Maternal Health

Maternal HealthMaternal Health

2005-06 National Family Health 2005-06 National Family Health Survey (NFHS-3)Survey (NFHS-3)

NFHS-3, India, 2005-06

Content

Antenatal Care and Use of Antenatal Care and Use of

Ultrasound Ultrasound

Delivery CareDelivery Care

Postnatal CarePostnatal Care


Women* Who Received Antenatal Women* Who Received Antenatal CareCare

7277

91

Total Urban Rural

NFHS-1 NFHS-2 NFHS-3

* For last births in the past 3 years* For last births in the past 3 years

PercentPercent


Women* Who Received Antenatal Women* Who Received Antenatal CareCare

65

83

5966 60

86

7277

91

Total Urban Rural

NFHS-1 NFHS-2 NFHS-3


Up 11 ptsUp 11 pts Up 12 ptsUp 12 pts

PercentPercent


Women* Who Received 3+ ANC VisitsWomen* Who Received 3+ ANC Visits

703744

7451 43

Total Urban Rural

NFHS-2

NFHS-3


• Only two-thirds of women who receive any Only two-thirds of women who receive any ANC, have the recommended 3+ ANC visitsANC, have the recommended 3+ ANC visits

• The share receiving 3+ ANC visits among The share receiving 3+ ANC visits among women who have any ANC is nearly unchanged women who have any ANC is nearly unchanged since NFHS-2since NFHS-2

PercentPercent


Women* Who Received ANC In the First Women* Who Received ANC In the First TrimesterTrimester

3356

2743

63

36

Total Urban Rural

NFHS-2

NFHS-3

* For last births in the past 3years* For last births in the past 3years

• 56% of women who receive any ANC, received 56% of women who receive any ANC, received ANC in the first trimester ANC in the first trimester

• The share receiving ANC in their first trimester The share receiving ANC in their first trimester among women who have any ANC is up by 6 among women who have any ANC is up by 6 percentage points since NFHS-2percentage points since NFHS-2

PercentPercent


Are womenAre women** receiving receiving appropriate ANC?appropriate ANC?

76% of women received two or more 76% of women received two or more tetanus toxoid injectionstetanus toxoid injections

Among women who received ANC:Among women who received ANC: Less than two-thirds had weight, blood, or Less than two-thirds had weight, blood, or

urine taken, or blood pressure measuredurine taken, or blood pressure measured Three-fourths had their abdomen Three-fourths had their abdomen

examinedexamined 36% were told about pregnancy 36% were told about pregnancy

complicationscomplications



56% of married and 59% of pregnant women 56% of married and 59% of pregnant women are anaemic. So, are pregnant women* getting are anaemic. So, are pregnant women* getting iron and folic acid (IFA) supplementation?iron and folic acid (IFA) supplementation?

65

76

61

23

35

19

Total Urban Rural

Given or purchased IFA Consumed IFA for 90 days

PercentPercent

*For last births in the past 5 years*For last births in the past 5 years


What are some notable differentials What are some notable differentials in access to ANC*?in access to ANC*?

Birth Order

8882

64

47

1 2-3 4-5 6+

Wealth Index

5969

8090

97

Lowest Highest

PercentPercent

**For last births in the past 5 yearsFor last births in the past 5 years


Pregnancies with an UltrasoundPregnancies with an Ultrasound

16

44

24

9

65

4

62

Total Rural Urban None 12+ Lowest Highest

Percent of pregnancies in the past 5 years

Residence Wealth IndexEducationEducation


Are ultrasounds being conducted for Are ultrasounds being conducted for sex-selection?sex-selection?

There is evidence of sex selection, There is evidence of sex selection, when the sex ratio at birth deviates when the sex ratio at birth deviates from the normal of about 960-970 from the normal of about 960-970 girls per 1,000 boysgirls per 1,000 boys

Thus, the question can be answered Thus, the question can be answered by examining the sex ratio of births by examining the sex ratio of births that result after a that result after a pregnancy with an pregnancy with an ultrasoundultrasound


Are ultrasounds being conducted for Are ultrasounds being conducted for sex-selection?sex-selection?

751

988849

570

876

665

908

Total 0 sons 1 son 0 sons 2 sons 0 sons 2-3 sons

Girls per 1,000 boys born in the past 5 years (for pregnancies with an ultrasound)

1 child 3 children2 children2 children


Content






Trends in Delivery CareTrends in Delivery Care

Institutional Delivery

41

34

26

NFHS-3NFHS-2NFHS-1

Delivery assisted by health personnel

4942

35

NFHS-3NFHS-2NFHS-1

**For live births in the past 5 yearsFor live births in the past 5 years

PercentPercent

Only about 1 in 7 Only about 1 in 7 home deliveries home deliveries are assisted by a are assisted by a skilled providerskilled provider


Percentage point change Percentage point change between NFHS-2 and NFHS-3between NFHS-2 and NFHS-3 StatesStates

