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1. Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India.

Author

Govil, Dipti, Purohit, Neetu, Gupta, Shiv Dutt, and Mohanty, Sanjay Kumar

Subjects
*PRENATAL care, *PUBLIC health, *PREGNANCY complications, *LOGISTIC regression analysis, *ECONOMIC status, *MATERNAL health services, *CHILDBIRTH at home, *COMPARATIVE studies, *DELIVERY (Obstetrics), *HEALTH facilities, *HEALTH services accessibility, *HEALTH status indicators, *RESEARCH methodology, *LABOR complications (Obstetrics), *MEDICAL care costs, *MEDICAL cooperation, *NATIONAL health services, *PUBLIC hospitals, *RESEARCH, *RURAL health, *SOCIAL classes, *SURVEYS, *EVALUATION research, *EDUCATIONAL attainment, *CROSS-sectional method, *PATIENTS' attitudes, *ECONOMICS, *PREVENTION, *THERAPEUTICS
Abstract

Background: Though Janani Suraksha Yojana (JSY) under National Rural Health Mission (NRHM) is successful in increasing antenatal and natal care services, little is known on the cost coverage of out-of-pocket expenditure (OOPE) on maternal care services post-NRHM period.Methods: Using data from a community-based study of 424 recently delivered women in Rajasthan, this paper examined the variation in OOPE in accessing maternal health services and the extent to which JSY incentives covered the burden of cost incurred. Descriptive statistics and logistic regression analyses are used to understand the differential and determinants of OOPE.Results: The mean OOPE for antenatal care was US$26 at public health centres and US$64 at private health centres. The OOPE (antenatal and natal) per delivery was US$32 if delivery was conducted at home, US$78 at public facility and US$154 at private facility. The OOPE varied by the type of delivery, delivery with complications and place of ANC. The OOPE in public health centre was US$44 and US$145 for normal and complicated delivery, respectively. The share of JSY was 44 % of the total cost per delivery, 77 % in case of normal delivery and 23 % for complicated delivery. Results from the log linear model suggest that economic status, educational level and pregnancy complications are significant predictors of OOPE.Conclusions: Our results suggest that JSY has increased the coverage of institutional delivery and reduced financial stress to household and families but not sufficient for complicated delivery. Provisioning of providing sonography/other test and treating complicated cases in public health centres need to be strengthened. [ABSTRACT FROM AUTHOR]

Published
2016
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2. Delivery practices of traditional birth attendants in Dhaka slums, Bangladesh.

Author

Fronczak, N., Arifeen, S. E., Moran, A. C., Caulfield, L. E., and Baqui, A. H.

Subjects
*MIDWIVES, *DELIVERY (Obstetrics), *SLUMS, *MATERNAL health services, *MIDWIFERY, *HYGIENE, *PUERPERAL disorders, *TRADITIONAL medicine, *PUERPERIUM, *LABOR complications (Obstetrics), *MATERNAL mortality, *INFANT mortality, *RURAL population, *LONGITUDINAL method
Abstract

This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993-May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity. [ABSTRACT FROM AUTHOR]

Published
2007