Trends and determinants of maternal health services utilization in India from 2015 to 2021
Wapangjungla Longchar, Prakash Babu Kodali, Sibasis Hense
Abstract
Continuum of care (CoC) in maternal health services refers to a pathway spanning from pregnancy and childbirth to post-pregnancy, covering routine antenatal care (ANC), institutional delivery (ID), and post-natal services (PNC). The current study aims to investigate the distribution, trends, dropouts, and determinants of maternal health services (ANC, ID, and PNC) utilization along the CoC pathway using NFHS-4 and NFHS-5 datasets from 2015 to 2021. The binary logistic regression examined the association between the continuum of maternal health services utilization and the predictor variables. The complete CoC utilization was 50% during NFHS 5, an 11.3%-point increase from NFHS-4. During the same period, the largest dropout was in the uptake of full ANC (41.5%). Odds of completing CoC were higher among women aged 25-34 (AOR:1.18; 95% CI: 1.09-1.27), with higher education (AOR:1.74; 95% CI: 1.58-1.92), urban women (AOR:1.09; 95% CI:1.01-1.19), in richer household (AOR: 1.42; 95% CI: 1.29-1.56), and with health insurance (AOR: 1.24; 95% CI: 1.15-1.35). Strengthening the public health system and addressing bottlenecks of government maternal health schemes remains an important consideration for improving the continuum of maternal care in India. Context-specific multi-sectoral strategies may be leveraged to increase the uptake of maternal health services, especially in high-focus states.