Prenatal care, delivery care and infant mortality in rural India (1992-1993): The role of community, household and individual characteristics
Using data from the National Family Health Survey (1992–93), the present study examined the role of socioeconomic characteristics at the community, household and individual levels and maternal demographic characteristics on the use of prenatal and delivery care and on infant mortality in rural India. We used the Mosley-Chen conceptual framework to identify relevant variables and specify their interrelationships. Consistent with the framework, women in villages with greater availability of health facilities, organizations, personnel and activities were more likely to reside in households with greater economic resources and to be individuals of higher socioeconomic status and with a greater exposure to modernity. Socioeconomic characteristics at all three levels increased the utilization of health services. Prenatal and delivery care played an important role in mediating the effect of these socioeconomic characteristics on infant mortality. The proximate determinants of maternal demographic characteristics and prenatal and delivery care showed the most dramatic direct effects on infant mortality. Among the community variables, the most dramatic effects on prenatal and delivery care were associated with distance to hospital, the presence of an anganwadi in the village and having health activities and family health worker visits in the past year. Of these four, the later three are more amenable to implementation since less government funding would be required. The most important socioeconomic characteristics directly affecting prenatal and delivery care were mother's education and her exposure to television and radio. Increasing community health resources must be accompanied by increasing the education opportunities of young women in order to improve their knowledge and efficient use of these resources. In this study, prenatal and delivery care was the major pathway linking higher maternal education to reductions in infant mortality. Among the maternal demographic characteristics, the three risk factors most dramatically affecting infant mortality were first births, short birth intervals of less than 24 months and prior child mortality. In developing the above policy initiatives, additional consideration should be given to the specific targeting of these three high risk groups in terms of health activities, in visits by a family health worker and media messages on the radio and television.
Philip, Bina Jayapaul, "Prenatal care, delivery care and infant mortality in rural India (1992-1993): The role of community, household and individual characteristics" (1999). ETD Collection for Fordham University. AAI9926890.