Utilization of Mother and Child health care services among the Telis of Raipur District

Abstract

The study was aimed to assess the level of utilization of mother and child health care services among the Telis of Raipur district in order to develop effective health planning falfilling specific local need. For the present investigation data, was collected from 11 blocks of Raipur district on the basis of preponderance of Teli population. Twenty two villages were selected on the basis of probability proportion to size of the population covering 303 households. Interview schedule was used for data collection. The study found out that home deliven; cases were very high, while prolonged labour and excessive bleeding were the post deliven; complications. Immunization status was also recorded to be low. Both the pregnant and the non pregnant woman are predominantly over burdened with heavy work load both in agriculture and in household. They continue to work until the time of birth and resume the work shortly after tlze delivery which puts deep impact on their health and general well being. Although Chhattisgarh government and health department have launched various good schemes for the betterment of maternal and child health care but substantial efforts and implementation is required as a priorihj for bettennent of the reproductive health amongst the Telis. INTRODUCTION India has been adopting many programmes to strengthen and increase quality services to regulate fertility as effectively as possible. Researchers and social scientists have identified a number of factors responsible such as poor accessibility, lack of infrastructures, poor quality of care involved in the way a client is tackled by the providers, lack of faith in the services, delivery system etc. However, the extent of impact of these factors on utilization of services varies according to traits, beliefs and perception of beneficiaries (Varma, et al., 1993). 91h five year plan has integrated all the related programmes of the earlier plans like Child Survival and Safe Motherhood (CSSM) and Maternal and Child Health (MCH) programmes. Since the Reproductive and Child •Address for Communication: *Research scholar, 5.0.S. in Anthropology, Pt. Ravishankar Shukla University, Raipur, India. The Oriental Anthropologist, Vol. 17, No. 2, 2017, Pages 345-358 © OICSR, Allahabad Corresponding Author E-mail: satyajeetkosariya@gmail.com 346 Neerja Sen, Moyna Chakravarty and Sah;ajeet Singh Kosariya Health (RCH) services are focused on women in reproductive age, its utilization is likely to be affected by socio-economic and other individual characteristics of women, viz education level, modernization, women's access to resources like empowerment, their knowledge, attitude and practices. Therefore, delivery of health services which is largely a technological and managerial process has to be viewed with an epidemiology and social dimension. Although, women and children throughout the developing world share common health problems associated with reproductive behaviour and child mortality, the key concerns vary from region to region and from population to population. Approximately 529,000 women die from pregnancy related causes annually with a vast majority of these maternal deaths occurring in developing nations. Common causes of maternal death, seen in most developing countries are largely preventable. Some basic causes of death during pregnancy, childbirth and postpartum period are obstructed labour, toxaemia and unsafe abortion. In addition, some 25 percent of maternal deaths were attributed to indirect causes. Leading among these was anaemia with 19% deaths (Bhatia J.C., 1993; Ganatra, Coyaji, & Rao, 1998). A study comparing pregnancy related complications among women in three states (Andhra Pradesh, Madhya Pradesh and Orissa) confirms that of the 170 deaths studied, leading causes were sepsis, obstructed labour and excessive bleeding (Murthy & Barua, 2001). Major causes of neonatal mortality include neonatal infections, birth asphyxia and trauma, pre-term birth and low weight and other causes, including congenital anomalies (Planning-Commission, 2002). Recent investigations highlight the leading causes of neonatal deaths as pre-maturity, low birth weight, birth asphyxia and neonatal sepsis (Gupta & Keyl, 1998; Kapoor, et al., 1996; Shrivastava, Kumar, & Ojha, 2001). Postpartum care also plays an important part to control maternal morbidity. Many studies indicate that lack of awareness was the main barrier to the utilization of postnatal care. Antenatal care tends to be perceived as unnecessary and to be availed only in care of health complications (Dhaka!, Champan, Simkhada, & Raja, 2007; Dhaher, Mikolajczyk, & Kramer, 2008) . Many studies suggest that women who experienced morbidity during pregnancy and sought care were considerably more likely to opt for care from private sector, including unqualified practitioners, rather than access free government services (Bhatia J.C., 1995; Griffiths & Stephenson, 