Trends in Choosing Place of Delivery and Assistance during Delivery in Nanded District, Maharashtra, India.
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Date
2011-02
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Abstract
Delivery in a medical institution promotes child survival and reduces the risk of maternal mortality. Many
initiatives under the National Rural Health Mission (NRHM) focus on increasing the institutional deliveries.
This study describes the trends in choosing place of delivery in Nanded district at the end of the
first phase of the mission. Key informants were interviewed to document the initiatives under NRHM
implemented in the district. A cross-sectional descriptive study was conducted in 30 villages selected using
one stage cluster-sampling method. A house-to-house survey was conducted in June 2009. A set of structured
open-ended questionnaire was used for interviewing all women who had delivered during January
2004–May 2009. The outcomes studied were place of delivery and assistance during delivery. Analysis was
done by calculating chi-square test and odds ratio. Interventions to improve the quality of health services
and healthcare-seeking behaviour were implemented successfully in the district. The proportion of institutional
deliveries increased from 42% in 2004 to 69% in 2009. A significant increase was observed in the
proportion of institutional deliveries [60% vs 45%; χ2=173.85, p<0.05, odds ratio (OR)=1.8 (95% confidence
interval (CI) 1.65-1.97)] in the NRHM period compared to the pre-NRHM period. The deliveries in
government institutions and in private institutions also showed a significant rise. The proportion of deliveries
assisted by health personnel increased significantly during the NRHM period [62% vs 49%; χ2=149.39;
p<0.05, OR=1.73, 95% CI 1.58-1.89] However, less than 10% of the deliveries in the home (range 2-9%)
were assisted by health personnel throughout the study period. There was a wide geographic variation in
place of delivery among the study villages. The results showed a significant increase in the proportion of
institutional deliveries and deliveries assisted by health personnel in the NRHM period. Since a less
proportion of deliveries in the home is conducted by health personnel, the focus should be on increasing
the institutional deliveries. Special and innovative interventions should be implemented in the villages
with a less proportion of institutional deliveries.
Description
Keywords
Community-based studies, Cross-sectional studies, Descriptive studies, Delivery, Rural health services, India
Citation
Pardeshi Geeta S, Dalvi Shashank S, Pergulwar Chandrakant R, Gite Rahul N, Wanje Sudhir D. Trends in Choosing Place of Delivery and Assistance during Delivery in Nanded District, Maharashtra, India. Journal of Health, Population and Nutrition. 2011 Feb; 29(1): 71-76.