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Socio-Economic Inequalities in the Use of Postnatal Care in India

OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine ine...

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Autores principales: Singh, Abhishek, Padmadas, Sabu S., Mishra, Udaya S., Pallikadavath, Saseendran, Johnson, Fiifi A., Matthews, Zoe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356397/
https://www.ncbi.nlm.nih.gov/pubmed/22623976
http://dx.doi.org/10.1371/journal.pone.0037037
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author Singh, Abhishek
Padmadas, Sabu S.
Mishra, Udaya S.
Pallikadavath, Saseendran
Johnson, Fiifi A.
Matthews, Zoe
author_facet Singh, Abhishek
Padmadas, Sabu S.
Mishra, Udaya S.
Pallikadavath, Saseendran
Johnson, Fiifi A.
Matthews, Zoe
author_sort Singh, Abhishek
collection PubMed
description OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. METHODS AND FINDINGS: Rich–poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007–08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. CONCLUSIONS: PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions.
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spelling pubmed-33563972012-05-23 Socio-Economic Inequalities in the Use of Postnatal Care in India Singh, Abhishek Padmadas, Sabu S. Mishra, Udaya S. Pallikadavath, Saseendran Johnson, Fiifi A. Matthews, Zoe PLoS One Research Article OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. METHODS AND FINDINGS: Rich–poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007–08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. CONCLUSIONS: PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions. Public Library of Science 2012-05-18 /pmc/articles/PMC3356397/ /pubmed/22623976 http://dx.doi.org/10.1371/journal.pone.0037037 Text en Singh et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Singh, Abhishek
Padmadas, Sabu S.
Mishra, Udaya S.
Pallikadavath, Saseendran
Johnson, Fiifi A.
Matthews, Zoe
Socio-Economic Inequalities in the Use of Postnatal Care in India
title Socio-Economic Inequalities in the Use of Postnatal Care in India
title_full Socio-Economic Inequalities in the Use of Postnatal Care in India
title_fullStr Socio-Economic Inequalities in the Use of Postnatal Care in India
title_full_unstemmed Socio-Economic Inequalities in the Use of Postnatal Care in India
title_short Socio-Economic Inequalities in the Use of Postnatal Care in India
title_sort socio-economic inequalities in the use of postnatal care in india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356397/
https://www.ncbi.nlm.nih.gov/pubmed/22623976
http://dx.doi.org/10.1371/journal.pone.0037037
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