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Utilization of Quality Source of Prenatal-Care in India: An Evidence from IDHS

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Abstract

India is committed to Millennium Development Goals regarding prenatal health but still the utilization of quality source of prenatal-care is lacking. In this paper an attempt has been made to examine the socioeconomic determinants of utilization of quality source of prenatal-care by the women in the age group of 15–49 years. Micro data having 25,896 observations from Indian Demographic Health Survey 2006 has been used. Binary logistic regression analysis is utilized to determine the association between the utilization of quality source of prenatal-care and explanatory variables categorized into demographic, socioeconomic, health and regional characteristics. Quality source of prenatal-care is defined as the prenatal-care taken from medical expert. The results have shown that age of woman at first marriage, husband’s age, woman’s education, husband’s education, final say on woman’s health-care by woman and husband collectively and husband alone, wealth index, female head of household, ever terminated pregnancy, household covered by insurance and husband’s presence during prenatal visits increase the probability of utilization of quality source of prenatal-care. However, the combined family structure, birth-order of the child and living of the household in the town as compared the capital and large city decrease the probability of utilization of quality source of prenatal-care by Indian women. The implementation of law of minimum age for marriage, expansion in maternal health insurance, participation of husband in prenatal-care are proposed for enhancing the utilization of quality source of prenatal-care.

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Notes

  1. See for instance, number of visits (Beeckman et al. 2010; Ye et al. 2010; Tran et al. 2011, 2012; Habibov 2011), the prenatal-care services taken from medical specialist (Titlay et al. 2010; Beeckman et al. 2010; Alemayehu et al. 2010; Sadiq et al. 2011), initiation of prenatal care at proper time (Ye et al. 2010; Tran et al. 2011, 2012; Habibov 2011), prenatal-care services provided by health-care providers (Sarkar et al. 2010; Nyemtema et al. 2012; Tran et al. 2012), parameters/components of prenatal-care (Yousaf et al. 2010; Sarkar et al. 2010; Nyemtema et al. 2012), index of quality of prenatal-care (Lavado et al. 2010), adequate use: early first visit, sufficient number of visits and all core services (Tran et al. 2012).

  2. The number of visits is diverse and not evidence-based. There is no consensus about the optimal number of visits. For instance, it ranges from a minimum of 6 in the Netherlands to 15 in Finland. In Belgium 10 visits for primiparae and about 7 for multiparae are advised. In the developing economies, 3 and 4 prenatal visits are advised in Indonesia and Vietnam respectively. In India only 3 visits are proposed by Reproductive and Child Health Program.

  3. Barber (2006) evidenced that women who receive care from medical doctors take more prenatal care items than those who receive care from nurse, midwife and traditional health-care providers (see also Barber et al. 2007; Lavado et al. 2010).

  4. Although the components of prenatal-care are important from the quality as well as policy perspectives.

  5. At the time of publication of this article possibly the time to achieve the target would have been reached so the recommendation of this paper would not be able to contribute to achieve the target. However, as a number of studies have forecasted and figures of maternal mortality ratio express, the target would not be achieved and further time frame would be required. So the policy proposals from this research may be helpful for the next target in a new time frame.

  6. If a woman received prenatal-care from more than one type of health providers, only the provider with the highest qualification has been taken.

  7. All these factors are demand side factors while the supply side aspect is equally important. Not only the proper supply of quality of prenatal-care but also at reasonable and affordable rate.

  8. All the variables included in this analysis are demand side variables based on Newman’s demand for health model. The supply side variables like distance from home to medical expert, numbers of hospitals and numbers of doctors are equally important for utilization of quality source of prenatal-care.

  9. It supports the notion that economic growth with not increasing in inequality at the national level is directly related with the maternal health of the women.

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Authors and Affiliations

  1. Department of Economics, Islamia University of Bahawalpur, Bahawalpur, Pakistan

    Rana Ejaz Ali Khan

  2. Center for Business and Economics Research, Institute of Business Administration, Karachi, Pakistan

    Muhammad Ali Raza

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  1. Rana Ejaz Ali Khan
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  2. Muhammad Ali Raza
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Correspondence to Rana Ejaz Ali Khan.

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Khan, R.E.A., Raza, M.A. Utilization of Quality Source of Prenatal-Care in India: An Evidence from IDHS. Soc Indic Res 131, 1163–1178 (2017). https://doi.org/10.1007/s11205-016-1286-5

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