable and quality health care to the rural population, especially the vulnerable populations. Reduction in MMR to 100/100,000 is one of its goals and the Janani Suraksha Yojana is the key strategy to achieve this reduction. But the awareness of scheme is low in women from rural areas and urban slums, especially in low performing states. Aims: To study the comparative awareness of JSY and the socio-demographic factors influencing it, among the recently delivered women (RDWs). Methodology: A community based cross-sectional study was carried out in the ten rural areas and urban slums coming under the practice areas of JNMC, AMU, Aligarh for a period of one year. The prevalence of institutional delivery in Uttar Pradesh as found in a study by UNFPA 2008 (50.2%) was used for calculation of sample size. The yielded sample size 300 was selected proportionately from these areas. The study subjects were interviewed by a pre-designed and pre-tested questionnaire. Statistical analysis used: MS excel, chi square and logistic regression. Results: Awareness regarding the existence of a monetary scheme related to institutional delivery was more in rural areas i.e 75%. Regarding components of JSY maximum people (78%) were aware about the cash component. Religion, caste, parity, socio-economic status and place of residence showed a significant statistical association with the level of awareness of JSY. Conclusions: There is an urgent need to strengthen IEC campaigns and monitoring strategies for JSY as well as regularize the monetary flow for the health workers [ABSTRACT FROM AUTHOR]

Background: The delivery of health education through mobile phones either through voice calls or text messages (mHealth) provide valuable opportunities for bridging gaps in maternal and child healthcare in resource constrained settings. Aims & Objectives: The objective of the present study was to assess willingness to receive m-Health services among women caregivers of under-5 children. Material & Methods: We conducted a cross sectional study in an urban resettlement colony of North East District of Delhi during the period from September' 2016 to Feb' 2017. We enrolled 201 adult women up to 35 years of age who were active caregiver of at-least one under 5 child in their familial household. Results: The mean age of the women was 26.4 and mean years of schooling was 10.1 years. Nearly three-fourth (73.2%) could read text messages (SMS) while more than a third (36.8%) were using mobile internet services. The willingness to receive mHealth services for health promotion was affirmed by 157 (78.2%) subjects but it was significantly lower in women with low educational attainment. Conclusion: There exists a strong unmet need for mHealth services among young women caregivers of under 5 children. However, bridging the digital divide is a key challenge towards advancing mHealth for all. [ABSTRACT FROM AUTHOR]

Background: Despite increase in accessibility and utilization of maternal health services in the state of Telangana, penetration of these services in vulnerable communities is inadequate. Aims & Objectives: To understand the determinants of utilization of reproductive health services by migrant population living in non-notified slums of Hyderabad city in the Indian state of Telangana. Material & Methods: It is a community based cross sectional study of 761 rural to urban internal migrant mothers with a child of less than 2 years of age residing for a period minimum of 30 days and not more than 10 years. Information was collected for socio demographic details, antenatal care and child delivery. Results: Mothers receiving at least 4 antenatal care visits and institutional deliveries in migrants was 69.6% and 69% respectively, compared to 85.8% and 97% in general population of Hyderabad city. The likelihood of mothers receiving adequate care is 6.7 times higher in mothers with secondary education compared to formal education. The likelihood of institutional delivery is 7.8 times higher in mothers availing adequate antenatal care versus inadequate care and 2.2 times higher in mothers with secondary education versus formal education. Conclusion: Utilization of antenatal care services and promotion of institutional deliveries can be improved by acting on the supply side barriers such as health care infrastructure and demand side barriers such as indirect consumer costs, financial constraints and community engagement. [ABSTRACT FROM AUTHOR]

