Utilization of maternal care services in rural India: An analysis of differentials and determinants

Jareena Shaik, Sri Venkateswara University
Ramachandran Paida, Sri Venkateswara Univeristy

Improvement of maternal and child health has been one of the pivotal components of India’s National Rural Health Mission (NRHM) especially in the states where the provision of quality of public health system is poor. The National Family Health Survey, 1998-99 (NFHS–2) reports that the utilization of various maternal care services are not encouraging, particularly in rural areas. Therefore, understanding of the factors that influence the utilization of maternal care services is crucial to the efforts of NRHM’s and reproductive health programmes. This paper attempts to examine how the characteristics of individual, household and community influence the utilization of maternal care services (antenatal, natal and post-natal) among the mothers in rural India. For the present study the states of Andhra Pradesh, Bihar, Gujarat, Madhya Pradesh and Rajasthan having the lowest utilization of maternal care services representing each of the five regions of India were purposefully selected to reflect the scenario at the all India level. Data on the two most recent births from the NFHS–2 were analyzed using a two-level multi-level (logit) model. The multivariate analysis shows that both socioeconomic and demographic variables were significantly associated with utilization of maternal care services in the study states, but at varied levels. Education, standard of living and birth order have emerged as the crucial determinants of utilization maternal care services in all the selected states. Community level facilities were observed to have strong positive effect on the utilization of maternal care services. Further, observance of recommended antenatal care had highly significant association with natal and postnatal care. Hence, it is imperative to emphasize the importance of recommended antenatal care for safe motherhood and child survival among the rural illiterate masses through appropriate IEC activities. This will pave the way for effective utilization of the available maternal care services in backward rural masses among the Indian states.