Academic journal article International Journal of Population Research

Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Academic journal article International Journal of Population Research

Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Article excerpt

Ranjan Kumar Prusty 1 and Jitendra Gouda 1 and Manas Ranjan Pradhan 2

Academic Editor:Sally Guttmacher

1, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, India 2, Department of Fertility Studies, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400 088, India

Received 16 August 2014; Revised 25 January 2015; Accepted 9 March 2015; 31 March 2015

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Maternal health refers to the state of complete physical, mental, and social well-being of women during pregnancy, childbirth, and the postpartum period. While motherhood is often a positive and fulfilling experience, for many women it is associated with suffering, ill health, and even death [1, 2]. According to World Health Organization (WHO), approximately 800 women die from preventable causes related to pregnancy and childbirth every day [3]. Out of all maternal deaths, 99 percent occur in developing countries. Further, maternal mortality is higher among women living in rural areas, among poorer communities [3, 4], and among those with low literacy [5].

Improving maternal health is one of the Millennium Development Goals (MDG) adopted by international community in 2000 [6, 7]. As per this agreement, all member countries have to reduce maternal mortality by three-quarters between 1990 and 2015 [6, 8]. The maternal mortality in Sub-Saharan Africa has been halved since 1990 [9]. In other regions, including Asia, greater headway has been achieved [1]. In India, among the armed forces there were 10 maternal deaths amongst 27,215 deliveries, making a MMR of 36 per 100,000 live births in the year 2004. This reflects the importance of comprehensive healthcare and institutionalized deliveries [1, 9, 10]. However, between 1990 and 2010, the global maternal mortality ratio (i.e., the number of maternal deaths per 100,000 live births) declined by only 3.1% per year which is far from the annual decline of 5.5% required to achieve MDG-5 [3]. Furthermore, the maternal mortality ratio in low income countries is 240 per 100,000 live births whereas it is only 16 per 100,000 live births in high income developed countries [3]. This disparity is even visible within countries between people with high and low income and between people living in rural and urban areas [11]. It is a mere indication of inequalities in access to maternal healthcare services and highlights the gap between the rich and the poor [12, 13].

India, like many other developing countries, records high maternal morbidities and deaths. The condition is even worse in the socioeconomically disadvantaged state of Odisha, which registers high maternal morbidities and mortalities well above the national average [14, 15]. Anemia among pregnant and lactating mothers is higher in the state [16]. Absence of health infrastructure and sparse utilization of available healthcare services between different subgroups of population were considered as important factors for the poor maternal health in the state [17, 18]. Though the National Rural Health Mission (NRHM) has firm positive impact in building the infrastructure and improving the maternal health, the development is not uniform across the regions and among diverse groups of population [12, 19, 20]. The reasons are multifactorial and embedded across individual, household, and geographical features [14, 20]. Hence, any insightful assessment of maternal healthcare utilization among different subgroups with varying socioeconomic and demographic characteristics will have better policy implications to enhance the service utilization and reduce maternal mortality and morbidity. In this context, the present study is an effort to assess the level and pattern of maternal healthcare services utilization among diverse groups of women in Odisha, with a special focus on the regional, economic, and educational inequality. …

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