Factors influencing the Utilization of Maternal Health Care Services in Uttarakhand Digambar A. Chimankar 1 and Harihar Sahoo 2 1 P.G. Department of Population Studies, Fakir Mohan University, Balasore, Orissa, India E-mail: dachimankar@yahoo.com 2 Department of Sociology, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, Maharashtra, India E-mail: hariharsahoo@sify.com KEYWORDS Antenatal Care. Safe Delivery. Postnatal Care. Predictors. Uttarakhand ABSTRACT The National Family Health Survey (NFHS-III 2005-06) provided a gloomy picture of the status of maternal health indicators of Uttarakhand. The state has witnessed a higher proportion of high risk pregnancies. A large number of births take place outside the health system (67.4 percent), the majority being attended by untrained dais (midwives). These have resulted in higher maternal morbidity and mortality. Therefore, the present paper attempts to find out the possible factors influencing the use of maternal health care services, using the data from NFHS III. Both bi-variate and multivariate analysis have been carried out for the study by taking ante-natal care and delivery care as dependant variables. The result reveals that the educational level of women, birth order and wealth index are significant predictors in explaining ante-natal and delivery care. Controlling the effect of other variables, the predictive power of women’s educational level, wealth index have been positively associated with antenatal care and also delivery care. INTRODUCTION Maternal mortality reflects one of the shame- ful failures of human development (Freedman et al. 2003). Approximately 80 percent of the ma- ternal deaths globally occur due to haemorrhage, sepsis, unsafe induced abortion, hypertensive disorder of pregnancy, and obstructed labour (WHO 2005). These deaths are unjust and can be avoided with key health interventions, like provision of antenatal care and medically assisted delivery (Adam et al. 2005; MCcaw-Binns et al. 2007). The emphasis on two out of eight critical United Nations Millennium Development Goals, that is, reducing under five mortality by two- thirds between 1990 and 2015; and reducing maternal mortality ratio by three quarters between 1990 and 2015 epitomise the relevance of these indicators in global efforts towards human de- velopment (Freedman et al. 2007; Rosenfield et al. 2006; World Health Organization 2004). A fully functioning, mother-baby package inter- vention has been estimated to have the poten- tial cumulative effect of averting 75–85% of ma- ternal deaths and disability in developing co- untries (Graham 2006). Factors influencing maternal health services utilization operate at various levels-individual, household, community. Depending on the indi- cator of maternal health services, the relevant determinants vary. Although, in general, women in higher socio-economic groups tend to exhibit patterns of more frequent use of maternal health services than women in the lower socio-econo- mic groups. A number of literatures have high- lighted the utilization of maternal health care services varies with the socio-economic charac- teristics of the population (Kanitkar and Sinha 1989; Govindaswamy 1994; Kavita and Audi- narayana 1997; Bloom 2001; Navaneetham and Dharmalingam 2002; Gymiah et al. 2006; Dey 2009). These studies have shown that education of the mother is an important social variable that has a positive effect on the utilization of mater- nal and child health services. The other socio- economic factors usually found to be important are place of residence, religion and standard of living of the household. The economic status of the household also determines the utilization of antenatal care and delivery care services (Pandey et al. 2002). Kavita and Audinarayana (1997) documented a strong association of the caste system with the utilization of maternal care ser- vices. Basu (2009) has made a comparative stu- dy on reproductive and child health status of the scheduled castes and scheduled tribes of West Bengal on the basis of National Family Health Survey I and II data. Sunil et al. (2005) made an attempt to examine individual and program factors matter in the utilization of maternal care services in rural India. Some studies on health seeking behaviour have focused on the impor- © Kamla-Raj 2011 Ethno Med, 5(3): 209-216 (2011)