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Why there is underutilization of four and more antenatal care services despite the colossal rise in institutional deliveries in Bihar, India

Ravi Durga Prasad (), Somya Arora (), Pradeep S. Salve (), Srinivas Goli (), K. S. James (), Saseendran Pallikadavath (), Udaya S. Mishra () and Irudaya S. Rajan ()
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Ravi Durga Prasad: Gokhale Institute of Politics and Economics (GIPE)
Somya Arora: Jawaharlal Nehru University (JNU)
Pradeep S. Salve: International Institute for Population Sciences
Srinivas Goli: International Institute for Population Sciences
K. S. James: International Institute for Population Sciences (IIPS)
Saseendran Pallikadavath: University of Portsmouth
Udaya S. Mishra: International Institute for Population Sciences
Irudaya S. Rajan: Centre for Development Studies (CDS)

Journal of Social and Economic Development, 2022, vol. 24, issue 2, No 7, 355-378

Abstract: Abstract Despite the colossal rise in institutional delivery (from 20% in 2005–2006 to 64% in 2015–2016), the state of Bihar shows the poorest performance in the country for utilization of four or more antenatal care services (4 or more ANCs) (14%). In this background, the present paper aims to investigate the factors associated with the low uptake of ANCs in Bihar, India. The study analyses a sample of 16,822 women aged 15–49 in Bihar from the fourth round of the National Family Health Survey (NFHS-4) conducted during 2015–2016. Bivariate and multivariate logistic and linear regression analyses are employed to identify the factors associated with the underutilization of 4 or more ANCs in Bihar. Five out of 38 districts of Bihar have more than 20% uptake of 4 or more ANCs while 13 districts have only 7 to 12% of uptake. However, 79% of women had institutional delivery without having 4 or more ANCs. The results from the logistic regression model suggest that mothers who belonged to the richest wealth index (OR = 3.90; 99% CI: 2.98–5.08) and a higher level of education (OR = 3.35; 99% CI: 2.74–4.08) have a greater likelihood of receiving 4 or more ANCs. In order of their importance, focusing on economic, education, and caste inequalities, awareness of pregnancy registration with MCP cards, and avoiding higher-order births are likely to improve the uptake of 4 or more ANCs in Bihar.

Keywords: Antenatal care; Institutional delivery; Maternal healthcare; Janani suraksha yojana; Bihar; India (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1007/s40847-022-00205-0

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