Antenatal Care Service Utilization Among Adolescent Pregnant Women-Evidence From Swabhimaan Programme in India.

Prakash H Fulpagare,Apollo Purty,Rabi N Parhi,Nikita Surani,Arjan De Wagt,Somya S,Neeraj Agrawal,Babita Mohapatra,Vikas Bhatia,Manisha Ruikar,Abhishek Saraswat,Sourav Bhattacharjee,Zivai Murira,Nita Kejrewal,Konsam Dinachandra,Raj Kumar Gope,Vani Sethi

doi:10.3389/fpubh.2019.00369

Abstract

Purpose: Pregnant adolescent girls (15–19 years) are more vulnerable to poor health and nutrition than adult pregnant women because of marginalization and lack of knowledge about the antenatal care (ANC) services. The present study aims to test this hypothesis and assess determinants of ANC service utilization among currently adolescent pregnant women.Methods: Data were drawn from the baseline survey of SWABHIMAAN project, which had been conducted in three states of India: Bihar, Chhattisgarh, and Odisha. Out of a total 2,573 pregnant women (15–49 years) included in the sample, about 10% (N = 278) were adolescent girls (15–19 years) at the time of the survey, and the rest were adults. Sample was selected from the population using simple random sampling, and information was collected using pretested questionnaires.Results: For all indicators of ANC service utilization, performance of adolescent pregnant women was better than adult pregnant women. However, significant variations were reported in the level of services received by adult pregnant women for different indicators. Religion, wealth, food insecurity, Village Health Sanitation and Nutrition Day meeting, Public Distribution System and Integrated Child Development Services entitlements, and knowledge of family planning methods had a significant effect on the ANC service utilization.Conclusion: Adolescent pregnant women have shown better utilization of selected indicators than their adult counterparts. Utilization of full ANC services starting from first trimester itself for adolescent pregnant women is an urgent need in present context. Intervention program must pay attention to such adolescent married girls who are entering into the motherhood phase of their lives.

Highlights

India is home to 243 million adolescents (10–19 years) out of which 120 million are adolescent girls, accounting for nearly 10% of its population [1]
Adolescent pregnancies account for nearly one-fourth of the total burden of disease due to obstetric factors among women, and around 95% of such births occurred in low- and middle-income countries, where pregnancy- and childbirth-related complications are the primary cause of fatality among adolescent girls [3]
Over 50% of adolescent pregnant women had 1–9 years of education, and another 20% had an education of 10 years and more; only 40 and 13% adult pregnant women had the former and latter education levels, respectively

Summary

Introduction

India is home to 243 million adolescents (10–19 years) out of which 120 million are adolescent girls, accounting for nearly 10% of its population [1]. Pregnancy in the adolescence period continues to be a challenge in low- and middle-income countries, with an estimated 16 million girls aged 15–19, and 2 million girls under the age of 15 years, becoming pregnant every year [2]. Adolescent pregnancies account for nearly one-fourth of the total burden of disease due to obstetric factors among women, and around 95% of such births occurred in low- and middle-income countries, where pregnancy- and childbirth-related complications are the primary cause of fatality among adolescent girls [3]. Teenage girls are biologically immature to handle pregnancy and are nutritionally vulnerable and have a risk of obstetric complications and adverse pregnancy outcomes (low birth weight; prematurity; small for gestational age births; and neonatal, postneonatal, and infant mortality) and morbidity [5, 6]. Children born to young mothers are disadvantaged in childhood nutrition and schooling [8]

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