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New evidence on the impact of the quality of prenatal care on neonatal and infant mortality in India

Published online by Cambridge University Press:  09 September 2019

Ashish Kumar Upadhyay*
Affiliation:
International Institute for Population Sciences, Mumbai, India
Abhishek Singh
Affiliation:
International Institute for Population Sciences, Mumbai, India
Swati Srivastava
Affiliation:
International Institute for Population Sciences, Mumbai, India
*
*Corresponding author. Email: [email protected]

Abstract

Evidence on the impact of the quality of prenatal care on childhood mortality is limited in developing countries, including India. Therefore, using nationally representative data from the latest round of the National Family Health Survey (2015–16), this study examined the impact of the quality of prenatal care on neonatal and infant mortality in India using a multivariable binary logistic regression model. The effect of the essential components of prenatal care services on neonatal and infant mortality were also investigated. The results indicate that improvement in the quality of prenatal care is associated with a decrease in neonatal (OR: 0.93, 95% CI: 0.91–0.97) and infant (OR: 0.94, 95% CI: 0.92–0.96) mortality in India. Tetanus toxoid vaccination, consumption of iron–folic acid tablets during pregnancy and having been weighed during pregnancy were statistically associated with a lower risk of neonatal and infant mortality. Educating women on pregnancy complications was also associated with a lower risk of neonatal mortality. No effect of blood pressure examination, blood test and examination of the abdomen during pregnancy were found on either of the two indicators of childhood mortality. Although the coverage of prenatal care has increased dramatically in India, the quality of prenatal care is still an area of concern. There is therefore a need to ensure high-quality prenatal care in India.

