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Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India

BACKGROUND: While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. METHODS: A population-based survey was carried out among...

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Autores principales: Adamson, Paul C, Krupp, Karl, Niranjankumar, Bhavana, Freeman, Alexandra H, Khan, Mudassir, Madhivanan, Purnima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269389/
https://www.ncbi.nlm.nih.gov/pubmed/22240002
http://dx.doi.org/10.1186/1471-2458-12-30
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author Adamson, Paul C
Krupp, Karl
Niranjankumar, Bhavana
Freeman, Alexandra H
Khan, Mudassir
Madhivanan, Purnima
author_facet Adamson, Paul C
Krupp, Karl
Niranjankumar, Bhavana
Freeman, Alexandra H
Khan, Mudassir
Madhivanan, Purnima
author_sort Adamson, Paul C
collection PubMed
description BACKGROUND: While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. METHODS: A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. RESULTS: Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. CONCLUSION: The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.
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spelling pubmed-32693892012-02-01 Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India Adamson, Paul C Krupp, Karl Niranjankumar, Bhavana Freeman, Alexandra H Khan, Mudassir Madhivanan, Purnima BMC Public Health Research Article BACKGROUND: While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. METHODS: A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. RESULTS: Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. CONCLUSION: The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015. BioMed Central 2012-01-12 /pmc/articles/PMC3269389/ /pubmed/22240002 http://dx.doi.org/10.1186/1471-2458-12-30 Text en Copyright ©2012 Adamson et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Adamson, Paul C
Krupp, Karl
Niranjankumar, Bhavana
Freeman, Alexandra H
Khan, Mudassir
Madhivanan, Purnima
Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title_full Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title_fullStr Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title_full_unstemmed Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title_short Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India
title_sort are marginalized women being left behind? a population-based study of institutional deliveries in karnataka, india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269389/
https://www.ncbi.nlm.nih.gov/pubmed/22240002
http://dx.doi.org/10.1186/1471-2458-12-30
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