Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-19T03:41:38.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Continuum of maternal health care services and its impact on child immunization in India: an application of the propensity score matching approach

Published online by Cambridge University Press:  24 August 2020

Mohd Usman Open the ORCID record for Mohd Usman [Opens in a new window] ,
Enu Anand Open the ORCID record for Enu Anand [Opens in a new window] ,
Laeek Siddiqui  and
Sayeed Unisa
Mohd Usman
Affiliation:
International Institute for Population Sciences, Deonar, Mumbai, India
Enu Anand*
Affiliation:
International Institute for Population Sciences, Deonar, Mumbai, India
Laeek Siddiqui
Affiliation:
International Institute for Population Sciences, Deonar, Mumbai, India
Sayeed Unisa
Affiliation:
International Institute for Population Sciences, Deonar, Mumbai, India
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Continuum of care throughout pregnancy, delivery and post-delivery has proved to be a critical health intervention for improving the health of mothers and their newborn children. Using data from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015–16, this study examined the correlates of utilization of maternal health care services and child immunization following the continuum of care approach in India. The study also assessed whether the continuity in utilizing maternal health care services affects the immunization of children. A total of 33,422 survey women aged 15–49 were included in the analysis of maternal health care indicators, and 8246 children aged 12–23 months for the analysis of child immunization. The results indicated that about 19% of the women had completed the maternal health continuum, i.e. received full antenatal care, had an institutional delivery and received postnatal care. Women with a higher level of education and of higher economic status were more likely to have complete continuum of care. Continuity of maternal health care was found to be associated with an increase in the immunization level of children. It was observed that 76% of the children whose mothers had complete continuum of care were fully immunized. Furthermore, the results from propensity score matching revealed that if mothers received continuum of care, the chance of their child being fully immunized increased by 17 percentage points. The results suggest that promotion of the continuum of maternal health care approach could help reduce not only the burden of maternal deaths in India, but also that of child deaths by increasing the immunization level of children.

Keywords

Maternal and child healthContinuum of careChild immunization
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 5 , September 2021 , pp. 643 - 662
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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

