August 2016 · Volume 5 · Issue 8 Page 2607
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Parashar A et al. Int J Reprod Contracept Obstet Gynecol. 2016 Aug;5(8):2607-2611
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Research Article
Status of maternal care and immunisation services in a hilly state of
north India: a cross sectional study
Anupam Parashar*, Salig Ram Mazta, Dineshwar Singh Dhadwal, Anita Thakur,
Harshvardhan Singh, Kamlesh Sharma, Kanica Kaushal, Sudhir Singh
INTRODUCTION
Maternal health refers to the health of women during
pregnancy, childbirth and the postpartum period. While
motherhood is often a positive and fulfilling experience,
for too many women it is associated with suffering, ill-
health and even death.
1
Antenatal care is one of the four most important pillars of
safe motherhood along with family planning, safe
delivery and essential obstetric care.
2
Utilisation of health services is a complex behavioural
phenomenon. In developing countries, health seeking
behaviours and health care services utilisation patterns
have been studied and the determinants have been
classified in physical, socio-economic, cultural and
political contexts.
Maternal mortality ratio in India is 167/100,000 live
births despite the existence of National program for
improving the maternal and child health.
3
Most of the
maternal deaths can be prevented if women have access
Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh-171001, India
Received: 29 May 2016
Accepted: 01 July 2016
*Correspondence:
Dr. Anupam Parashar,
E-mail: anupamvikrant@yahoo.co.in
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period.
While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering,
ill-health and even death. The objective of this study was to assess the utilisation of maternal health care services and
coverage of maternal Tetanus immunisation in six districts of Himachal Pradesh, India.
Methods: A cross-sectional study was conducted using the WHO cluster sampling method during the period October
2015 to January 2016 among children of 0-11 month age covering 1,260 children in total.
Results: A total of 21,097 households were surveyed in 180 clusters. Card availability was 81.1% and 95.9% recalled
receiving the antenatal card and tetanus immunisation during their respective pregnancies. Out of the total of 1,260
infants surveyed, 1,255 (99.6%) were found to be fully protected against neonatal tetanus and only 5 (0.39%) were
found not to be fully protected. 1,241 (98.5%) of the mothers had undergone full Antenatal check-ups (ANC) during
their pregnancy. 210 (100%) had at least one ANC. All had undergone the ANC at the nearest government health
facility. 1055 (83.7%) deliveries were institutional deliveries and 201 (16%) were home deliveries. Overall, deliveries
conducted by skilled personnel stood at 91.3%.
Conclusions: Overall, the utilisation of maternal health services and immunisation against maternal and neonatal
Tetanus are excellent in the state. The coverage targets for key RMNCH and A, an interventions have been well
achieved in the state. Further, sustained efforts with Supportive Supervision are required to achieve 100% universal
coverage of immunisation and full utilisation of maternal health care services.
Keywords: Maternal care, Tetanus immunisation, Institutional deliveries
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162630