Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Prusty, Ranjan Kumar; Gouda, Jitendra; Pradhan, Manas Ranjan

doi:10.1155/2015/531485

Cited by 25 publications

(21 citation statements)

References 17 publications

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“…For example, in the year 2011, women in the age group 20–29, 30–39 and 40–49 were nearly twice (OR = 1.972(95% CI = 1.220–3.188), (OR = 2.303 (95% CI = 1.352–3.922) and (OR = 2.299 (95% CI = 1.238–4.272) more likely to uptake the skilled delivery care than those in the age group 15–19. This is consistent with the results from other studies [ 7 , 24 , 25 , 26 , 27 ]. The finding that older women in Ethiopia had higher odds of skilled assistance during delivery could be attributed to the better awareness of availability and accessibility of such services.…”

Section: Resultssupporting

confidence: 94%

“…Similar gradient is observed in 2005. Similar finding was also observed in other studies [ 7 , 10 , 15 , 25 , 26 , 28 ]. However, the finding that older aged women have higher odds of uptake of skilled delivery care services and on the other women of higher birth order have lower odds of uptake of such services was surprising since higher birth order women who would generally be older were less likely to seek these services than women of first order birth who would generally be younger.…”

Section: Resultssupporting

confidence: 92%

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Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys

et al. 2017

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Despite evidence that social contexts are key determinants of health, research into factors associated with maternal health service utilization in Ethiopia has often focused on individual and household factors. The downside is that this underestimates the importance of taking contextual factors into account when planning appropriate interventions in promoting safe motherhood in the country. The purpose of this study is to fill this knowledge gap drawing attention to the largely unexplored contextual factors affecting the uptake of skilled attendance at delivery in a nationally representative sample. Data for the study comes from two rounds of the Ethiopian Demographic and Health Surveys (EDHS) conducted in the year 2005 and 2011. Analysis was done using a two-level multivariable multilevel logistic regression model with data from 14, 242 women who had a live birth in the five years preceding the surveys clustered within 540 (in the year 2005) and 624 (in the year 2011) communities. The results of the study point to multiple levels of measured and unmeasured factors affecting the uptake of skilled delivery care in the country. At community level, place of residence, community level of female education and fertility significantly predict the uptake of skilled delivery care. At individual and household level, maternal age, birth order, maternal education, household wealth and access to media predict the uptake of such service. Thus, there is a need to consider community contexts in the design of maternal health programs and employ multi-sectorial approach to addressing barriers at different levels. For example, improving access and availability of skilled delivery care should eventually enhance the uptake of such services at community level in Ethiopia. At individual level, efforts to promote the uptake of such services should constitute targeted interventions paying special attention to the needs of the youth, the multiparous, the less educated and women in the poorest households.

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Section: Resultssupporting

confidence: 94%

Section: Resultssupporting

confidence: 92%

Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys

et al. 2017

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“…Rural residence in this finding of the study was a hindering factor to the non-use of skilled birth attendants during delivery in Ghana. This finding is consistent with previous studies conducted in India, Sudan and Tanzania [16,19,38] which reported greater use of skilled birth attendants during delivery among urban mothers than rural mothers. This may be due to the fact that women in the rural settlement may not access skilled birth attendants due to lack of health facilities.…”

Section: Discussionsupporting

confidence: 92%

“…Studies conducted in low and middleincome countries show wide gaps in skilled birth delivery. Findings from these studies had shown that wealth, women and husband's educational levels were significantly associated with skilled birth delivery [18][19][20]. For example in Namibia, the concentration index and curve showed that wealth-related inequities were statistically significant in skilled delivery to the benefit of women from economically better-off households.…”

Section: P a G Ementioning

confidence: 99%

Socioeconomic Inequalities in Access to Skilled Birth Attendants During Childbirth in Ghana: A Decomposition Analysis

Kpodotsi¹,

Baku²,

Adam³

et al. 2020

Preprint

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Background: Equitable access to, and use of skilled birth attendance during delivery is vital for the achievement of the Sustainable Development Goals (SDGs) in reducing global maternal deaths to 70 deaths per 100, 000. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequities in the use of skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assessed the socioeconomic inequalities related to the use of skilled birth attendants during delivery in Ghana.Methods: This study analyzed data from the 2014 Ghana Demographic and Health Survey (GDHS). Concentration index (CI) and concentration curves (CC) were employed to measure the magnitude of socioeconomic inequality in the use of skilled birth attendants during child delivery. The concentration index was decomposed to identify the underlying factors driving the inequalities.Results: Out of a total of the 1,305 women who gave birth in the year prior to the interview, 28% of the deliveries had no skilled birth attendants of which 60% lives in rural compared to 40% in urban. A concentration index of 0.147 showed a pro-rich utilization of skilled birth attendance during delivery. The decomposition analysis revealed that wealth, education and location of residence were the major contributors to socioeconomic inequalities in the use of skilled birth attendants during child delivery among Ghanaian women.Conclusion: This study suggests that factors such as wealth, area of residence and education are worthy of increased attention and policy interventions because they are amenable to the reduction of observed inequality.

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“…The present study is the first of its kind which assessed the maternal healthcare service provision from human rights perspective in Odishaan infamous state for its high maternal morbidity and mortality in India. 5,24 The other novelty of this study is that, it included respondents from three differently managed i.e. public, private and public-private partnerships health facilities to have a comparative assessment with reference to their experience during childbirth.…”

Section: Discussionmentioning

confidence: 99%

How respectfully women are treated during difficult phase like childbirth? A primary survey of differently-managed health facilities in Odisha, India

Gouda

Shekhar

2020

Clinical Epidemiology and Global Health

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Objective: The study was explorative in nature, implemented at hospital level to investigate how respectfully women are treated while accessing delivery care in the health facilities. Methods: A total of 115 differently-managed i.e. public, private and public-private partnerships (PPP) health facilities in Ganjam and Kandhamal districts of Odisha were selected to undertake this study. Three women each having given childbirth in the last six months preceding the survey in the sampled 115 health facilities were selected randomly to participate in the study. Results: The result presented a distinct picture wherein provision of respectful maternity care is not uniform for all the respondents included in the study. Management of the health facility remained as the major transpiring factor to providing respectful maternity care. Public health facility (ATT: 5.503) -which happened to be the largest service provider in the study population, affects respectful maternity care adversely. Contrary to this, women having accessed delivery care from the PPP facilities received more respectful maternity care. The private facilities whose number is mushrooming alarmingly at the present time also fails to provide the needed respectful maternity care to women during their difficult phase like childbirth. Conclusion: Women's memory of birth experience including any disrespectful and abusive care stays with her lifetime and affects her physical and emotional health. It may also discourage her to have institutional deliveryby which, opportunities may be lost to diagnose morbidities early that are associated with pregnancy and childbirth.

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Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Cited by 25 publications

References 17 publications

Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys

Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys

Socioeconomic Inequalities in Access to Skilled Birth Attendants During Childbirth in Ghana: A Decomposition Analysis

How respectfully women are treated during difficult phase like childbirth? A primary survey of differently-managed health facilities in Odisha, India

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