Type
Research Article
Copyright
© Cambridge University Press 2019

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References

Arunda, M, Emmelin, A and Asamoah, BO (2017) Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: analysis of national survey data. Global Health Action 10, 1328796.CrossRefGoogle ScholarPubMed
Ashworth, A (1998) Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. European Journal of Clinical Nutrition 52 (Supplement 1), S3441; discussion S41–42.Google ScholarPubMed
Awiti, JO (2014) A multilevel analysis of prenatal care and birth weight in Kenya. Health Economics Review 4, 33.CrossRefGoogle ScholarPubMed
Behrman, JR and Rosenzweig, MR (2004) Returns to birthweight. Review of Economics and Statistics 86, 586601.CrossRefGoogle Scholar
Bergsjø, P (2001) What is the Evidence for the Role of Antenatal Care Strategies in the Reduction of Maternal Mortality and Morbidity? Safe Motherhood Strategies: A Review Of The Evidence. Studies in Health Services Organisation and Policy, Institute of Tropical Medicine Press, Antwerp, pp. 3554.Google Scholar
Bloom, SS, Lippeveld, T and Wypij, D (1999) Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy and Planning 14, 3848.CrossRefGoogle ScholarPubMed
Bryce, J, Arnold, F, Blanc, A, Hancioglu, A, Newby, H, Requejo, Jet al. (2013) Measuring coverage in MNCH: new findings, new strategies, and recommendations for action. PLoS Medicine 10, e1001423.CrossRefGoogle Scholar
Carroli, G, Villar, J, Piaggio, G, Khan-Neelofur, D, Gülmezoglu, M, Mugford, Met al. (2001) WHO systematic review of randomised controlled trials of routine antenatal care. The Lancet 357, 15651570.CrossRefGoogle ScholarPubMed
Celik, Y and Younis, MZ (2007) Effects of antenatal care services on birthweight: importance of model specification and empirical procedure used in estimating the marginal productivity of health inputs. Journal of Medical Systems 31, 197204.CrossRefGoogle ScholarPubMed
Conway, KS and Kutinova, A (2006) Maternal health: does prenatal care make a difference? Health Economics 15, 461488.CrossRefGoogle Scholar
Cuckle, H and Wood, J (1984) Principles of screening. In Wood, N (ed.) Antenatal and Neonatal Screening. Oxford University Press, Oxford.Google Scholar
Darmstadt, GL, Bhutta, ZA, Cousens, S, Adam, T, Walker, N, De Bernis, Let al. (2005) Evidence-based, cost-effective interventions: how many newborn babies can we save? The Lancet 365, 977988.CrossRefGoogle ScholarPubMed
Deb, P and Sosa-Rubi, SG (2005) Does onset or quality of prenatal care matter more for infant health. Health Econometrics and Data Group Working Paper 5(11).Google Scholar
Doku, DT and Neupane, S (2017) Survival analysis of the association between antenatal care attendance and neonatal mortality in 57 low- and middle-income countries. International Journal of Epidemiology 46, 16681677.Google ScholarPubMed
Dormann, CF, Elith, J, Bacher, S, Buchmann, C, Carl, G, Carré, Get al. (2013) Collinearity: a review of methods to deal with it and a simulation study evaluating their performance. Ecography 36, 2746.CrossRefGoogle Scholar
Habibov, NN and Fan, L (2011) Does prenatal healthcare improve child birthweight outcomes in Azerbaijan? Results of the national Demographic and Health Survey. Economics and Human Biology 9, 5665.CrossRefGoogle ScholarPubMed
Hall, MH (1990) 4 Identification of high risk and low risk. Baillieres Clinical Obstetrics Gynaecology 4, 6576.CrossRefGoogle ScholarPubMed
Hedderson, MM, Gunderson, EP and Ferrara, A (2010) Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and Gynecology 115, 597604.CrossRefGoogle ScholarPubMed
Hollowell, J, Oakley, L, Kurinczuk, JJ, Brocklehurst, P and Gray, R (2011) The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review. BMC Pregnancy and Childbirth 11, 13.CrossRefGoogle ScholarPubMed
Hug, L, Sharrow, D and You, D (2017) Levels and Trends in Child Mortality: Report (2017). Estimates developed by the UN Inter-agency Group for Child Mortality Estimation, United Nations Children’s Fund, New York, 2017.Google Scholar
Ibrahim, J, Yorifuji, T, Tsuda, T, Kashima, S and Doi, H (2012) Frequency of antenatal care visits and neonatal mortality in Indonesia. Journal of Tropical Pediatrics 58, 184188.CrossRefGoogle ScholarPubMed
IIPS and ICF (2017) National Family Health Survey (NFHS-4), 2015-16: India. IIPS, Mumbai.Google Scholar
Joyce, TJ and Grossman, M (1990) Pregnancy wantedness and the early initiation of prenatal care. Demography 27, 117.CrossRefGoogle ScholarPubMed
Kuhnt, J and Vollmer, S (2017) Antenatal care services and its implications for vital and health outcomes of children: evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open 7(11).CrossRefGoogle Scholar
Lawn, JE, Cousens, S and Zupan, J (2005) 4 million neonatal deaths: when? Where? Why? Lancet 365, 891900.CrossRefGoogle ScholarPubMed
Liu, L, Li, M, Yang, L, Ju, L, Tan, B, Walker, Net al. (2013) Measuring coverage in MNCH: a validation study linking population survey derived coverage to maternal, newborn, and child health care records in rural China. PLoS One 8, e60762.CrossRefGoogle ScholarPubMed
McCormick, MC (1985) The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 312, 8290.CrossRefGoogle ScholarPubMed
