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Haryana

Posted at: Sep 17, 2019, 7:41 AM; last updated: Sep 17, 2019, 3:05 PM (IST)

Survey: Inequities in use of maternal, childcare services

Two-year study

  • In all, 12,191 women who had delivered in the last one year, 10,314 women with 12 to 23 months old children and 45,864 couples were surveyed on service utilisation from 2012 to 2014
  • The overall eight performance indicators were computed, of which six were related to the reproductive and maternal health, while one each was related to child health and family planning
Survey: Inequities in use of maternal, childcare services
A team of Dr Shankar Prinja, Deepak Balasubramanian, Atul Sharma, Saroj Kumar Rana and Rajesh Kumar of the PGIMER and Rakesh Gupta of the NHM surveyed 12,191 women who had delivered in the last one year, 10,314 women with 12 to 23 months old children and 45,864 couples on service utilisation for the study from 2012 to 2014.

Bhartesh Singh Thakur
Tribune News Service
Chandigarh, September 16

A joint study by experts from the Post Graduate Institute of Medical Education and Research (PGIMER) and the National Health Mission (NHM), Haryana, has reported widespread inter-district and intra-district inequities in the utilisation of reproductive, maternal and child health (RMCH) services across Haryana. 

Mewat, Bhiwani, Palwal and Karnal districts fall in the ‘poor performance’ category in full ante-natal care (ANC), and Mewat and Gurugram are at the bottom when it comes to the full immunisation of infants.

A team of Dr Shankar Prinja, Deepak Balasubramanian, Atul Sharma, Saroj Kumar Rana and Rajesh Kumar of PGIMER and Rakesh Gupta of NHM, surveyed about 12,191 women who had given birth in the last one year, 10,314 women with a 12-23 month-old child and 45,864 couples on service utilisation for the study from 2012-2014. 

Overall eight performance indicators were computed, of which six were related to reproductive and maternal health while one each was related to child health and family planning.

For inter-district comparisons, the districts with whose indictors were less than 50 per cent of the state average were classified as ‘poor performing’; between 50–80 per cent as ‘average performing’ while those higher than 80 per cent as ‘good performing’.

For intra-district comparisons, Sub Centres (SCs) with results less than 50 per cent of the district average were classified as ‘poor performing’; between 50–80 per cent as ‘average performing’ while those higher than 80 per cent as ‘good performing’.  

The paper, published in the Maternal and Child Health Journal in August this year, says that interventions and investments should, apart from health, focus on finance, education, housing, employment, transport and other sectors as well to reduce inter-district and intra-district health inequities in the state.  

How different districts fared

The full ANC coverage in the state is 26.2 %. Mewat (3.2 %), Bhiwani (9.4 %), Palwal (10.9 %) and Karnal (12.8 %) districts were in ‘poor performance’ category while Sirsa (13.9 %) and Faridabad (17.8%) were in the ‘average performance’ category relative to the state average. All other districts were observed to be in the ‘good performance’ category.

Though Haryana had a full immunisation rate of 70.9 %, Mewat (28.9%) and Gurugram (49.1%) appeared at the bottom.

The institutional delivery rate in the state came at 82.2 % but Mewat (52 %) and Palwal (57%) were found to be ‘average performing’.

The contraceptive prevalence rate was 58.1 % in the state. While Mewat (24%) and Palwal district (46%) were the only districts in ‘poor’ and ‘average performing’ categories, Kaithal and Ambala districts were the top scorers, with 75.5% and 87.2% coverage.

50 % Sub Centres in Panchkula had ‘low performance’ 

In intra-district comparison, more than one-thirds of the total Sub Centres (SCs) in Panchkula (50%), Ambala (37%), Gurugram (37%) and Mewat (36%) districts were in ‘low performance’ category in providing full ANC. Nearly one-fourth were in ‘moderate’ grade in Rewari (26%), Jhajjar (25%), Hisar (23%) and Kurukshetra (22%) districts.

Most of the districts in Haryana, except Kurukshetra and Rohtak had moderate to ‘low performing’ SCs in providing full immunisation to infants. Mewat (35%), Panipat (23%), Hisar (21%), Palwal (14%), Fatehabad (11%), Kaithal (10%) and Gurugram (10%) districts had a high proportion of SCs with full immunisation rate below 50% of the state average.   

In the institutional delivery, 13 of the total districts were found to have no SCs in the low performance grade, with Mahendragarh (15%), Mewat (8%), Panchkula (7%), Faridabad (6%), Kaithal (6%), Jind (5%), Yamunanagar (3%) and Bhiwani (3%) having a small proportion of low performing SCs.

 

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