Abstract
BackgroundAs part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan.MethodsA cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility.ResultsThe demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention.ConclusionsOur findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains a work in progress.
Highlights
Maternal deaths decreased by 47% from 1990 to 2010
By 2010, two regions, Sub- Saharan Africa (56%) and Southern Asia (29%), together attributed about 85% of the global burden (245 000 maternal deaths) [1]. This is commonly monitored by the Maternal Mortality Ratio (MMR), the number of maternal deaths in a given time period per 100 000 live births during the same time period
Descriptive Analysis We interviewed a total of 924 Married Women of Reproductive Age (MWRA) in the two areas, 432 in the intervention area and 492 in the non-intervention area
Summary
By 2010, two regions, Sub- Saharan Africa (56%) and Southern Asia (29%), together attributed about 85% of the global burden (245 000 maternal deaths) [1]. This is commonly monitored by the Maternal Mortality Ratio (MMR), the number of maternal deaths in a given time period per 100 000 live births during the same time period. In 2010, the estimate for Pakistan was 260 (range of uncertainty 150–500); within the country the ratio is even higher in remote, rural and underdeveloped areas, largely due to non-availability and low utilization of maternal health services. As part of the mid-term evaluation of a Women’s Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan
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