LETTER TO EDITOR
|Year : 2007 | Volume
| Issue : 2 | Page : 148
Factors influencing maternal health in Rewa town
Divya Sahu, SS Kushwah
Department of Community Medicine, S. S. Medical College, Rewa, M.P, India
|Date of Submission||15-Feb-2002|
S S Kushwah
Department of Community Medicine, S. S. Medical College, Rewa, M.P
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sahu D, Kushwah S S. Factors influencing maternal health in Rewa town. Indian J Community Med 2007;32:148
The current maternal mortality rate in Madhya Pradesh is 498 per 100 000 live births. Nearly 700-800 mothers die every month because of inadequate maternal care.  Hence, this study was undertaken in Rewa urban area to identify the factors influencing maternal health.
The present study was carried out in five wards, which were randomly selected from among the 45 wards of Rewa municipal area. In the selected wards, those households were listed in which females had delivered babies within the past one year. Out of these listed households, a random sample was drawn. The size of the sample was as per the criteria laid out in a WHO publication,  taking 95% confidence limits with absolute precision. Thus, 141 mothers were interviewed in the selected wards by door-to-door visits using a pretested questionnaire. For the purposes of this study, a participant was said to have received full ANC if she had had at least three antenatal checkups +1 T.T. injection +100 iron folic acid tablets. 
We found that as female literacy increased, the percentage of females having ≤2 children also increased. Similarly, better educated females availed of more antenatal checkups and their age at marriage also tended to be higher. It was also observed that 32.6% of the women were married before 18 years of age, while 67.4% (95 females) were married at or after 18 years of age. Out of 95 females, 69 had been educated up to higher secondary school or beyond.
Only 14.8% of pregnant women in India receive full ANC,  while 67.2% have been found to receive at least some ANC. In our study of Rewa, we found that 23.4% of the women had received full ANC and 68% had received some ANC, which is close to the national data. The wide difference in the numbers of those who receive full antenatal care and those who receive only some antenatal care clearly implies poor efficiency and quality of maternal care services.
It was observed that about 61% of the women were registered in the 1 st trimester, 25.8% in 2 nd trimester, and 5.6% in 3 rd trimester. There were 8.5% women who were not registered at all, and all of them were from a low socioeconomic background. According to the recommendations of the Decentralized Participatory Planning in Family Welfare Program, under the target-free approach (TFA), antenatal case registration should be 100% and early registration (<16 weeks) should be 60%. In our study, we found that, overall, there was 91.5% registration, with 61% who were registered early, which is close to the recommended target.
Out of the 141 women studied, only 93 had >3 ANC visit (65.9%). Out of these 93 women, 34 (36.6%) were registered in government hospitals, while 59 (63.4%) were registered in private clinics. Quality of antenatal services was assessed by inquiring about performance of physical examination more than thrice during pregnancy. In private clinics, some measures like weight recording (34%), hemoglobin estimation (20.3%), BP recording (41%), and urine examination (15.3%) were done frequently, while physical examination was conducted more often (85.3%) in government hospitals.
The influence of economic status on institutional care was also studied. It was observed that about 85% of the women had institutional deliveries, while 14.89% had home deliveries. Women having a family income above Rs. 4000 per month had deliveries either at home or at government hospitals. Those with an income between Rs. 4000 and Rs. 8000 per month preferred government hospitals. Private hospitals were the preferred place for delivery for those in the higher income groups. The conclusion is that the women belonging to higher socioeconomic groups preferred private nursing homes for antenatal and natal services.
We conclude that the role of education is of paramount importance in female empowerment as well as for enhancing the economic status of women, so that they can take independent decisions when availing of safe motherhood services.
| References|| |
|1.||Park K. Textbook of preventive and social medicine. M/S Banarsidas Bhanot (India): Jabalpur; 2000. p. 381. |
|2.||Lwanga SK, Lameshow S. Sample size determination in health studies: A practical manual. WHO: Geneva; 1991. p. 25. |