National improvements in quality of prenatal healthcare across states and territories in India from 2006 to 2021: a systematic analysis

Lin, K; Chen, E; Taylor, I; Hunter, S; Sun, J

National improvements in quality of prenatal healthcare across states and territories in India from 2006 to 2021: a systematic analysis

Lin, K Chen, E Taylor, I Hunter, S Sun, J

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Publisher:: SPRINGER HEIDELBERG
Publication Type:: Journal Article
Citation:: Journal of Public Health (Germany), 2023
Issue Date:: 2023-01-01

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Field	Value	Language
dc.contributor.author	Lin, K
dc.contributor.author	Chen, E
dc.contributor.author	Taylor, I
dc.contributor.author	Hunter, S
dc.contributor.author	Sun, J https://orcid.org/0000-0002-0097-2438
dc.date.accessioned	2024-03-14T02:23:40Z
dc.date.available	2024-03-14T02:23:40Z
dc.date.issued	2023-01-01
dc.identifier.citation	Journal of Public Health (Germany), 2023
dc.identifier.issn	2198-1833
dc.identifier.issn	1613-2238
dc.identifier.uri	http://hdl.handle.net/10453/176682
dc.description.abstract	Aim: This study aimed to assess changes in India’s prevalence of low birth weight (LBW) infants relating to the quality of prenatal healthcare, coverage of the Integrated Child Development Services Scheme (ICDS) and maternal factors from 2006 to 2021. Subject and methods: Data from India’s demographic health survey (DHS) were analysed at three times points – 2006, 2016 and 2021. States were classified as ‘low healthcare spending and resource (HSR)’ or ‘high HSR’. Chi-square analysis was conducted to identify differences between quality of prenatal healthcare, coverage of pregnancy benefits, prevalence of LBW infants and changes in maternal factors across three time points and between low HSR and high HSR states. Factor analysis was subsequently used to devise a quality of pregnancy healthcare index, while multi-level analysis was conducted to identify the influence of quality of pregnancy healthcare on LBW and the influence of adolescent pregnancies on quality of prenatal healthcare at both individual and state levels. Results: A significant reduction in LBW infants was found from 2006 to 2021, while significant improvements in quality of prenatal healthcare, coverage of ICDS pregnancy benefits and maternal factors were identified. Significantly poorer quality of pregnancy health was consistently identified across low HSR states, with mothers reporting having received fewer aspects of standard and advanced prenatal care. Prevalence of adolescent (under 20 years) pregnancies remained above 30%, and adolescent pregnancies significantly predicted worse scores in quality of prenatal care. Conclusion: Significant disparity in quality of prenatal healthcare is still evident between low and high HSR states. Adolescent pregnancies also remain as a critical issue that needs to be addressed in India, predicting poor access to prenatal healthcare, yielding a lower score on standard and advanced prenatal care subscales. Further government and community-based efforts are required to bridge the gap in the accessibility and quality of prenatal care between low HSR and high states in India.
dc.language	English
dc.publisher	SPRINGER HEIDELBERG
dc.relation.ispartof	Journal of Public Health (Germany)
dc.relation.isbasedon	10.1007/s10389-023-02015-y
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.title	National improvements in quality of prenatal healthcare across states and territories in India from 2006 to 2021: a systematic analysis
dc.type	Journal Article
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology/School of Computer Science
utslib.copyright.status	closed_access	*
dc.date.updated	2024-03-14T02:23:36Z
pubs.publication-status	Published

Abstract:

Aim: This study aimed to assess changes in India’s prevalence of low birth weight (LBW) infants relating to the quality of prenatal healthcare, coverage of the Integrated Child Development Services Scheme (ICDS) and maternal factors from 2006 to 2021. Subject and methods: Data from India’s demographic health survey (DHS) were analysed at three times points – 2006, 2016 and 2021. States were classified as ‘low healthcare spending and resource (HSR)’ or ‘high HSR’. Chi-square analysis was conducted to identify differences between quality of prenatal healthcare, coverage of pregnancy benefits, prevalence of LBW infants and changes in maternal factors across three time points and between low HSR and high HSR states. Factor analysis was subsequently used to devise a quality of pregnancy healthcare index, while multi-level analysis was conducted to identify the influence of quality of pregnancy healthcare on LBW and the influence of adolescent pregnancies on quality of prenatal healthcare at both individual and state levels. Results: A significant reduction in LBW infants was found from 2006 to 2021, while significant improvements in quality of prenatal healthcare, coverage of ICDS pregnancy benefits and maternal factors were identified. Significantly poorer quality of pregnancy health was consistently identified across low HSR states, with mothers reporting having received fewer aspects of standard and advanced prenatal care. Prevalence of adolescent (under 20 years) pregnancies remained above 30%, and adolescent pregnancies significantly predicted worse scores in quality of prenatal care. Conclusion: Significant disparity in quality of prenatal healthcare is still evident between low and high HSR states. Adolescent pregnancies also remain as a critical issue that needs to be addressed in India, predicting poor access to prenatal healthcare, yielding a lower score on standard and advanced prenatal care subscales. Further government and community-based efforts are required to bridge the gap in the accessibility and quality of prenatal care between low HSR and high states in India.

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http://hdl.handle.net/10453/176682