Assessment of knowledge and utilization of antenatal care services among tribal women of Palakkad district, Kerala: a cross-sectional study

Abstract

Background: Nearly 800 women die out of preventable causes associated with pregnancy and childbirth worldwide every day, with low and middle-income countries contributing approximately 90% of the mortality. The majority of pregnancy-related deaths are preventable with the provisioning of cost-effective services like antenatal care (ANC). Despite Kerala having a good human development index compared to other states in India, marginalized groups like Dalit, Adivasi, and fisher folks are still behind the development process, including the utilization of ANC services. This study assessed the knowledge and utilization of ANC services among tribals in Kerala, India. Methods: A cross-sectional study was conducted among 45 tribal women of Palakkad district, Kerala, who registered for ANC and delivered child. Convenient sampling was used to select study participants. Descriptive statistics were used to obtain frequency and percentage. The chi-square test was carried out to see the association between identified variables. Results: Among 45 participants, 28.89% fell under the adequate ANC utilization. 64.46% did early ANC registration, 73.3% visited ANC more than four times, 75.56% completed the 2 tetanus toxoid (TT) injections, and 66.67% consumed more than 100 iron-folic acid tablets. About 73.3% of participants knew the importance of immunizing children against vaccine-preventable diseases. Conclusions: Even in an egalitarian state like Kerala with high literacy, ANC service utilization among tribal communities is still below 70%. The issue is multifaceted and requires a more nuanced approach. The health system must adopt comprehensive, context-specific, and community-based approaches.