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Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India

BACKGROUND: The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of i...

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Autores principales: Bruce, Sharon G, Blanchard, Andrea K, Gurav, Kaveri, Roy, Anuradha, Jayanna, Krishnamurthy, Mohan, Haranahalli L, Ramesh, Banadakoppa M, Blanchard, James F, Moses, Stephen, Avery, Lisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345019/
https://www.ncbi.nlm.nih.gov/pubmed/25884166
http://dx.doi.org/10.1186/s12884-015-0481-8
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author Bruce, Sharon G
Blanchard, Andrea K
Gurav, Kaveri
Roy, Anuradha
Jayanna, Krishnamurthy
Mohan, Haranahalli L
Ramesh, Banadakoppa M
Blanchard, James F
Moses, Stephen
Avery, Lisa
author_facet Bruce, Sharon G
Blanchard, Andrea K
Gurav, Kaveri
Roy, Anuradha
Jayanna, Krishnamurthy
Mohan, Haranahalli L
Ramesh, Banadakoppa M
Blanchard, James F
Moses, Stephen
Avery, Lisa
author_sort Bruce, Sharon G
collection PubMed
description BACKGROUND: The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional deliveries there are still considerable barriers to utilization and quality of services, particularly in rural areas, that may mitigate improvements achieved by MNCH interventions. This paper aims to explore the factors influencing preference for home, public or private hospital delivery among rural pregnant and new mothers in three northern districts of Karnataka state, South India. METHODS: In-depth qualitative interviews were conducted in 2010 among 110 pregnant women, new mothers (infants born within past 3 months), their husbands and mothers-in-law. Interviews were conducted in the local language (Kannada) and then translated to English for analysis. The interviews of pregnant women and new mothers were used for analysis to ultimately develop broader themes around definitions of quality care from the perspective of service users, and the influence this had on their delivery site preferences. RESULTS: Geographical and financial access were important barriers to accessing institutional delivery services in all districts, and among those both above and below the poverty line. Access issues of greatest concern were high costs at private institutions, continuing fees at public hospitals and the inconsistent receipt of government incentives. However, views on quality of care that shaped delivery site preferences were deeply rooted in socio-cultural expectations for comfortable, respectful and safe care that must ultimately be addressed to change negative perceptions about institutional, and particularly public hospital, care at delivery. CONCLUSIONS: In the literature, quality of care beyond access has largely been overlooked in favour of support for incentives on the demand side, and more trained doctors, facilities and equipment on the supply side. Taking a comprehensive approach to quality of care in line with cultural values and community needs is imperative for improving experiences, utilization, and ultimately maternal and neonatal health outcomes at the time of delivery.
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spelling pubmed-43450192015-03-02 Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India Bruce, Sharon G Blanchard, Andrea K Gurav, Kaveri Roy, Anuradha Jayanna, Krishnamurthy Mohan, Haranahalli L Ramesh, Banadakoppa M Blanchard, James F Moses, Stephen Avery, Lisa BMC Pregnancy Childbirth Research Article BACKGROUND: The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional deliveries there are still considerable barriers to utilization and quality of services, particularly in rural areas, that may mitigate improvements achieved by MNCH interventions. This paper aims to explore the factors influencing preference for home, public or private hospital delivery among rural pregnant and new mothers in three northern districts of Karnataka state, South India. METHODS: In-depth qualitative interviews were conducted in 2010 among 110 pregnant women, new mothers (infants born within past 3 months), their husbands and mothers-in-law. Interviews were conducted in the local language (Kannada) and then translated to English for analysis. The interviews of pregnant women and new mothers were used for analysis to ultimately develop broader themes around definitions of quality care from the perspective of service users, and the influence this had on their delivery site preferences. RESULTS: Geographical and financial access were important barriers to accessing institutional delivery services in all districts, and among those both above and below the poverty line. Access issues of greatest concern were high costs at private institutions, continuing fees at public hospitals and the inconsistent receipt of government incentives. However, views on quality of care that shaped delivery site preferences were deeply rooted in socio-cultural expectations for comfortable, respectful and safe care that must ultimately be addressed to change negative perceptions about institutional, and particularly public hospital, care at delivery. CONCLUSIONS: In the literature, quality of care beyond access has largely been overlooked in favour of support for incentives on the demand side, and more trained doctors, facilities and equipment on the supply side. Taking a comprehensive approach to quality of care in line with cultural values and community needs is imperative for improving experiences, utilization, and ultimately maternal and neonatal health outcomes at the time of delivery. BioMed Central 2015-02-27 /pmc/articles/PMC4345019/ /pubmed/25884166 http://dx.doi.org/10.1186/s12884-015-0481-8 Text en © Bruce et al.; licensee BioMed Central. 2015 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 credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Bruce, Sharon G
Blanchard, Andrea K
Gurav, Kaveri
Roy, Anuradha
Jayanna, Krishnamurthy
Mohan, Haranahalli L
Ramesh, Banadakoppa M
Blanchard, James F
Moses, Stephen
Avery, Lisa
Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title_full Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title_fullStr Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title_full_unstemmed Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title_short Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India
title_sort preferences for infant delivery site among pregnant women and new mothers in northern karnataka, india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345019/
https://www.ncbi.nlm.nih.gov/pubmed/25884166
http://dx.doi.org/10.1186/s12884-015-0481-8
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