Effect of various socio-demographic determinants on the utilization of ANC services under Janani Suraksha Yojana amongst married women(15-49 years) in our field practice area of Dehradun.

Parul Sharma ,Surekha Kishore,Jayanti SemwalAssistant Professor,Subharti Medical College,Meerut

INTRODUCTION

Maternal health is a key barometer of functional health system. There are however,constraints to provide comprehensive obstretic services for mother and newborn.

Maternal mortality continues to be high in developing countries. A WHO,UNICEF and UNFPA had reported an estimate of 536,000 Maternal deaths worldwide in 2005 out of which 99% were from developing countries.

Maternal mortality in resource-poor nations has been attributed to the “3 delays”.

To combat this JSY was launched on 12th April 2005, under the umbrella of NRHM with the main objective of reducing maternal,neo-natal mortality and promoting institutional delivery.

It was implemented in all states and UTs with special focus on 10 low performing states (LPS).

Uttarakhand is one of the LPS and JSY was implemented here in Sept.2005.

There are however various socio-demographic factors that effect the utilization of ANC services and this study was an attempt to study these factors.

AIMS AND OBJECTIVES

“To study the effect of socio-demographic

factors on utilization of ANC services

under JSY ”.

MATERIAL & METHODS

Study Area: Rural health training centre (8 villages) & Urban health training centre(two slums) of department of Community Medicine, HIMS, Swami Ram Nagar, Dehradun.

Study population: Married Women (15-49 years age group) with children <2 years of age who delivered in government hospital and gave consent.

Study Design: Cross sectional study

Period of Study: The study was carried out over a period of 12 months (15May-08 to 14th May-09)

METHODOLOGY Verbal consent was taken from married women (15-49 years). All married women (15-49 years),one from each

alternate house of eight villages of RHTC and two slums of UHTC were enlisted with the help of ANM/AWW//MSW (N=2273).

During the study 52 women were dropped out due to incomplete information on their questionnaire,so the final sample size for analysis was restricted to N=2221.

Out of these (N=2221),530 women had children <2 years but JSY utilizers were only 227 women,who had delivered within last two years in government hospital.

These were interviewed by means of a self-designed and pre-tested questionnaire for utilization of JSY services and socio-demographic factors.

RESULTSDistribution of married women (15-49yrs) according to place of delivery of last child

S.NoPlace of delivery

No. of married women with <2 yr child Total

Rural Urban slums  

1 Home 158(69.30) 70(30.70) 228(43.02)

2 Institution 117(38.74) 185(61.26) 302(56.98)

  (a)Private 29(38.67) 46(61.33) 75(24.83)

  (b)Govt. 88(38.77) 139(61.23) 227(75.17)

  Total 275(51.89) 255(48.11) n=530 x2=47.37, df=1, p<0.00004

Distribution of married women (15-49 years) according to registration with health

personnel and their religion.

x2=12.78, df=2, p<0.01

Hindu(202) Muslim(25) Sikh(2) Total(227)0%

10%

20%

30%

40%

50%

60%

70%

80%

90%82%

52% 50%

78%

18%

48% 50%

22%

Yes

No

Distribution of married women (15-49 years) according to registration with health personnel and soci-economic status

x2=10.44, df=4, p<0.05

(178)Upper class(9) Upper middle

class(80)Lower middle

class(84)Upper lower

class(47)Lower class(7) Total(178)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

66.67% 68.75%

80.95%

91.49%85.71%

78.42%

33.33% 31.25%

19.05%

8.51%14.29%

21.59%

No Yes

Distribution of married women (15-49 years) according to number of ANC visits and their educational status

x2=4.75, df=6, p<0.05

Illiterate(63)

Just literate(11)

Primary(27)

Junior high school(30)

High school(24)

Intermediate(10)

Graduate and above(13)

Total(178)

80.95%

54.55%

74.07%

73.33%

66.67%

60.00%

38.46%

70.79%

19.05%

45.45%

25.93%

26.67%

33.33%

40.00%

61.54%

29.21%

< 3 ANC visits

>= 3 ANC visits"

Distribution of married women (15-49 years) according to number of ANC visits and socio-economic status

x2=17.29, df=4, p<0.01

Upper class(6)

Upper middle class(55)

Lower middle class(68)

Upper lower class(43)

Lower class(6)

Total(178)

0.00% 20.00% 40.00% 60.00% 80.00% 100.00%

33.33%

63.64%

67.65%

93.02%

50.00%

70.79%

66.67%

36.36%

32.35%

6.98%

50.00%

29.21%

>=3 ANC visits

< 3 ANC visits

Distribution of married women (15-49 years) according to number of IFA tablets consumed and educational status

x2=30.21, df=6, p<0.01

Illiterate(63)

Just literate(11)

Primary(27)

Junior high school(30)

High school(24)

Intermediate(10)

Graduate & above(13)

Total(178)

0.00% 20.00% 40.00% 60.00% 80.00% 100.00%

76.19%

45.45%

55.55%

33.33%

37.50%

30.00%

15.38%

51.69%

23.81%

54.55%

44.45%

66.67%

62.50%

70.00%

84.62%

48.31%

Number of IFA tablets consumed <100

Number of IFA tablets consumed ≥100

CONCLUSION JSY users were found to be 227 (42.83%),majority of which

belonged to urban areas i.e 139(61.23%). Majority (78.42%) of the women were registered with some

health personal.Only 29.21% women went for ≥ 3 ANC visits and 48.31% women consumed hundred IFA tablets whereas TT immunization was 100%.

Majority (82%) of hindu women and women (91.49%) from upper lower class registered themselves with health personnel.

More percentage (80.95%) of women who were illiterates and women of belonging to upper lower class i.e 93.02%, went for ≥ 3 ANC visits.

Majority(76.19 %) of the illiterate women consumed hundred IFA tablets.