Effectiveness of Community Intervention Program to Improve Maternal Healthcare Services Uptake among Young Married Women in Rural India

Abstract

Background: The uptake of maternal healthcare services by young women in rural India is limited. This study aims to assess the effectiveness of community intervention model to improve the maternal healthcare service uptake of young married couples (15-24 years) in rural India. A three year project was carried out to reach young married women through a multi-pronged community intervention involving sensitizing family members, community mobilization, and capacity building of frontline health functionaries. Methods: The study was conducted among the young married couples aged 15-25 years in states of Uttar Pradesh and Rajasthan of India. A quasi-experimental evaluation design was adopted for this study. Two rounds of cross-sectional surveys at baseline and end line were carried out at both intervention and control sites. Net impact of intervention (Difference-in-Difference and multivariate regression) on key outcomes was assessed adjusting for control variables. Composite maternal healthcare uptake score significantly increased in intervention area compared to control area. Results: Women who were able to discuss about delivery care with family, were five times more likely to go for institutional delivery, also the utilization of maternal health care services was higher among these women (β=1.58). Likelihood of uptake for more than three visits for antenatal care (3+ANC) service indicated three times (OR=3.14, p<0.001), and more than three visits. Postnatal care (3+PNC) service indicated two fold (OR=1.82, p<0.001) increase in intervention area than those in control area. Regression result on composite maternal health care uptake score significantly increased by 2.5 (β=2.23, p<0.001) in intervention area compared to control area. Conclusion: This study demonstrated that the community intervention to foster enabling environment was effective in improving the awareness and uptake of maternal healthcare services.