Utilization of institutional delivery services across successive births in India

Abstract

As institutional delivery centers usually have much better modern facilities and hygienic conditions in India, utilization of institutional delivery services could improve maternal and child health. The objective of this paper is to address the issue of whether women were consistent in delivering births in an institutional care center over successive pregnancies in India and investigate the factors associated with consistent utilization of institutional delivery. We applied multivariate multilevel models that allow for a strong dependence between successive outcomes at the same unit to the third round of the National Family Health Survey in 2005-2006. Results show that region and place of residence, woman’s education, wealth index, having experienced the loss of a child, ever having terminated a pregnancy, and birth order are significant predictors of place of delivery for all three recent births among ever-married women. Our results further show that previous utilization of institutional delivery was an important predictor of utilization for subsequent institutional deliveries. Policies aimed at improving the wide or persistent utilization of institutional delivery in India should focus on first-time mothers targeting disadvantaged women who are from rural areas, poor families, illiterate, Muslim, and scheduled castes.