2001). Few studies in rural Karnataka and Pondicherry, however suggested that large proportion of women did not indeed receive timely antenatal care within the first trimester and were not motivated by perceived health problems (Mathews, Mahendra, Kilaru, & Ganapathy, 2001; Srivastava, Narayan, Oumachigui, & Roa, 1997). A large number of studies show that women who received no antenatal care were more likely to die of maternal causes than women who had three or more antenatal contacts The Oriental Anthropologist Utilization of Mother and Child health care services among the Tel is of Raipur District 347 (Ganatra, Coyaji, & Rao, 1998). The still birth and perinatal mortality rate were reportedly lower and birth weight higher among women who received antenatal care compared to those who did not (Brown, Sohani, Khan, & Mukhwan, 2008; Kapoor, Reddaiah, & Lobo, 1985). Moreover women who made regular antenatal visits were more likely to initiate breast feeding promptly and feed colostrums to their infants than other women (Nielson, Hedgaard, Thilsted, Josheph, & Lilijestrand, 1998). The universal immunization of pregnant women and children is positively and significantly correlated with the educational status and income of the mother (Kaur & Narwal, 1988; Mohanty S. K., 2012; Vishwanathan & Rohde, 1990) MATERIAL AND METHODS The present investigation was conducted in Raipur district of Chhattisgarh. The studied population, Telis inhabiting Chhattisgarh is classified under the backward caste groups of Chhattisgarh state. Telis were originally of Vaishya division of the Hindu and occupation caste of oil pressers and vendors. Now, they have abandoned their traditional occupation and are primarily agriculturist. For the present study, data was collected from 303 households. 22 Teli predominated villages were selected from 11 blocks of Raipur district. A systematic multistage stratified sampling design was adopted and from each village 14 households were selected for the study. Data on basic information on education, type of family, type of house hold, type of toilet facility, source of drinking water, standard of living index etc. were collected. Information pertaining to utilization of health services included quality of Ante Natal Checkups (ANC), postpartum care, complications during pregnancy, immunization and child care etc. To analyse the data descriptive analysis, correlation analysis and multiple regression was computed with the help of SPSS 15.0 software. Present data was compared with that of National Family Health Survey-2 (NFHS-2) and NFHS-3 of Chhattisgarh (UPS, National Family Health Survey, India;2005-6, Chhattisgarh, 2008; UPS, National Family Health Survey (NFHS-2) India, Chhattisgarh, 1998-99). AIMS AND OBJECTIVES Weak health systems, poor coverage and quality of antenatal care, lack of trained assistance during delivery, lack of access to essential emergency obstetric services for high risk and complicated cases and lack of referral and transport system are major reasons for high maternal morbidity and mortality. Numerical strength of Telis is very high in Chhattisgarh state therefore, an attempt has been made to assess the level of health services among the Telis of Raipur district of Chhattisgarh state. The Oriental Anthropologist 348 Neerja Sen, Moyna Chakravarty and Satt;ajeet Singh Kosariya RESULT AND DISCUSSION In the present paper, current level of knowledge about the Maternal and Child Health services and utilization of the same is assessed. All the women who had their last live birth were asked about the medical health care they received during antenatal and postnatal period. In addition, the immunization status of the children was also assessed for children below the age 0-48 months at the time of survey. The literacy rate of the population has been found to be 64.8 percent. Sex differential in literacy show higher percentage of male literates (68. 98 % ) as compared to females (60.59 % ). 62.71 percent of females are agricultural labourer in either their own land or engaged as wage labourer in field of others and 37.29% of them are not engaged in any occupational work. The demographic profile of the population has been presented in table no. 8-11. Important elements of antenatal care include provision of iron supplement and two doses of tetanus toxoid vaccines. Table no. 3 indicates that nearly 89.25 percent of women had two doses of TT and 27.98 percent of pregnant women consumed IronFolic Acid (IFA) tablets more than 100 in their last pregnancy. Table no. 4 shows the distribution of women according to type of ANC services and information on specific pregnancy complications. Among women receiving ANC care, 75.36 percent had an abdominal examination, 55.51 % had their blood tested and 53.30 percent had their weight measured, very few women conducted X-ray and Ultrasound i.e. 1.84 percent and 1.47 percent respectively. The percent of home delivery in Chhattisgarh is very high. The population under study also showed 85 percent home delivery. Ta