Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T12:51:49.122Z Has data issue: false hasContentIssue false

INTRA- AND INTER-HOUSEHOLD DIFFERENCES IN ANTENATAL CARE, DELIVERY PRACTICES AND POSTNATAL CARE BETWEEN LAST NEONATAL DEATHS AND LAST SURVIVING CHILDREN IN A PERI-URBAN AREA OF INDIA

Published online by Cambridge University Press:  05 March 2010

ROHINI GHOSH
Affiliation:
Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India
ARUN KUMAR SHARMA
Affiliation:
Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India

Summary

Nearly a quarter of the world's neonatal deaths take place in India. The state of Uttar Pradesh alone accounts for one-quarter of all neonatal deaths in the country. In this study 892 married women aged less than 50 years living in a peri-urban area of Kanpur city in Uttar Pradesh were interviewed. In all, 109 women reported neonatal deaths. Characteristics of the last neonatal deaths of these 109 women were compared with those of the last surviving children. Also, characteristics of women who had a neonatal death were compared with those of 783 women who had no neonatal death. It was found that as compared with neonatal deaths, the last surviving children of the 109 women had: (a) significantly better antenatal tests during pregnancy, intake of iron/folic acid tablets and higher percentage of tetanus toxoid immunization; (b) safer delivery practices such as a higher percentage of institutional delivery, sterilization of instruments and application of antiseptic after removal of umbilical cord; (c) postnatal care, such as application of antiseptic to the navel and postnatal checkups; and (d) higher maternal age and greater birth spacing. Likewise, better antenatal care and safer delivery practices and postnatal care were observed among the 783 women with no neonatal deaths, when compared with women who had experienced neonatal death. The complexities of inter- and intra-household differences in health care are discussed. The paper concludes that to improve child survival general education and awareness regarding safe delivery should be increased. Continuing cultural stigmas and misconceptions about birth practices before, during and after childbirth should be an important part of the awareness campaigns.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akello, B., Nabiwemba, E., Zirabamuzaale, C. & Orach, C. G. (2008) Risk factors for perinatal mortality in Arua regional referral hospital, West Nile, Uganda. East African Journal of Public Health 5(3), 180185.Google ScholarPubMed
Alam, N. (1995) Birth spacing and infant and early childhood mortality in a high fertility area of Bangladesh: Age-dependent and interactive effects. Journal of Biosocial Science 27(4), 393404.CrossRefGoogle Scholar
Awasthi, S., Srivastava, N. M. & Pant, S. (2008) Symptom-specific care-seeking behavior for sick neonates among urban poor in Lucknow, Northern India. Journal of Perinatology 28, S6975.CrossRefGoogle ScholarPubMed
Baqui, A. H., Darmstadt, G. L., Williams, E. K., Kumar, V., Kiran, T. U., Panwar, D. et al. (2006) Rates, timing and causes of neonatal deaths in rural India: Implications for neonatal health programmes. Bulletin of the World Health Organization 84(9), 706713.CrossRefGoogle ScholarPubMed
Bhutta, Z. A., Darmstadt, G. L., Hasan, B. S. & Haws, R. A. (2005) Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: A review of the evidence. Pediatrics 115, 519617.CrossRefGoogle ScholarPubMed
Birley, M. & Lock, K. (1999) The Health Impacts of Peri-Urban Natural Resource Development. Cromwell Press, Liverpool School of Tropical Medicine, Trowbridge, UK.Google Scholar
Black, R. E., Morris, S. S. & Bryce, J. (2003) Where and why are 10 million children dying every year? Lancet 36, 22262234.CrossRefGoogle Scholar
Dadhich, J. P. & Paul, V. (2004) State of India's Newborns. National Neonatology Forum and Save the Children, New Delhi/Washington, DC, USA.Google Scholar
Darmstadt, G. L., Bhutta, Z. A., Cousens, S., Adam, T., Walker, N. & de Bernis, L. (2005) Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet Neonatal Survival Steering Team, 2005. Lancet 365(9463), 977988.CrossRefGoogle Scholar
