Utilisation Of Health Schemes By The Registered Pregnant Women In The Rural Field Practice Area Of Handiganur In Belagavi: A Community Based Cross Sectional Study

Abstract

Background: Mothers and children approximately form 71.14% of the total population in any developing country. In India women of child bearing age (15-45 years) constitute about 32.2% of the total population. The risk is associated with pregnancy, childbirth and post natal period. Promoting women’s health improves not only individual health, but also the health of the family, community and the nation. Hence women acquire a special place in the community. A number of programs have been launched by the Government of India for the welfare of the women belonging to reproductive age group, but still significant reduction in maternal mortality and morbidity has not been achieved yet. Objectives: To study the utilization of Maternal Health services after launching/implementing of Demand Generation Schemes by Government of Karnataka, viz Janani Suraksha Yojana (JSY), Prasuthi Araike Programme (PA), Madilu-kit Programme and Thaiyi Bhagya Plus programme (TBP). Methodology: A community based cross sectional study was done among 540 pregnant mothers who delivered from 1st January 2015 to 31st December 2015in the rural field practice area of P. H. C. Handiganur, administered by the Department of Community Medicine, K.L.E. University’s Jawaharlal Nehru Medical College, Belagavi. Information regarding socio-demographic profile, utilisation of Maternal and Child Health Services, assessment of Demand Generation Schemes (DGS) was collected after obtaining written informed consent. The participants were interviewed using pre-designed and pre-tested questionnaire. Results: In the present study, the mean age of study participants was 24.1 + 2.8 years ranging from 20-35 years. About 92.4% wereof 18 years and above at the time of marriage.80.7% were Hindus, 50.2% belonged to general category, 88.9% mothers were literates, 54.1% were home-makers,58.5% belonged to SES class V, 56.9% belonged to below poverty line. About 42% of women after knowing their pregnancy, first contacted ASHA worker. About 96.1% of pregnancies were registered and also first antenatal check-up was done within 12 weeks of gestation. About 42.2% women had moderate anemia, 31.1% of the study participants had mild anemia. 100% pregnant women had received free supply of IFA tablets out ofwhich 53.3% consumed 75%-100% tablets of iron and folic acid. About 83.3% mothers delivered in governmentfacilities. 46.1% pregnant women were accompanied by ASHA workers to hospital for delivery.100% new borns received OPV0 and BCG dose, whereas only 45.6% received Hepatitis B0.84.6% participants came for two PNC visits. 61.7% women were the beneficiaries who utilized the demand generation schemes services. Among beneficiaries, 82% there was delay in receiving incentives and only 18% beneficiaries got incentives on time.The main reason for delay (63.7%) was due to insufficient budget released at that time from the government. Conclusion: Factors influencing maternal health services like younger age of the woman, higher education of the woman, age at married and higher socio-economic status were associated with better utilization of maternal health services. ASHA workers, Anganwadi workers and ANM workers are the important link between the health care services and at the gross root level in community. Even after receiving free iron and folic acid tablets, it was observed that the compliance of the pregnant mothers was less. Knowledge about immediate starting of breast feeding after delivery was medium. Most of the woman availed two post-natal check-ups services. The awareness about Demand Generation Schemes was very high, which has successfully promoted women’s preference to institutional deliveries, but the knowledge about the benefits covered under Demand generation Schemes (DGS) was low. Benefits covered under the various schemes were received by all beneficiaries but there was overall delay in receiving cash incentives. However, insufficient budget was the main reason for delay in majority of women. Incentive money received in schemes by the beneficiaries was mainly spent for various house-hold expenditure. Overall satisfaction level among the women regarding maternal health services and the Demand Generation Scheme was high.