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IJHSR. 2016; 6(8): 291-300


Predictors of Utilization of Maternal and Child Health Services in India: An Analysis of District-Level Information.

Rahul Srivastava, Sonam Bedi.

Abstract
Background: India has been observing high maternal mortality due to pregnancy complications. Apart from the availability of health care facilities, many women and children are deprived of these facilities.
Objectives: To assess the contribution of some of the key factors to the utilization of maternal and child health (MCH) services in India.
Data and Methods: The data of District Level Household & Facility Survey (DLHS-3) was utilized. The four components for MCH utilization at the district level e.g. practice of modern methods of contraception; antenatal care (ANC), institutional deliveries and immunization status of children were considered as the outcome variables. Binary logistic regression analysis was carried to identify the level of contribution of each of the predictors on the outcome variables.
Results: For the contraceptive practices three ANC visits, unmet need emerged as the major contributors. The ANC seeking behavior of women is significantly affected by wealth quintile, birth order, JSY beneficiaries and PHC functioning 24 hours; female literacy having the highest influence. For institutional delivery, wealth quintile, ANC visits, and birth order emerged as the significant contributors. Immunization status was significantly predicted by the female literacy status, ANC taken and birth order. The sensitivity and specificity varied from 74% to 90%; showing a very high predictive ability of the significant predictors to assess the district level performance of MCH.
Conclusion: Study highlights that participation of the community as a whole may bring substantial changes; suggesting the need and scope for information, education and communication (IEC), with a special focus in states with poor performing districts with poor literacy and wealth quintiles for sustenance and further improvisation of MCH service utilization.

Key words: Maternal and Child Health, Institutional deliveries, Unmet need.



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