Geographical divide led inequality in accessing maternal healthcare services between hills and valley regions of Manipur state, India

Mishra, Prem Shankar; Pautunthang, N.; Marbaniang, Strong P.; N, Anushree K.

doi:10.1016/j.cegh.2021.100744

Cited by 12 publications

(16 citation statements)

References 19 publications

(22 reference statements)

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“…Exposure to mass media among women has also significantly influenced in utilizing the early ANC visits and initiated within the first trimester of their pregnancy. Our results have also coincided with other studies 16,21 . There are regional level variations in approaching first ANC services among women and found to be the north-south divide.…”

Section: Discussionsupporting

confidence: 94%

“…Previous studies have talked a lot about the inequality in receiving ANC coverage within and between countries 13 , determinants of socio-economic inequality in maternal health care services such as ANC, institutional delivery and postnatal care [14][15][16] , multiple deprivations in utilizing maternal care services 17,18 , and examined the association between maternal care and health outcomes in India 5,19 . However, hardly any of the studies have tried to understand the socio-economic determinant and its estimates in mothers surviving by initiating the timing of the first ANC check-up in India as being home to one of the highest contributors to maternal mortality in the world 20 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inequality in time to first antenatal care visits and its predictors among pregnant women in India: an evidence from national family health survey

Tripathy

Mishra

2023

Sci Rep

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For countries with high maternal mortality and morbidity, on-time initiation of antenatal care (ANC) is indispensable. Therefore this paper aims for studying the median survival time (MST) of first ANC among pregnant women as well as understanding the contextual factors that influence a mother’s decision to access ANC services in India. The study used cross-sectional survey data obtained from the NFHS-4 conducted in 2015–2016. The MST of the timing of the first ANC visit was estimated using the Kaplan-Meir estimate. A multivariate Cox-proportional hazard regression model was used to identify the factors related to the timing of the first ANC visit with a 95% confidence interval (CI). Overall at least one ANC checkup was assessed by 60.15% of women and the median survival time for the first ANC checkup was found to be 4 months. Early initiation of ANC in pregnant women increased by 37% (AHR: 1.37, CI:1.34–1.39) for primary education, and 88% (AHR:1.88, CI:1.86–1.90) for secondary education compared to women having no formal education. Results of the current study revealed that the median survival time of the first ANC visit was 4 months in India which is delayed compared to recommendations of WHO. Therefore boosting the access and utilization of antenatal care coverage among pregnant women can ensure the best health outcomes for their pregnancy.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Inequality in time to first antenatal care visits and its predictors among pregnant women in India: an evidence from national family health survey

Tripathy

Mishra

2023

Sci Rep

Self Cite

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“…In both industrialized and developing nations, a large body of literature has documented the disproportionate usage of maternal health care services among women of various socioeconomic levels, and rural-urban residences [ 14 – 17 ]. Women from higher socioeconomic classes are more likely to utilize healthcare facilities, and over the years, the economic inequality in the use of healthcare services has widen [ 18 – 20 ]. Despite overwhelming evidence of geographical and economic disparities in maternal health, not much Information is available on the urban–rural differences in maternal health care services.…”

Section: Introductionmentioning

confidence: 99%

Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa

2021

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Background There has been a substantial improvement in reducing maternal mortality in the Sub-Saharan African region. The vast rural-urban gap in maternal health outcomes, however, is obscured by this average achievement. This study attempts to measure the contribution of identified risk factors to describe the average rural-urban difference in the use of antenatal care, health facilities for delivery, and health professional assistance at delivery. Method To achieve this objective, we used descriptive analysis and Fairlie non-linear decomposition method to quantify covariates’ contribution in explaining the urban–rural difference in maternal healthcare services utilisation. Result The study’s finding shows much difference between urban and rural areas in the use of maternal healthcare services. Socio-economic factors such as household wealth index, exposure to media, and educational level of women and their husbands/partners contributed the most in explaining the gap between urban and rural areas in healthcare services utilisation. Conclusions Interventions to bridge the gap between urban and rural areas in maternal healthcare services utilisation in Sub-Saharan Africa should be centred towards socio-economic empowerment. Government can enforce targeted awareness campaigns to encourage women in rural communities in Sub-Sharan Africa to take the opportunity and use the available maternal health care services to be at par with their counterparts in urban areas.

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“…This means that public transport has a great impact on the spatial accessibility of healthcare services [ 32 ]. The low accessibility of public healthcare services is due to inadequate infrastructure construction [ 33 , 34 , 35 ]. As one of the central cities of China, Wuhan implemented the referral system earlier than others, and its public healthcare resources are concentrated in the Metropolitan Development Zone.…”

Section: Introductionmentioning

confidence: 99%

The Effect of the Referral System on the Accessibility of Healthcare Services: A Case Study of the Wuhan Metropolitan Development Zone

Chen

2022

IJERPH

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The geographical accessibility of public healthcare institutions is the key factor affecting the equity of healthcare services. Based on the hierarchical medical system and referral system in China, we analyzed the referral accessibility of hospitals in the Wuhan Metropolitan Development Zone. Before the implementation of the referral system, only 7.91% of the total communities met the accessibility standard for secondary and tertiary hospitals, which meant that there was significant inequality in high-level healthcare. Moreover, 5.4% of the total communities did not meet the accessibility standard for primary hospitals, which meant that there were insufficient primary hospitals. After the implementation of the referral system, the proportions of communities meeting the accessibility standards for the first-stage referral, second-stage referral and cross-level referral were 92.6%, 99.9% and 98.3%, respectively. The results show that the referral system has improved the accessibility of healthcare, but it has not completely solved healthcare inequality. The first-stage referral accessibility of healthcare services in the northern, western and eastern groups does not meet the accessibility standard, which is due to the inefficient layout of secondary hospitals. The Wuhan government should construct secondary hospitals in these groups and primary hospitals in the central urban area and the southeastern, southern, western and eastern groups.

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Geographical divide led inequality in accessing maternal healthcare services between hills and valley regions of Manipur state, India

Cited by 12 publications

References 19 publications

Inequality in time to first antenatal care visits and its predictors among pregnant women in India: an evidence from national family health survey

Inequality in time to first antenatal care visits and its predictors among pregnant women in India: an evidence from national family health survey

Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa

The Effect of the Referral System on the Accessibility of Healthcare Services: A Case Study of the Wuhan Metropolitan Development Zone

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