McDonagh, M (1996) Is antenatal care effective in reducing maternal morbidity and mortality? Health Policy and Planning 11, 115.CrossRefGoogle ScholarPubMed
Macdonald-Wallis, C, Tilling, K, Fraser, A, Nelson, SM and Lawlor, DA (2013) Gestational weight gain as a risk factor for hypertensive disorders of pregnancy. American Journal of Obstetrics and Gynecology 209, e1327.CrossRefGoogle ScholarPubMed
Maitra, P (2004) Parental bargaining, health inputs and child mortality in India. Journal of Health Economics 23, 259291.CrossRefGoogle ScholarPubMed
Makate, M and Makate, C (2017) The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys. Health Policy and Planning 32, 395404.Google ScholarPubMed
Maternal Health Division (2005) Guidelines for Ante‐Natal Care and Skilled Attendance at Birth by ANMs and LHVs. Maternal Health Division, Department of Family Welfare, Ministry of Health and Family Welfare, Government of India.Google Scholar
Moran, AC, Sangli, G, Dineen, R, Rawlins, B, Yaméogo, M and Baya, B (2006) Birth-preparedness for maternal health: findings from Koupéla District, Burkina Faso. Journal of Health, Population and Nutrition 24, 489497.Google ScholarPubMed
Mosley, WH and Chen, LC (1984) An analytical framework for the study of child survival in developing countries. Population and Development Review 10, 2545.CrossRefGoogle Scholar
Mwabu, G (2009) The production of child health in Kenya: a structural model of birth weight. Journal of African Economies 18, 212260.CrossRefGoogle Scholar
Pallikadavath, S, Foss, M and Stones, RW (2004) Antenatal care: provision and inequality in rural north India. Social Science & Medicine 59, 11471158.CrossRefGoogle ScholarPubMed
Raatikainen, K, Heiskanen, N and Heinonen, S (2007) Under-attending free antenatal care is associated with adverse pregnancy outcomes. BMC Public Health 7, 268.CrossRefGoogle ScholarPubMed
Ram, F and Singh, A (2006) Is antenatal care effective in improving maternal health in rural uttar pradesh? Evidence from a district level household survey. Journal of Biosocial Science 38, 433448.CrossRefGoogle ScholarPubMed
Redman, C (1982) Screening for pre-eclampsia. In Enkin, M & Chalmers, I (eds) Effectiveness and Satisfaction in Antenatal Care. Spastics International Medical Publications, London.Google Scholar
Reichman, NE, Corman, H, Noonan, K and Dave, D (2009) Infant health production functions: what a difference the data make. Health Economics 18, 761782.CrossRefGoogle Scholar
Rooney, C (1992) Antenatal Care and Maternal Health: How Effective Is It? Maternal Health and Safe Motherhood Programme, Division ofFamily Health, World Health Organisation, Geneva.Google Scholar
Rosenberg, K and Twaddle, S (1990) Screening and surveillance of pregnancy hypertension – an economic approach to the use of daycare. Baillieres Clinical Obstetrics Gynaecology 4, 89107.CrossRefGoogle ScholarPubMed
Rosenzweig, MR and Schultz, TP (1983) Estimating a household production function: heterogeneity, the demand for health inputs, and their effects on birth weight. Journal of Political Economy 91, 723746.CrossRefGoogle Scholar
Shah, D, Shroff, S and Ganla, K (2000) Factors affecting perinatal mortality in India. International Journal of Gynaecology and Obstetrics 71, 209210.CrossRefGoogle ScholarPubMed
Singh, A, Chalasani, S, Koenig, MA and Mahapatra, B (2012a) The consequences of unintended births for maternal and child health in India. Population Studies 66, 223239.CrossRefGoogle ScholarPubMed
Singh, A, Pallikadavath, S, Ram, F and Alagarajan, M (2014) Do antenatal care interventions improve neonatal survival in India? Health Policy and Planning 29, 842848.CrossRefGoogle ScholarPubMed
Singh, A, Pallikadavath, S, Ram, F and Ogollah, R (2012b) Inequalities in advice provided by public health workers to women during antenatal sessions in rural India. PLoS One 7, e44931.CrossRefGoogle ScholarPubMed
Titaley, CR and Dibley, MJ (2012) Antenatal iron/folic acid supplements, but not postnatal care, prevents neonatal deaths in Indonesia: analysis of Indonesia Demographic and Health Surveys 2002/2003–2007 (a retrospective cohort study). BMJ Open 2, e001399.CrossRefGoogle Scholar
Titaley, CR, Dibley, MJ, Roberts, CL, Hall, J and Agho, K (2010) Iron and folic acid supplements and reduced early neonatal deaths in Indonesia. Bulletin of the World Health Organization 88, 500508.CrossRefGoogle ScholarPubMed
Wahabi, HA, Esmaeil, SA, Fayed, A, Al-Shaikh, G and Alzeidan, RA (2012) Pre-existing diabetes mellitus and adverse pregnancy outcomes. BMC Research Notes 5, 496.CrossRefGoogle ScholarPubMed
WHO (2006) Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Standards for Maternal and Neonatal Care (1.6). Department of Making Pregnancy Safer, World Health Organization, Geneva.Google Scholar
WHO (2016) WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. World Health Organization, Geneva.Google Scholar
Yasmin, S, Osrin, D, Paul, E and Costello, A (2001) Neonatal mortality of low-birth-weight infants in Bangladesh. Bulletin of the World Health Organization 79, 608614.Google ScholarPubMed
Zeng, L, Cheng, Y, Dang, S, Yan, H, Dibley, MJ, Chang, Set al. (2008) Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation, and perinatal mortality in rural western China: double blind cluster randomised controlled trial. BMJ 337, a2001.CrossRefGoogle ScholarPubMed