Infidelity During Pregnancy
Institutional deliveries in India – A socio-economically and culturally
Institutional Deliveries
A socio-economic and cultural view
In developing countries like India, with different cultures and different languages and the world's largest country population the impact of these social and cultural aspects of institutional births is important as India has the highest no. of births in the world (27 million) and high maternal mortality 300 to 500 births per lakh. This is 20% of the global burden. therefore, progress in reducing maternal mortality is essential to achieving the overall goal Millennium Development 5.There many factors influence the use of maternal health services in India. WHO and Magadi and others are some of the obstacles for poor use of delivery services, which are
• Distance from health services;
• The costs, including fees user
• The cost of transport,
• Quality of care
• Availability of drugs and supplies
• The attitudes of health personnel
• Multiple demands on women's time;
• The lack of autonomy of indecision decisions.
Poverty plays a role in the utilization of maternal health services. There is great disparity in the use of services delivery between rich and poor as well as individuals as evidenced by the World Bank report by Gwatkin et al. India, with high rates of growth and yet a developing country with a large number of BPL families, despite all the efforts made by the Government. NGOs and there are only three states that have more than 75% of institutional deliveries (NFHS3). Poverty is acting on the misuse of maternal-related services to other causes which, in turn influencing service maternal health literacy, the availability of health services.
Norms and beliefs in different parts of India have a significant effect seeking behavior of women's health. In rural India there are some false beliefs such as prolonged labor as a punishment for past infidelity, and the safe delivery help is a sign of courage. Traditionally in rural India, pregnancy is considered a natural state of being rather than a condition that requires medical attention and care. This perception lay limited – culture of health is a factor between the presence of the disease condition and its appropriate treatment. (NFHS3). These traditional beliefs about childbirth along with the fears of medical institutions misconceptions have led many women to maintain the dependence of births home in India. (American Journal of Public Health 2006). Even in this highly developed IT and industrialization in parts of India, women rely on midwives traditional and some State Government. also supporting the Triple Frontera (mithani) Chattisgadh system thus indirectly supporting the delivery.
Shame at first birth and newly pregnant girls are expected to exihi9bit modest demeanor to be calm in their life condition and not talk at all about the pregnancy, social pressure may create a major barrier to seeking prenatal care or deliver in the hospital. Muro (1998). This is reinforced by some religions and illiteracy, some cultures. such beliefs and norms are not only limited to India and is also seen in some countries of Africa and Latin America and the pain south Asian cultures and the disease is considered as a natural part of women, so it is considered unnecessary to 9 to seek medical care, including care delivery. (Ascadi and Johnson-Ascadi (1993)
Literacy is a strong partnership in the utilization of maternal health services. education of women is an important factor affecting the utilization of maternal health services in northern and southern India (Govindasamy and Ramesh, 1997). Literacy also is related to other factors such as poverty and overcome some old rules and beliefs and to know itself about the physiology of pregnancy. when a girl is in studies extending the age of marriage to prevent early marriage is associated with more problems such as low birth weight, infant mortality and contributes to the limited use services for maternal health. (NFHS1, 2.3). High levels of husbands' education increases the likelihood of health services (American Journal of Public Health 2006)
In India the cost of transportation and the opportunity cost of donor and patient care when necessary to have a significant negative impact on the utilization of delivery care services. In real terms, most rural women in the land of India at a health care with advanced stage of labor or after developing complications. This is also influenced by factors such as availability of transport, availability carers, from the center of health care and included the cost of user fees. The loss of wages to support pregnant women play an important role in the caregivers and their attitude to pregnant women delays the use of delivery services.
The quality of care health in India, with limited human resources in the health sector and health staff attitude toward the patient and higher absenteeism questioning the rights of improving use of health services of motherhood. A woman with a complication, can delay or prevent access to the care of a health center, which has experienced good treatment, but a lack of respect for previous normal delivery. Hulton et al (2000). This may be one reason, parity, increasing women are less likely facilities to reach health care. The quality of care has been to have impact on utilization of health services of motherhood for women who receive one or more prenatal visits is the strongest predictor of institutional delivery. (NFHS2)
Rural mothers belonging to SC / ST registered are much less likely to give birth in medical facilities than the other (NFHS2). This is associated with many other causes such as accessibility, Customs, accessibility services of health care. Interesting religion itself has different levels of institutional births in different parts of India as seen below. mothers Muslims are more likely than Indian mothers to give birth in a medical institution in Andhra Pradesh and Gujarat, but the Muslim mothers are much less likely than Hindu mothers do in Bihar and Rajasthan. (NFHS2). There is a difference in the use of health services castes and tribes between rural and urban areas. castes and scheduled tribes mothers living in urban areas are the use of maternal health services. According to NFHS data growth is a study of the use of maternal health services in rural and urban areas. The growth is faster in urban than in rural areas, but growth should be to achieve the objectives of the IMR and MMR established by NRHM.
The inability of women in some developing countries to make decisions about the choice of care seriously affects the choice of delivery care. Causes a conflict between the biomedical and the traditional perception health conditions also limits women's access to delivery care. Surprisingly, the empowerment of women, as measured by the decision-making their own health care, shows little relation to the institutional deliveries in India. (NFHS2).
Institutional deliveries were also influenced as some of the demographic factors, some of them are raising the age of the mother has a strong positive effect on the use of delivery services Increased birth order has a negative effect on the use of maternal services, (NFHS-2) in Andhra Pradesh, 53 percent of first births order, but only 24 percent of higher-order births, fourth, and was conducted in medical institutions. Unmarried pregnant girls are less likely to use maternal health services. High fertility may also reflect a lack of reproductive health services and lack of awareness These services, which have obvious implications for the use of maternal health services. (American Journal of Public Health 2006). Urban working mothers are less likely to give birth in a medical institution mothers.NFHS2 not working.
The role of the media should not forget, the delivery of instruction are higher for mothers who are regularly exposed to electronic media that mothers are not regularly exposed (NFHS2)
It is a bitter part that no political party is interested in maternal health and maternal health is in agenda. If India wants to achieve the NRHM objectives that needs strong political commitment with more attention to the health sector which in turn contribute to the "healthy''INDIA
– Dr.V.Sudhakaram, MBBS (PGDPHM)
About the Author
6 yrs experience in public health working with Govt. of Andhra pradesh of INDIA
Maury: Top 10 Guests of 2008! – Part 1/4 – #10, 9, 8