There have been little studies carried out to assess the effect of the free maternal care policy on the access to and utilization of health care facilities, maternal health and deaths. Women of childbearing age all over the world irrespective of race, education, occupation or marital status are faced with the agony of pregnancy’s possibility leading to the death of the mother. Maternal mortality even though has been reducing slightly over the years, still remains a problem which needs to be seriously tackled. It is a serious problem just as Dr. Elias Sory; Director-General of the Ghana Health Service asserted that “you must wake up to the realization that one maternal death is a calamity”. “This is a must read book for anybody interested in Maternal Health”- Dr. Smile Dzisi (Lecturer).
Millennium Development Goal (MDG) five targets to reduce maternal mortality rate by three quarters in 2015. Experiences from both developed and some developing countries have shown that maternal deaths could have been prevented if women had access to basic maternity care services and utilize it. Utilization of maternal health care services is associated with improved maternal and neonatal health outcomes. To achieve the MDG 5 understanding the factors associated with maternal health care use is crucial.
Bangladesh has one of the highest maternal mortality rates (MMR) in the world, i.e. 3/1000 live births. The situation is worse due to inadequate access to modern health care services & poor utilization. One of the public health challenges is, therefore, to identify vulnerable groups and to provide them with needed health care services. Considering this matter, this study examined the socio-economic, demographic & cultural determinants of utilization of maternal health care services in slum areas of Dhaka city. The primary data was collected from 540 women aged 15-49. A semi-structured questionnaire was used to collect the information from slum dwellers. The overall MHCS was utilized by 86.3% of women; however, utilization of different sorts of MHCS was very low, i.e., the mean utilization was found to be 2.25 out of 5 MHCS. Indicator wise, ANC, receiving TT, institutional delivery, delivery assistance by health professional & PNC were received by respectively 61.3%, 80.4%, 12.6%, 33.2% and 55.4% of women. Thus, this study might be a significant consideration in formulating the policy and future plan for reducing maternal mortality & morbidity in disadvantaged women of slum areas.
Maternal mortality in Ethiopia is the highest in the world. A study was carried out in 2006 among Family Planning, Antenatal Care, and Delivery Care Service attendees in the health facilities, Ethiopia. A quantitative and qualitative methodologies were applied. The study indicated that integration of programs is critically important to increase utilization of services and minimize missed opportunities in maternal care and HIV/AIDS services in health facilities of Ethiopia.
This book reveals the conditions of utilization of antenatal and postnatal services by the rural women in most populated province (Punjab) of Pakistan. What are the socio-economic and demographic factors that affect the utilization of these services. The results are quite promising regarding the awareness of the rural women and men for the importance of maternal and neonatal health. The role of doctors, para-medical staff and of media is quite important in boosting the utilization of maternal health care services.
Maternal health matters have dominated many forums in the world for over a long period of time. Regardless of various initiatives put in place to address maternal mortality/morbidity, very little progress has been made in this area especially in Kenya and other countries in Sub-Saharan Africa. Authoritative sources indicate that millions of women in developing countries continue to experience life threatening and other serious health problems related to pregnancy and/or childbirth as nearly 99 percent of maternal deaths occur to women in developing countries. Given the intricate relationship between utilization of maternal health care services and reduction of maternal mortality, understanding determinants of utilization of these services is a crucial step towards reduction of maternal morbidity and mortality. This book provides practical evidence based information useful to academicians and researchers interested in maternal health. Further, the book can be used as reference material by managers to design program interventions geared towards promotion of maternal health.
Present study examines the level and differential in utilization of maternal health care (MCH) services by various socio-economic and demographic factors with respect to “Janani Suraksha Yojana” scheme. There is a general consciences that the use of MHC services reduces maternal and child mortality and improve the reproductive health of women. The considerable variation in maternal and child health in the developing world is believed to partly in the availability of and access to health services. This study describes the determinants of MHC services utilization and also characteristic of women who received antenatal care, delivery care and post natal care by various socio-economic characteristic. Result indicates that determinants of MHC services are not same across states and for different MHC indicators. Place of residence, women and her spouse’s education, economic status has significantly affecting utilization of full ANC delivery care & post delivery care. Scheme has a strong and positive impact on coverage of antenatal care, natal care and postnatal care in different socio-economic demographic characteristics of women.
There is considerable interest at present in achieving the MDG-5 by implementation of the Free Maternal Health Policy embedded in the social health insurance to increase access to and affordability of health care in Ghana. Ghana's National Free Maternal Health Policy was passed into operation in July, 2007. This book aims to provide assessment of the explicit costs of maternal healthcare services rendered to NHIS clients in Ghana. The book revealed that there is increase utilization of the free maternal health service. The NHIS offers the entire maternal health package to their clients free of charge. There is a cost gap between the tariffs paid by the NHIA which uses the G-DRG compared to the cost of services rendered by the health providers if they use the itemized billing system. The challenges were the NHIA paying less to the service rendered by the health providers and payment of the claims on late. The free maternal health care in the Health insurance has become the alternative option of the health care financing in achieving the MDG-5 in Ghana.