Adhikari, R (2016) Effect of women’s autonomy on maternal health service utilization in Nepal: a cross sectional study. BMC Women’s Health 16(1), 26.CrossRefGoogle ScholarPubMed
Ahmed, S, Creanga, AA, Gillespie, DG and Tsui, AO (2010) Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS One 5(6), e11190.CrossRefGoogle ScholarPubMed
Austin, PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research 46(3), 399–424.CrossRefGoogle ScholarPubMed
Barman, B, Saha, J and Chouhan, P (2020) Impact of education on the utilization of maternal health care services: an investigation from National Family Health Survey (2015–16) in India. Children and Youth Services Review 108, doi: 10.1016/j.childyouth.2019.104642CrossRefGoogle Scholar
Baru, R, Acharya, A, Acharya, S, Shiva Kumar, AK and Nagaraj, K (2010) Inequities in access to health services in India: caste, class and region. Economic and Political Weekly 45(38), 49–58.Google Scholar
Barua, A and Kurz, K (2001) Reproductive health-seeking by married adolescent girls in Maharashtra, India. Reproductive Health Matters 9(17), 53–62.CrossRefGoogle ScholarPubMed
Baum, CF (2013) Propensity score matching regression discontinuity limited dependent variables. In EC 823: Applied Econometrics. Boston College, pp. 1–99.Google Scholar
Becerril, J and Abdulai, A (2010) The impact of improved maize varieties on poverty in Mexico: a propensity score-matching approach. World Development 38(7), 1024–1035.CrossRefGoogle Scholar
Bhutta, ZA, Ali, S, Cousens, S and Black, RE (2008) Alma-Ata: Rebirth and Revision 6 – interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make? The Lancet 372(9642), 972–989.CrossRefGoogle Scholar
Black, RE, Morris, SS and Bryce, J (2003) Where and why are 10 million children dying every year? Lancet 361(9376), 2226–2234.CrossRefGoogle ScholarPubMed
Bloom, SS, Wypij, D and Das Gupta, M (2001) Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography 38(1), 67–78.CrossRefGoogle Scholar
Burns, LR and Pauly, MV (2002) Integrated delivery networks: a detour on the road to integrated health care? Health Affairs 21(4), 128–143.CrossRefGoogle ScholarPubMed
Caliendo, M and Kopeinig, S (2008) Some practical guidance for the implementation of propensity score matching. Journal of Economic Surveys 22(1), 31–72.CrossRefGoogle Scholar
Chalasani, S (2012) Understanding wealth-based inequalities in child health in India: a decomposition approach. Social Science & Medicine 75(12), 2160–2169.CrossRefGoogle ScholarPubMed
Choi, JY and Lee, SH (2006) Does prenatal care increase access to child immunization? Gender bias among children in India. Social Science & Medicine 63(1), 107–117.Google ScholarPubMed
Currie, DH and Wiesenberg, SE (2003) Promoting women’s health-seeking behavior: research and the empowerment of women. Health Care for Women International 24(10), 880–899.CrossRefGoogle ScholarPubMed
Dharmalingam, A, Navaneetham, K and Morgan, SP (2005) Muslim–Hindu fertility differences. Economic and Political Weekly 40(5), 429–436.Google Scholar
Dixit, P, Dwivedi, LK and Ram, F (2013) Strategies to improve child immunization via antenatal care visits in India: a propensity score matching analysis. PLoS One 8(6), e66175.CrossRefGoogle ScholarPubMed
Ekman, B, Pathmanathan, I and Liljestrand, J (2008) Integrating health interventions for women, newborn babies, and children: a framework for action. The Lancet 372(9642), 990–1000.CrossRefGoogle Scholar
Furuta, M and Salway, S (2006) Women’s position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspectives 32(1), 17–27.CrossRefGoogle ScholarPubMed
Ganle, JK, Obeng, B, Segbefia, AY, Mwinyuri, V, Yeboah, JY and Baatiema, L (2015) How intra-familial decision-making affects women’s access to, and use of maternal healthcare services in Ghana: a qualitative study. BMC Pregnancy and Childbirth 15(1), 173.CrossRefGoogle ScholarPubMed
Govindasamy, P and Ramesh, BM (1997) Maternal education and the utilization of maternal and child health services in India. National Family Health Survey Subject Reports 5, 1–28.Google Scholar
Guo, S and Fraser, MW (2014) Propensity Score Analysis : Statistical Methods and Applications. Sage Publications.Google Scholar
Houweling, TA, Ronsmans, C and Kunst, AE (2011) Huge poor–rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries. Bulletin of the World Health Organization, doi: 10.2471/BLT.Google Scholar
IIPS (2015) National Family Health Survey (NFHS-4). IIPS, Mumbai.Google Scholar
James, KS (2011) India’s demographic change: opportunities and challenges. Science, doi: 10.1126/science.1207969CrossRefGoogle ScholarPubMed
Kerber, KJ, De Graft-Johnson, JE, Bhutta, ZA, Okong, P, Starrs, A and Lawn, JE (2007) Continuum of care for maternal, newborn, and child health: from slogan to service delivery. Lancet 370(9595), 1358–1369.CrossRefGoogle ScholarPubMed
Kodner, DL and Kyriacou, CK (2000) Fully integrated care for frail elderly: two American models. International Journal of Integrated Care 1, e08.CrossRefGoogle ScholarPubMed
Lawn, JE, Tinker, A, Munjanja, SP and Cousens, S (2006) Where is maternal and child health now? The Lancet 368(9546), 1474–1477.CrossRefGoogle ScholarPubMed
Li, M (2013) Using the propensity score method to estimate causal effects: a review and practical guide. Organizational Research Methods 16(2), 188–226.CrossRefGoogle Scholar
