Abstract of Dissertation

Agency : Maternal Health, Coverage Evaluation, Institutional Delivery, Maternal Health Services

Objective : Not Available

Background : Medical attention received by pregnant women is important to reduce maternal and infant mortality. DLHS 3 showed that institutional delivery is 28.3%. In 2013-14 institutional delivery in Dang district was 54.67%. Although institutional delivery has risen, the growth is very slow. Coverage evaluation of maternal health program which focuses on antenatal care service and cash incentive programs along with other flag ship programs is essential to understand the situation of the district. This study has been taken up with the objective to find the coverage of maternal health services with focus on ante natal care service.

Methodology : 30*7 cluster sampling technique was used. 210 women who delivered in 2013-2014 were interviewed and services utilized by them were noted down in closed ended questionnaire. Awareness about the cash incentive programs and other programs related to promotion of institutional delivery were also taken in the questionnaire. Reasons for preference of institutional/home delivery were asked to see the prevalence

Findings : Utilization of 3 ante natal check up was 73%, drop out from1st ANC and 3rd ANC service was 25%. 96% women were immunized with TT-2/booster. Urine examination was done in 13% women. Awareness and utilization of JSY, KPSY, JSSK was low in comparison to MIS. Awareness of free referral transport was high but utilization was low. Major reasons reported for home delivery were never felt the need and delay in decision making, followed by pressure from family. And reasons reported for home deliveries were good facilities at health institution and motivation by ASHA.

Recommendations :

Drop out from ante natal care should be reduced by utilizing MCTS and due list of the beneficiary should be given to ASHA day prior to Mamta session. Education and counseling of Flagship programs should be increased. Currently only 5 PHC, 1 CHC and 1 DH is providing delivery facility in the district. Rest of the health institutions should be made functional to increase institutional delivery. Partnering with private hospital to reduce out of pocket expenditure. Operationalising Mamta ghar in the district to reduce the delays (3 delay model).