Dikici, B., Uzun, H., Yilmaz-Keskin, E., Tas, T., Gunes, A., Kocamaz, H. et al. (2008) Neonatal tetanus in Turkey: What has changed in the last decade? BMC Infectious Diseases 19(8), 112.CrossRefGoogle Scholar
Freeman, J. V., Christian, P., Khatry, S. K., Adhikari, R. K., LeClerq, S. C., Katz, J. & Darmstadt, G. L. (2005) Evaluation of neonatal verbal autopsy using physician review versus algorithm-based cause-of-death assignment in rural Nepal. Paediatric and Perinatal Epidemiology 19, 323331.CrossRefGoogle ScholarPubMed
Ghosh, R. (2003) Maternal and child health in two ethnic groups inhabiting a peri-urban habitat: A micro level study. PhD thesis, Calcutta University.Google Scholar
Ghosh, R. & Bharati, P. (2010) Determinants of child mortality at micro level in a peri-urban area of Kolkata city, India. Asia Pacific Journal of Public Health 22(1).CrossRefGoogle Scholar
Kalk, P., Guthmann, F., Krause, K., Relle, K., Godes, M., Gossing, G. et al. (2009) Impact of maternal body mass index on neonatal outcome. European Journal of Medical Research 14(5), 216222.CrossRefGoogle ScholarPubMed
Kidanto, H. L., Mogren, I., Lindmark, G., Massawe, S. & Nystrom, L. (2009) Risks for preterm delivery and low birth weight are independently increased by severity of maternal anaemia. South African Medical Journal 99(2), 98102.Google ScholarPubMed
Kumar, R., Jaiswal, V., Tripathi, S., Kumar, A. & Idris, M. Z. (2007) Inequity in health care delivery in India: The problem of rural medical practitioners. Health Care Analysis 15, 223233.CrossRefGoogle ScholarPubMed
Manda, S. O. (1999) Birth intervals, breastfeeding and determinants of childhood mortality in Malawi. Social Science & Medicine 48(3), 301312.CrossRefGoogle ScholarPubMed
Martines, J., Paul, V. K., Bhutta, Z. A., Koblinsky, M., Soucat, A., Walker, N., Bahl, R. et al. (2005) Neonatal survival: A call for action. Lancet Neonatal Survival Steering Team. Lancet 365(9465), 11891197.CrossRefGoogle Scholar
Mohan, P., Iyengar, S. D., Agarwal, K., Martines, J. C. & Sen, K. (2008) Care-seeking practices in rural Rajasthan: Barriers and facilitating factors. Journal of Perinatology 28, S3137.CrossRefGoogle ScholarPubMed
National Family Heath Survey (2001) National Family Heath Survey-II 1989–1999. International Institute for Population Sciences and ORC-Macro, Mumbai.Google Scholar
National Family Health Survey (2007) National Family Health Survey 2005–06: India. International Institute of Population Sciences (IIPS) and Macro International, Vol. 1, Mumbai.Google Scholar
National Rural Health Mission (2009) ASHA: Accredited Social Health Activists. URL: http://www.mohfw.nic.in/NRHM/asha.htmGoogle Scholar
Pallikadavath, S., Foss, M. & Stones, R. W. (2004) Antenatal care: Provision and inequality in rural north India. Social Science & Medicine 59, 11471158.CrossRefGoogle ScholarPubMed
Poudel, P., Singh, R., Raja, S. & Budhathoki, S. (2008) Pediatric and neonatal tetanus: A hospital based study at eastern Nepal. Nepal Medical College Journal 10(3), 170175.Google ScholarPubMed
Quddus, A., Luby, S., Rahbar, M. & Pervaiz, Y. (2002) Neonatal tetanus: Mortality rate and risk factors in Loralai District, Pakistan. International Journal of Epidemiology 31(3), 648653.CrossRefGoogle ScholarPubMed
Sreeramareddy, C. T., Joshi, H. S., Sreekumaran, B. V., Giri, S. & Chuni, N. (2006) Home delivery and newborn care practices among urban women in western Nepal: A questionnaire survey. BMC Pregnancy Childbirth 23(6), 27.CrossRefGoogle Scholar
Srivastava, N. M., Awasthi, S. & Agarwal, G. G. (2009) Care-seeking behavior and out-of-pocket expenditure for sick newborns among urban poor in Lucknow, northern India: A prospective follow-up study. BMC Health Service Research 2(9), 61.CrossRefGoogle Scholar
Titaley, C. R., Dibley, M. J., Agho, K., Roberts, C. L. & Hall, J. (2008) Determinants of neonatal mortality in Indonesia. BMC Public Health 9(8), 232.CrossRefGoogle Scholar
UNICEF (2007) The State of the World's Children 2008. Child Survival. United Nation Children's Fund, p. 117.Google Scholar