, in the ‘practice’ variables group, total number of pregnancies (t(4182)=17.6, p=<.001) was significantly associated with PC status of women. Women whether or not smoked (χ2 = 228.25, p = <.001) had strong relationship with the status of PC. The proportion of PC status was much higher among women who did not smoke (77.5%) compared to women who smoked (51.3%). Also, use of caesarean section (χ2 = 33.183, p = <.001) to deliver child was strongly associated with PC status. Interestingly, 96.4% of women who used C-section during delivery reported receiving PC in comparison to 71.6% in women who did not use C-section.
Likewise, preparation for delivery (χ2 = 268.95, p = <.001) for example, saved money, arranged transportation, contacted health worker, found blood donor, bought safe delivery kit and clothes and prepared food, was significantly associated with PC status of women. The majority (83.3%) of women who made preparation for delivery did receive P, whereas only 60.3% of women who did not make preparation received PC. Finally, both the variables, ‘special safe delivery kit used’ (χ2 = 194.3, p = <.001) and ‘iron/folic acid tabled used’(χ2 =252.96, p = <.001), showed significant relationship with the PC status. 62.1% of mothers reported to have received PC who did not use special safe delivery, in comparison to 93.6% of women who did not use special safe delivery kit. Similarly, the proportion of use of PC was much higher among women who used iron/folic acid tablet during pregnancy (94.2%) than women who did not use (66.7%).
Of all health indicators in Nepal, maternal mortality reveals the greatest gap between rich and poor, women residing in rural and urban areas and uneducated and educated women. Previous studies have shown that interventions to increase utilization of PC significantly help to reduce this gap of maternal death. A countrywide analysis of 2006 NDHS data showed that perceived barriers to utilization of PC, such as access to MHS, knowledge about PC, family barrier, transportation and the distance to health facility significantly explained why Nepalese women did not receive PC. These results suggest that increasing awareness on PC through mass media and focus groups, educating other influential members in the family (husbands, mother-in-laws) about PC and increasing access to MHS in healthcare facilities may have a significant impact on improving utilization rates for PC. The application of our multilevel intervention designed to increase utilization of PC among women is stratified into two levels 1) Organizational level and 2) Population level. This collaborative interventional approach from both levels will primarily focus on increasing awareness on PC use among women and their families.Continued on Next Page »
Keywords:Maternal Health Maternal Mortality Prenatal Care Public Health Nepal International Health Antenatal Care
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