Indian Journal of Public Health Research & Development

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Determinants of Institutional Delivery in Rural Uttar Pradesh: Choice of Delivery Location


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1 International Institute for Population Sciences, GS Road, Deonar, Mumbai, India
     

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Access to quality care during pregnancy and especially at delivery seems to be the crucial factor in explaining the disparity in maternal health status. The choice of place of delivery has consistently been found to be associated with maternal and neonatal outcomes. The objective of the present paper is to understand the determinants of delivery location-institutional (public or private) and home; and reasons for non-utilization of facility for delivery care. The District Level Household Survey (2002-04) data for Rural Uttar Pradesh have been used, adopting the conceptual framework of Andersen Behavioural Model. A multinomial Logistic regression analysis was conducted to assess the determinants of home, public and private facilities for delivery. Most of the delivery had taken place at home, with public and private sector accounting for only seven percent and nine percent respectively. Women with higher birth order and those residing far from Primary health centres had greater odds of delivering at home than public facility, while maternal education, Antenatal care visits, regions and pregnancy complications are the significant predictor of institutional delivery. The results indicate that, after controlling for other variables access to health facilities do not have much effect on choice of public facility over home/private. Regional analysis showed significant differentials in reasons for not delivering at health facility. Given the predominance of home deliveries in the rural Uttar Pradesh, every attempt should be made to ensure that these are attended by trained birth attendants.

Keywords

Determinants, Location of delivery, Public, Private
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  • Andersen, RM. Revisiting the Behavioral Model and Access to Medical Care: Does it Matter? Journal of Health and Social Behaviour, 1995; 36(1):1-10.

  • Faundes A, Rosenfield A ,Pinotti JA. Maternity care in developing countries: relevance of new technological advances. Int J Gynecol Obstet, 1988; 24:103-109.

  • Population Policy of Uttar Pradesh. Department of health and Family Welfare. Government of Uttar Pradesh; 2000.

  • Stephenson R, Tsui AO. Contextual influences on reproductive wellness in northern India. Am J Public Health. 2003; 93(11):1820–1829.

  • Stephenson R, Tsui AO. Contextual influences on reproductive health service use in Uttar Pradesh. Studies in Family Planning. 2002; 33(4):309-320.

  • Tsu VD. Antenatal screening: its use in assessing obstetric risk factors in Zimbabwe. J Epidemiol Community Health. 1994;48:297–305

  • Jejeebhoy SJ, Rao SR. Unsafe Motherhood: A Review of Reproductive Health. In: Das Gupta M, Chen LC, Krishnan TN, eds. Women’s Health in India: Risk and Vulnerability. Bombay, India: Oxford University Press; 1995

  • Sheriff A, Singh G. Determinant of Maternal health Care Utilization in India: Evidences from a Recent Household Survey. Working Paper Series No. 85, NCAER, New Delhi; 2002.

  • Rahman, MH, Mosley WH, Ahmed, S, Akhter, HH. Does service accessibility reduce socioeconomic differentials in maternity care seeking? Evidence from rural Bangladesh. Journal of Biosocial Science. 2008; 40: 19-33.

  • Bhatia, J, Cleland, J. Determinants of maternal care in a region of South India. Health Transition Review, 1995; 5:127-142.

  • Magadi, MA, Madise, NJ,Rodrigues, RN. Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities. Soc Sci Med, 2000;51: 551-561.

  • Bloom,,S, Lippeveld,T ,Wypij,D. Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India, Health Policy & Planning. 1999; 14(1):38-48.

  • International Institute for Population Sciences. District level Household Survey: Uttar Pradesh. (2002-04). International Institute for Population Sciences, Mumbai.2007.

  • International Institute for Population Sciences (IIPS), Macro International. National Family Health Survey (NFHS-3), 2005–06: India: Volume II. Mumbai: IIPS, 2007.

  • Navaneetham K, Dharmalingam A. Utilization of maternal health care services in Southern India. Soc Sci Med, 2002; 55(10):1849-1869.


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  • Determinants of Institutional Delivery in Rural Uttar Pradesh: Choice of Delivery Location

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Authors

Neelanjana Pandey
International Institute for Population Sciences, GS Road, Deonar, Mumbai, India

Abstract


Access to quality care during pregnancy and especially at delivery seems to be the crucial factor in explaining the disparity in maternal health status. The choice of place of delivery has consistently been found to be associated with maternal and neonatal outcomes. The objective of the present paper is to understand the determinants of delivery location-institutional (public or private) and home; and reasons for non-utilization of facility for delivery care. The District Level Household Survey (2002-04) data for Rural Uttar Pradesh have been used, adopting the conceptual framework of Andersen Behavioural Model. A multinomial Logistic regression analysis was conducted to assess the determinants of home, public and private facilities for delivery. Most of the delivery had taken place at home, with public and private sector accounting for only seven percent and nine percent respectively. Women with higher birth order and those residing far from Primary health centres had greater odds of delivering at home than public facility, while maternal education, Antenatal care visits, regions and pregnancy complications are the significant predictor of institutional delivery. The results indicate that, after controlling for other variables access to health facilities do not have much effect on choice of public facility over home/private. Regional analysis showed significant differentials in reasons for not delivering at health facility. Given the predominance of home deliveries in the rural Uttar Pradesh, every attempt should be made to ensure that these are attended by trained birth attendants.

Keywords


Determinants, Location of delivery, Public, Private

References