Background: Low use of maternal care services is one of the reasons why child mortality and maternal mortality is still considerably high in India. Most maternal deaths are preventable if mothers receive essential health care before, during, and after childbirth. In India, the eight socioeconomically backward states referred to as the Empowered Action Group (EAG) states; lag behind in the demographic transition and low utilization of maternal health care services. Addressing the maternity care needs of women may have considerable ramifications for achieving the Millennium Development Goal (MDG - 5). Aims & Objectives: To explore the prevalence, trends and factors associated with the utilization of maternal care services in Empowered Action Group States, India (1990-2006). Material Methods: Data from three rounds of the round of the Demographic and Health Survey (DHS), known as the National Family Health Survey (NFHS) of India were analyzed. Bivariate and multivariate-pooled logistic regression model were applied to examine the utilization of the maternal and child health care trends over time. Result: The results from analysis indicate that the full ANC and skilled birth attendant (SBA) has increased from 17% and 20% to 25% and 35% respectively during the last one and half decade (1990-2006). Conclusion: Various socioeconomic and demographic factors are associated with the utilization of maternal care services in EAG states, India. Promoting the use of family planning, female education, targeting vulnerable groups such as poor, illiterate, high parity women, involving media and grass root level workers and collaboration between community leaders and health care system could be some important policy level interventions to address the unmet need of maternal and child health care services among women. The study concludes that much of these differentials are social constructs that can be reduced by prioritizing the needs of the disadvantaged and adopting appropriate policy change options in EAG states in India [ABSTRACT FROM AUTHOR]

Background: India continues to face challenges in improving key maternal health indicators with about 1/3rd of global maternal deaths happening in India. Utilization of health care services is an important issue in India with significant proportion of home deliveries and majority of mothers not receiving adequate antenatal care. Mortality among poor rural women is the highest with lowest utilization. To make maternal healthcare more equitable, numerous schemes such as Janani Suraksha Yojana, Chiranjeevi Yojana, Kasturba Poshan Sahay Yojana have been introduced. Studies suggest that utilization of such schemes by target population is low and there is a need to understand factors affecting maternal health care utilization in the context of these schemes. Current community based study was done in rural Gujarat to understand characteristics of women who utilize such schemes and predictors of utilization. Methodology: Data collection was done in two districts of Gujarat from June to August, 2013 as a pilot phase of MATIND project. Community based cross-sectional study included 827 households and socio-demographic details of 1454 women of 15-49 years age groups were collected. 265 mothers, who had delivered after 1st January, 2013 are included in the regression analyses. The data analysis carried out with R version 3.0.1 software. Results: The analysis indicates socioeconomic variables such as caste, maternal variables such as education and health system variables such as use of government facility are important predictors of maternal health scheme utilization. Results suggest that socioeconomic and health system factors are the best predictors for availing scheme. Conclusion: Health system variables along with individual level variables are important predictors for availing maternal health schemes. The study indicates the need to examine all levels of predictors for utilizing government health schemes to maximize the benefit for underserved populations such as poor rural mothers. [ABSTRACT FROM AUTHOR]

Introduction: JSY is a safe motherhood intervention and modified alternative of the National Maternity Benefit Scheme (NMBS).It was launched on 12th April 2005 by the Honorable Prime Minister. JSY has been implemented in all states and UTs with special focus on low performing states under the National Rural Health Mission (NRHM) with objective to reduce maternal, neo-natal mortality and promote institutional delivery among pregnant women of rural and urban areas and it is integrated with cash monetary help to pregnant women. Objective: To evaluate antenatal and post natal care services provided under JSY at different health care settings & to know the client suggestions for improvement in JSY. Methodology: this is a health care institute based observational cross sectional study including randomly selected 200 JSY beneficiary mothers from the different health care settings i.e. PHC,CHC,DH & Medical College Hospital; of Rewa Distt, M.P. Data was collected with the help of set proforma & then analyzed with applying epi info 2000.Chi square test was applied appropriately. Results: in case of ANC services provided at different health care settings it was observed that services were provided among more numbers of mothers at higher centers in comparison of PHC & CHC. The distribution of ANC provided to the beneficiary mothers among different health care settings was found to be statistically significant (X2 =17.24, p=0.002), similarly postnatal services were also provided among more numbers of mothers at Higher centers. 120 (60%) mothers suggested that there should be provision of other services i.e. Diet, tonics, and medicines during or after hospital stay along with cash benefit for better utilization of JSY. [ABSTRACT FROM AUTHOR]