Lincetto, O, Mothebesoane-anoh, S, Gomez, P and Munjanja, S (2006) Antenatal Care. Opportunities for Africa’s Newborns: Practical Data, Policy and Programmatic Support for Newborn Care in Africa. URL: https://www.who.int/pmnch/media/publications/aonsectionIII_2.pdfGoogle Scholar
Linden, A (2015) Graphical displays for assessing covariate balance in matching studies. Journal of Evaluation in Clinical Practice 21(2), 242–247.CrossRefGoogle ScholarPubMed
Mistry, R, Galal, O and Lu, M (2009) Women’s autonomy and pregnancy care in rural India: a contextual analysis. Social Science & Medicine 69(6), 926–933.CrossRefGoogle ScholarPubMed
Morgan, C J (2018) Reducing bias using propensity score matching. Journal of Nuclear Cardiology 25(2), 404–406.CrossRefGoogle ScholarPubMed
Nigatu, D, Gebremariam, A, Abera, M, Setegn, T and Deribe, K (2014) Factors associated with women’s autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study. BMC Women’s Health 14(1), 79.CrossRefGoogle ScholarPubMed
Oyerinde, K (2013) Can antenatal care result in significant maternal mortality reduction in developing countries? Journal of Community Medicine & Health Education, doi: 10.4172/2161-0711.1000e116CrossRefGoogle Scholar
Pan, W and Bai, H (2015) Propensity score analysis: concepts and issues. Propensity Score Analysis: Fundementals and Developments, doi: 10.1108/S1474-7863(2012)0000013012Google Scholar
Pathak, PK, Singh, A and Subramanian, SV (2010) Economic inequalities in maternal health care: prenatal care and skilled birth attendance in India, 1992–2006. PloS One 5(10), e13593.CrossRefGoogle Scholar
Paul, S and Sridhar, KS (2015) The Paradox of India’s North–South Divide: Lessons from the States and Regions. SAGE Publications, India.Google Scholar
Registrar General of India (2018) Special Bulletin on Maternal Mortality in India 2014–16. SRS Bulletin.Google Scholar
Rosenbaum, PR and Rubin, DB (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70(1), 41–55.CrossRefGoogle Scholar
Sarker, AR, Sheikh, N, Mahumud, RA and Sultana, M (2018) Determinants of adolescent maternal healthcare utilization in Bangladesh. Public Health 157, 94–103.CrossRefGoogle ScholarPubMed
Saroha, E, Altarac, M and Sibley, LM (2008) Caste and maternal health care service use among rural Hindu women in Maitha, Uttar Pradesh, India. Journal of Midwifery and Women’s Health 53(5), e41–e47.CrossRefGoogle ScholarPubMed
Senarath, U and Gunawardena, NS (2009) Women’s autonomy in decision making for health care in South Asia. Asia-Pacific Journal of Public Health 21(2), 137–143.CrossRefGoogle ScholarPubMed
Sharma, D, Shastri, S and Sharma, P (2016) Intrauterine growth restriction: antenatal and postnatal aspects. Clinical Medicine Insights: Pediatrics 10, CMPed.S40070.CrossRefGoogle ScholarPubMed
Shrivastwa, N, Gillespie, BW, Kolenic, GE, Lepkowski, JM and Boulton, ML (2015) Predictors of vaccination in India for children aged 12-36 months. American Journal of Preventive Medicine 49(6), Suppl. 4, S435–S444.CrossRefGoogle ScholarPubMed
Sines, BE, Syed, U, Wall, S and Worley, H (2007) Postnatal care : a critical opportunity to save mothers and newborns. Policy Perspectives on Newborn Health 1(7).Google Scholar
Singh, A, Pallikadavath, S, Ram, F and Alagarajan, M (2014) Do antenatal care interventions improve neonatal survival in India? Health Policy and Planning 29(7), 842–828.CrossRefGoogle ScholarPubMed
Singh, L, Rai, RK and Singh, PK (2012a) Assessing the utilization of maternal and child health care among married adolescent women: evidence from India. Journal of Biosocial Science 44(1), 1–26.CrossRefGoogle ScholarPubMed
Singh, PK (2013) Trends in child immunization across geographical regions in India: focus on urban-rural and gender differentials. PLoS One 8(9), e73102.CrossRefGoogle ScholarPubMed
Singh, PK, Rai, RK, Alagarajan, M and Singh, L (2012b) Determinants of maternity care services utilization among married adolescents in rural India. PLoS One 7(2), doi: 10.1371/journal.pone.0031666Google ScholarPubMed
Sohn, M and Jung, M (2020) Effects of empowerment and media use by women of childbearing age on maternal health care utilization in developing countries of Southeast Asia. International Journal of Health Services : Planning, Administration, Evaluation 50(1), 32–43.CrossRefGoogle ScholarPubMed
StataCorp (2015) Stata Statistical Software: Release 14. doi: 10.1186/s12970-017-0182-yCrossRefGoogle Scholar
Sword, W (1999) A socio-ecological approach to understanding barriers to prenatal care for women of low income. Journal of Advanced Nursing 29(5), 1170–1177.CrossRefGoogle ScholarPubMed
UNICEF (2019) Neonatal mortality – UNICEF Data. URL: https://data.unicef.org/topic/child-survival/neonatal-mortality/ (accessed9th April 2020).Google Scholar
Weitzman, A (2017) The effects of women’s education on maternal health: evidence from Peru. Social Science & Medicine 180, 1–9.CrossRefGoogle ScholarPubMed
WHO (2014) Skilled Birth Attendants. WHO, Geneva. URL: https://www.who.int/reproductivehealth/topics/mdgs/skilled_birth_attendant/en/Google Scholar
WHO (2015) Postnatal Care for Mothers and Newborns: Highlights from the World Health Organization 2013 Guidelines. Postnatal Care Guidelines. WHO, Geneva.Google Scholar
WHO (2018) Sustainable Development Knowledge Platform. WHO, Geneva. doi: 10.5194/nhess-10-2713-2010Google Scholar
Yaya, S, Bishwajit, G and Shah, V (2016) Wealth, education and urban-rural inequality and maternal healthcare service usage in Malawi. BMJ Global Health 1(2), e000085.CrossRefGoogle ScholarPubMed