Remained unchanged Remained unchanged

(2 states)(2 states)Arunachal Pradesh, NagalandArunachal Pradesh, Nagaland

Increased less than 7 percentage Increased less than 7 percentage pointpoint

(7 states)(7 states)

Assam, Chhattisgarh, Delhi, Assam, Chhattisgarh, Delhi, Goa, Goa, JharkhandJharkhand, Tripura, West , Tripura, West BengalBengal

Increased by 7-14 percentage Increased by 7-14 percentage pointspoints


BiharBihar, Gujarat, Maharashtra, , Gujarat, Maharashtra, Madhya PradeshMadhya Pradesh, Meghalaya, , Meghalaya, RajasthanRajasthan, Tamil Nadu, , Tamil Nadu, Kerala, Kerala, Uttar PradeshUttar Pradesh , , MizoramMizoram

Increased by 15 or more Increased by 15 or more percentage points percentage points


Andhra Pradesh, Haryana, Andhra Pradesh, Haryana, Himachal Pradesh, Jammu & Himachal Pradesh, Jammu & Kashmir, Karnataka, Manipur, Kashmir, Karnataka, Manipur, OrissaOrissa, Punjab, Sikkim, , Punjab, Sikkim, UttaranchalUttaranchal

Trends in Institutional Deliveries by StateTrends in Institutional Deliveries by State


Selected Differentials in Selected Differentials in Institutional Deliveries*Institutional Deliveries*

18

33

84

13

29

68

39

Total Urban Rural Lowest Highest SC ST

*For live births in the past five years*For live births in the past five years

ResidenceResidence Wealth indexWealth index Caste/tribeCaste/tribe

Percent


Are women* using the public sector Are women* using the public sector for their deliveries?for their deliveries?

1829

148

24 1912

Total Urban Rural Lowest Highest SC ST

*For live births in the past 5 years*For live births in the past 5 years

ResidenceResidence Wealth indexWealth index Caste/tribeCaste/tribe

3939

6868

2020

1313

8484

3333

1818

Percent


How common are caesarean-How common are caesarean-section deliveries?section deliveries?

9% of live births in the past 5 years were 9% of live births in the past 5 years were delivered by c-sectiondelivered by c-section

16% of 16% of first birthsfirst births are delivered by a c- are delivered by a c-sectionsection

C-sections C-sections increaseincrease sharply with women’s sharply with women’s education and wealtheducation and wealth

C-sections are almost twice as common C-sections are almost twice as common for deliveries in the private sector than in for deliveries in the private sector than in the public sector: 28 vs. 15 percentthe public sector: 28 vs. 15 percent


Content






Are women receiving postnatal Are women receiving postnatal care?care?

42

66

3437

61

29

Total Urban Rural

Any Within 2 days

PercentPercent

**For last births in the past 5 yearsFor last births in the past 5 years

For births whose mothers For births whose mothers received postnatal care, received postnatal care,

care was provided:care was provided:-By doctors for 72% -By doctors for 72%

-By ANMs and other -By ANMs and other health personnel by 20% health personnel by 20%

-By -By daisdais or TBAs by 8% or TBAs by 8%

• For only 20% of home For only 20% of home births was there any births was there any postnatal carepostnatal care



1113 14 16 17

23

28 29 29 29 30 32 3337

4143 45 46 48

5156 57 58 59 59

62 64

76

8587

0

20

40

60

80

100

120

NA

UP

AS

BH JH AR

CH

MP

MG

RJ

TR UT

OR IN

WB

HP

SK

MN

JK MZ

HR GJ

DL

KA

MH

PJ

AP

GA

KE

TN

Institutional Deliveries

Percent


SummarySummary Any ANC increased by 11 percentage points and 3+ Any ANC increased by 11 percentage points and 3+

ANC visits by 7 percentage points between NFHS-2 ANC visits by 7 percentage points between NFHS-2 and NFHS-3and NFHS-3

Still, half or less than half of women get ANC in the Still, half or less than half of women get ANC in the first trimester and get 3+ ANC visits first trimester and get 3+ ANC visits

Institutional deliveries increased by 7 percentage Institutional deliveries increased by 7 percentage points between NFHS-2 and NFHS-3points between NFHS-2 and NFHS-3

Nonetheless, more than half the deliveries still Nonetheless, more than half the deliveries still take place at home; half are not assisted by health take place at home; half are not assisted by health personnelpersonnel

The majority of mothers with a recent delivery did The majority of mothers with a recent delivery did not receive any postnatal carenot receive any postnatal care


ConclusionConclusion

Despite improvements in the provision Despite improvements in the provision of maternal health care, at the current of maternal health care, at the current

rate of change at no more than one rate of change at no more than one percentage point a year, women’s percentage point a year, women’s reproductive health will continue to reproductive health will continue to

suffer well into this century.suffer well into this century.

Maternal Health

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