A community based cross sectional study was conducted from October to December 2004 in in Afar Regional state, Ethiopia to assess factors influencing utilization of maternal health care services. Analysis revealed that 79.6% of the women had at least one prenatal visit during their recent pregnancy. Most of the antenatal care (ANC) attendants made their first visit during their second trimester of pregnancy. Among ANC users 53% of had less than four antenatal care contacts. Majority of deliveries took place at home, of which 93.7% were attended by TBAs. Absences of a health problem, lack of awareness, work overload, and distant health service were the main reasons for no ANC attendance. . In conclusion, the study revealed low maternal health care utilization in the area. Demographic and socio cultural factors were found to be barriers to utilization of maternal healthcare services. Increasing maternal health service coverage and promotion of IEC in the community are recommended.
The study investigated access opportunities created by organisation of maternal health care and social relations and how this in turn influences health seeking behaviour. Pregnancy related maternal health care was studied based on cases of 16 women and health care providers. This was a study from a qualitative background of interviews, focus group discussions and observatioins. The result showed that characteristics embedded in social structure and organisation of maternal health care influence the attitude of women. The women use maternal health services especially antenatal care due to the introduction of the virtually free maternal health care but rather give birth at home. Home births which are normally without professional supervision are more widespread among women who live in Abono than in Kuntenase health zones of the district.
Many of women in developing countries are at high risk in terms of maternal morbidity and mortality due to factors related to pregnancy and childbirth. A cross sectional study was conducted at Gozamin Woreda to assess factors affecting utilization of maternal health care services. Structured questionnaires and FGD were used to collect quantitative and qualitative data respectively. The study revealed that about 59.3% of the women had at least one prenatal visit and 64% of those had less than four antenatal care contacts. Being healthy and being too busy were the most reasons not to attend ANC service. The risk of non-attendance of ANC and home delivery was higher for those women whose residence was rural, higher parity and being housewife at old age. About 71% of deliveries took place at home. Presence of relatives nearby, Transportation, and lack of privacy were the main reasons to home delivery. In conclusion, demographic and socio-cultural factors were found to be barriers to utilization of maternal health care services. Increasing maternal health service coverage and promotion of IEC in the community are recommended.
Maternal mortality in Bangladesh is 320 per 100,000 live births between the years of 1998 and 2000. In Bangladesh, around 4 million women become pregnant each year and more than half million women suffered pregnancy complications. This study attempts to evaluate the levels, patterns and trends of utilization of maternal health services in Bangladesh. This is a descriptive study based on national surveys of Bangladesh Demographic and Health Survey (BDHS) 2004, BDHS 1999-2000, BDHS 1996-1997 and BDHS 1993-1994. Despite the gaps in access to skilled delivery, delivery at health facility, assistance sought for pregnancy complications and postnatal care, receiving antenatal care, tetanus toxoid and delivery by cesarean have made a remarkable progress. Delivery at health facility and assistance sought from medically trained providers remained resistant to change. Women sought assistance for their complications around delivery from non-medically trained providers. Very few women received postnatal care though it was a period during which most maternal deaths occurred.
The study described in this book was conducted in Pemba Island, Tanzania. Pemba has a relatively high rate of newborn mortality. The study investigated infant feeding within the context of newborn care. In the first part of the study, I interviewed a small sample of mothers to whom no prior instruction or advice about infant feeding had been provided. This part of the study allowed a description of women''s beliefs about the vulnerability of the newborn, and the implication of these. In the second part of the study, a small sample of Pemban mothers who were provided with in-depth, personalized information about exclusive breastfeeding using an approach inspired by the “Trial of Improved Practices” were interviewed. The study results highlight the practices that women found most difficult to adopt following recommendations for behavior change and those that fitted well with local cultural understandings.
In conflict situation around the world, it’s a common observation that, it’s a woman, who suffers the most. Jammu & Kashmir has been undergoing geopolitical strife for the past two decades and so as the women. The Utilization of Antenatal care and place of delivery is an important determinant for reducing the risk of infant and maternal death. Antenatal care and Institutional delivery are seen as one of the important intervention for emergency obstetric care. Considering the situation, Jammu and Kashmir has been selected for the study which is geographically difficult area and suffered from political disturbances. However, the figures from J&K are highly encouraging keeping in view that the region has been facing strife and conflict for the past two decades. In Jammu & Kashmir, considerable improvement in the situation of maternal health care has observed in comparison to the overall situation of the country. The rate of progress is slow but steady, and there is positive change in all the women?s health indicators in Jammu & Kashmir.
The Obasanjo administration(1999-2007)embarked on several reforms in the social institutions of Nigeria.The health sector was one that the reforms were enacted upon.The health policy was reviewed and modified by stake holders in the health sector.The study is an evaluation of the reproductive health reforms policy on maternal mortality of women in Jos North from 1999-2007.The research method was based on Focus Group Discussions in three residential areas of Jos North namely Millionaires quarters,University of Jos community and Angwan Rogo areas.The study also collected secondary data from the Jos University Teaching Hospital on maternal mortality.In conclusion,it was discovered that the level of awareness and knowledge on the reproductive health policy on maternal mortality was restricted to ones social class and cultural values in society.Maternal mortality was reducing as there was an improvement in the standard of living in Jos North and that women are consciously making efforts at getting antenatal services to avoid maternal mortality and not necessarily because there is a policy on reproductive health and maternal mortality, though access to health care is still an issue.