Divya Rajvanshi, John Anthony, Vasanthakumar Namasivayam, Bidyadhar Dehury, Ramesh Banadakoppa Manjappa, Ravi Prakash, Dhanunjaya Rao Chintada, Shagun Khare, Lisa Avery, Maryanne Crockett, Shajy Isac, Marissa Becker, James Blanchard, Shiva Halli
Timely and skilled care is key to reducing maternal and neonatal mortality. Birth preparedness involves preparation for safe childbirth during the antenatal period to reach the appropriate health facility for ensuring safe delivery. Hence, understanding the factors associated with birth preparedness and its significance for safe delivery is essential. This paper aims to assess the levels of birth preparedness, its determinants and association with institutional deliveries in High Priority Districts of Uttar Pradesh, India.
A community-based cross-sectional survey was conducted between June–October 2018 in the rural areas of 25 high priority districts of Uttar Pradesh, India. Simple random sampling was used to select 40 blocks among 294 blocks in 25 districts and 2646 primary sampling units within the selected blocks. The survey interviewed 9458 women who had a delivery 2 months prior to the survey. Descriptive statistics were included to characterize the study population. Multivariable logistic regression analyses were performed to identify the determinants of birth preparedness
and to examine the association of birth preparedness with institutional delivery.
Among the 9458 respondents, 61.8% had birth preparedness (both facility and transportation identified) and 79.1% delivered in a health facility. Women in other caste category (aOR = 1.24, CI 1.06–1.45) and those with 10 or more years of education (aOR = 1.68, CI 1.46–1.92) were more likely to have birth preparedness. Antenatal care (ANC) service uptake related factors like early registration for ANC (aOR = 1.14, CI 1.04–1.25) and three or more front line worker contacts (aOR = 1.61, CI 1.46–1.79) were also found to be significantly associated with birth preparedness. The adjusted multivariate model showed that those who identified both facility and transport were seven times more likely to undergo delivery in a health facility (aOR = 7.00, CI 6.07–8.08).
The results indicate the need for focussing on marginalized groups for improving birth preparedness. Increasing ANC registration in the first trimester of pregnancy, improving frontline worker contact, and optimum utilization of antenatal care check-ups for effective counselling on birth preparedness along with system level improvements could improve birth preparedness and consequently institutional delivery rates in Uttar Pradesh, India.
ASHAs act as an interface between the community and the public health system in creating awareness on health and its social determinants within the community, and mobilizing the community towards local health planning and increased utilization of health services. This brief highlights importance of building capacities of ASHAs through the cluster meeting platform.
This brief identifies the opportunity gaps in the effective coverage cascade for prevention of anaemia among pregnant women in India. The effective coverage cascade is used to identify coverage gaps, quantify coverage at each step, determine where the largest gaps exist within the cascade and prioritize where actions are most urgent. The findings are based on NFHS 5 data.
The fifteenth edition of PAHAL newsletter throws light on UP TSU’s support to GoUP in adopting a scientific approach for allocating Area of Responsibility (AoR) to ANMs working in sub-centres; also, geo-mapping of more than 1,80,000 Anganwadi Centres across the state by ICDS department with the support of UP TSU has been the highlight of the quarter.