Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India

The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional...

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Bibliographic Details
Published in:BMC pregnancy and childbirth 2015-02, Vol.15 (1), p.49-49, Article 49
Main Authors: Bruce, Sharon G, Blanchard, Andrea K, Gurav, Kaveri, Roy, Anuradha, Jayanna, Krishnamurthy, Mohan, Haranahalli L, Ramesh, Banadakoppa M, Blanchard, James F, Moses, Stephen, Avery, Lisa
Format: Article
Language:English
Subjects:
Adult
Births
Childbirth & labor
Childrens health
Developing countries
Ethics
Families & family life
Female
Health promotion
Health services
Health Services Accessibility - economics
Hospitals, Private - standards
Hospitals, Public - standards
Humans
India
Infant
LDCs
Maternal & child health
Mortality
Mothers
Mothers - psychology
Needs Assessment
Patient Preference
Perinatal Care - methods
Perinatal Care - organization & administration
Pregnancy
Pregnant Women - psychology
Public health
Qualitative research
Quality
Quality Improvement
Reproductive health
Rural areas
Rural Health
Rural Population - statistics & numerical data
Socioeconomic Factors
Womens health
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Summary:The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional deliveries there are still considerable barriers to utilization and quality of services, particularly in rural areas, that may mitigate improvements achieved by MNCH interventions. This paper aims to explore the factors influencing preference for home, public or private hospital delivery among rural pregnant and new mothers in three northern districts of Karnataka state, South India. In-depth qualitative interviews were conducted in 2010 among 110 pregnant women, new mothers (infants born within past 3 months), their husbands and mothers-in-law. Interviews were conducted in the local language (Kannada) and then translated to English for analysis. The interviews of pregnant women and new mothers were used for analysis to ultimately develop broader themes around definitions of quality care from the perspective of service users, and the influence this had on their delivery site preferences. Geographical and financial access were important barriers to accessing institutional delivery services in all districts, and among those both above and below the poverty line. Access issues of greatest concern were high costs at private institutions, continuing fees at public hospitals and the inconsistent receipt of government incentives. However, views on quality of care that shaped delivery site preferences were deeply rooted in socio-cultural expectations for comfortable, respectful and safe care that must ultimately be addressed to change negative perceptions about institutional, and particularly public hospital, care at delivery. In the literature, quality of care beyond access has largely been overlooked in favour of support for incentives on the demand side, and more trained doctors, facilities and equipment on the supply side. Taking a comprehensive approach to quality of care in line with cultural values and community needs is imperative for improving experiences, utilization, and ultimately maternal and neonatal health outcomes at the time of delivery.
ISSN:1471-2393
1471-2393
DOI:10.1186/s12884-015-0481-8