Factors affecting accessibility of maternal health-care institutions in Meghalaya: A hospital-based study

Bibiana Momin, P. Dutta
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Abstract

BACKGROUND: The present study determines to understand the maternal health-care infrastructure in Meghalaya, a state of Northeast India. The state has large number of population of 2,964,007 (Census 2011), however, the state has only two public District Hospitals related to maternal health-care services – one in East Khasi Hills District and the other one in West Garo Hills District. Furthermore, according to the National Rural Health Mission (2015–2016), the maternal mortality ratio of Meghalaya is 211/100,000 live births which is higher than the national average. MATERIALS AND METHODS: A hospital-based mixed method study has carried out to identify the problems faced by the women during their maternity period and to assess the quality and availability of maternal care infrastructure in Meghalaya. To conduct the interview, the present study covered all 80 pregnant women who were admitted in the major two district maternal health-care hospitals of Meghalaya for maternity care (i.e., delivery and postdelivery period) during the period of hospital visit in October 2019. RESULTS: The study shows that majority of the admitted women came from different villages of different districts of Meghalaya as those remote areas have no adequate maternal health-care institutions nearby other than dispensary or subcenter. The study also revealed that women who came to get treatment in hospital during pregnancy had to face difficulties like to travel a long distance, use public transport, bad road conditions, and financial problems. CONCLUSION: To improve the health scenario of health-care system in the remote village areas, the Government should give more focus on infrastructure development in terms of availability of adequate facilities for handling any emergency cases of maternal care in remote areas of Meghalaya.
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影响梅加拉亚邦孕产妇保健机构可及性的因素:一项基于医院的研究
背景:本研究旨在了解印度东北部梅加拉亚邦的孕产妇保健基础设施。该州人口众多,达2 964 007人(2011年人口普查),然而,该州只有两家与孕产妇保健服务有关的公立区医院——一家在东卡西山区,另一家在西加罗山区。此外,根据国家农村卫生特派团(2015-2016年)的数据,梅加拉亚邦的孕产妇死亡率为211/10万活产,高于全国平均水平。材料和方法:开展了一项以医院为基础的混合方法研究,以确定妇女在生育期间面临的问题,并评估梅加拉亚邦孕产妇保健基础设施的质量和可用性。为了进行访谈,本研究涵盖了2019年10月在梅加拉亚邦两家主要地区孕产妇保健医院就诊期间接受产科护理(即分娩和产后)的所有80名孕妇。结果:研究表明,大多数入院妇女来自梅加拉亚邦不同地区的不同村庄,因为这些偏远地区附近除了药房或分中心外没有足够的孕产妇保健机构。研究还显示,在怀孕期间到医院接受治疗的妇女不得不面临长途旅行、乘坐公共交通工具、路况恶劣和经济问题等困难。结论:为了改善偏远乡村地区卫生保健系统的健康状况,政府应该更多地关注基础设施的发展,以提供足够的设施来处理梅加拉亚邦偏远地区的任何紧急孕产妇护理病例。
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