PMID- 34914883
OWN - NLM
STAT- MEDLINE
DCOM- 20220325
LR  - 20220429
IS  - 1654-9880 (Electronic)
IS  - 1654-9716 (Print)
IS  - 1654-9880 (Linking)
VI  - 14
IP  - 1
DP  - 2021 Jan 1
TI  - Institutional deliveries in India's nine low performing states: levels, 
      determinants and accessibility.
PG  - 2001145
LID - 10.1080/16549716.2021.2001145 [doi]
LID - 2001145
AB  - BACKGROUND: Despite the implementation of several national-level interventions, 
      institutional delivery coverage remains unsatisfactory in India's low performing 
      states (LPS), leading to a high burden of maternal mortality. OBJECTIVE: This 
      study investigates the levels, differentials, and determinants of institutional 
      deliveries in LPS of India. The study also delineates a holistic understanding of 
      barriers to delivery at health facilities and the utilization of the Janani 
      Suraksha Yojana (JSY) specifically designed to improve maternal and child health 
      of disadvantaged communities. METHODS: A cross-sectional study was conducted 
      using data from the National Family Health Survey (NFHS)-4, 2015-16. The study 
      was carried out over India's nine LPS utilizing 112,518 women who had a living 
      child in the past five years preceding the survey. Bivariate and multivariate 
      regression analysis techniques were used to yield findings. RESULTS: Of the study 
      sample, nearly three-quarters (74%) of women delivered in a health institution in 
      the study area, with the majority delivered in public health facilities. The 
      multivariate analysis indicates that women who lived in rural areas, belonged to 
      disadvantaged social groups (e.g. Scheduled caste/tribes and Muslims), and those 
      who married early (before 18 years) were less likely to utilize institutional 
      delivery services. On the other hand, women's education, household wealth, and 
      exposure to mass media were found to be strong facilitators of delivering in a 
      health facility. Meeting with a community health worker (CHW) during pregnancy 
      emerged as an important predictor of institutional delivery in our study. 
      Further, interaction analysis shows that women who reported the distance was a 
      'big problem' in accessing medical care had significantly lower odds of 
      delivering at a health facility. CONCLUSIONS: The study suggests emphasizing the 
      quality of in-facility maternal care and awareness about the importance of 
      reproductive health. Furthermore, strengthening sub-national policies 
      specifically in underperforming states is imperative to improve institutional 
      delivery coverage.
FAU - Saha, Ria
AU  - Saha R
AUID- ORCID: 0000-0002-0286-1985
AD  - Public Health Consultant, London, UK.
FAU - Paul, Pintu
AU  - Paul P
AUID- ORCID: 0000-0002-6727-6082
AD  - Centre for the Study of Regional Development, School of Social Sciences, 
      Jawaharlal Nehru University, New Delhi, India.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Glob Health Action
JT  - Global health action
JID - 101496665
SB  - IM
MH  - Child
MH  - Cross-Sectional Studies
MH  - Delivery, Obstetric
MH  - Female
MH  - Health Facilities
MH  - *Health Services Accessibility
MH  - Humans
MH  - India/epidemiology
MH  - *Maternal Health Services
MH  - Maternal Mortality
MH  - Pregnancy
PMC - PMC8682830
OTO - NOTNLM
OT  - *Institutional delivery
OT  - *JSY scheme
OT  - *NFHS-4
OT  - *low performing states (LPS)
OT  - *maternal mortality
COIS- No potential conflict of interest was reported by the author(s).
EDAT- 2021/12/17 06:00
MHDA- 2022/03/26 06:00
PMCR- 2021/12/16
CRDT- 2021/12/16 20:14
PHST- 2021/12/16 20:14 [entrez]
PHST- 2021/12/17 06:00 [pubmed]
PHST- 2022/03/26 06:00 [medline]
PHST- 2021/12/16 00:00 [pmc-release]
AID - 2001145 [pii]
AID - 10.1080/16549716.2021.2001145 [doi]
PST - ppublish
SO  - Glob Health Action. 2021 Jan 1;14(1):2001145. doi: 10.1080/16549716.2021.2001145.