Determinants of Quality of Antenatal Care in a Rural Block of Haryana

Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. Maternal mortality is higher in women living in rural areas and among poorer communities. The trend of maternal mortality in developing countries has been increasing and various international organizations have reported that an important factor related to maternal and infant mortality has been linked to lack of quality antenatal care. This study was done with an objective to assess the quality of ANC services received by the pregnant women of rural area and factors affecting the quality ANC. A community based longitudinal, descriptive study was carried out during April 2014 to July 2015 among 204 pregnant women registered at randomly selected five sub-centers by lottery method in the rural areas of block Beri, District Jhajjar, Haryana. A pre-tested semi-structured interview schedule was used for interviewing the study subjects. Data so collected were compiled & analyzed using statistical software (SPSS version 20.0). Out of 204 pregnant women, 133 (65.2%) were from general category, 42 (20.6%) schedule caste and 29 (14.2%) other backward class. Majority (96.6%) were Hindus and only 7 (3.4%) were Muslims. Majority (35%) were belong to class-II SES and only 9% were from class V. Mean age of the study subjects was 23.05 ± 2.92 and mean age at marriage was 19.98 ± 1.86. Nearly half (49.5%) were multigravida and (3.9%) were grand multigravida. Majority (86.8%) were anaemic (<11gram %) at the time of registration showing the higher prevalence of anaemia in this area. full antenatal care utilization was directly associated with factors like younger age, upper caste, higher education and SES, primigravida and early registration of the study subjects (p<0.05). higher proportion (46.7% and 39.2%) of study subjects who were in the age group <20 years and 20-24 years respectively availed full ANC than (7.9% and 0%) the women of higher age groups (25-29 years and >30 years respectively). Again, more proportion (43.8%) of women who got registered in first trimester availed full ANC as compared to women registered after first trimester (13 to 26 week -21.6% and >26 weeks-0%). Early registration of pregnancy and hence, early detection of high risk pregnancies and timely refer them to higher institutions for management had good effect on maternal and neonatal outcome.