Comparison of Domiciliary and Institutional Delivery-care Practices in Rural Rajasthan, India
AUTOR(ES)
Iyengar, Sharad D.
FONTE
International Centre for Diarrhoeal Disease Research
RESUMO
A retrospective cross-sectional survey was conducted to assess key practices and costs relating to home- and institutional delivery care in rural Rajasthan, India. One block from each of two sample districts was covered (estimated population–279,132). Field investigators listed women who had delivered in the past three months and contacted them for structured case interview. In total, 1,947 (96%) of 2,031 listed women were successfully interviewed. An average of 2.4 and 1.7 care providers attended each home- and institutional delivery respectively. While 34% of the women delivered in health facilities, modern care providers attended half of all the deliveries. Intramuscular injections, intravenous drips, and abdominal fundal pressure were widely used for hastening delivery in both homes and facilities while post-delivery injections for active management of the third stage were administered to a minority of women in both the venues. Most women were discharged prematurely after institutional delivery, especially by smaller health facilities. The cost of accessing home-delivery care was Rs 379 (US$ 8) while the mean costs in facilities for elective, difficult vaginal deliveries and for caesarean sections were Rs 1,336 (US$ 30), Rs 2,419 (US$ 54), and Rs 11,146 (US$ 248) respectively. Most families took loans at high interest rates to meet these costs. It is concluded that widespread irrational practices by a range of care providers in both homes and facilities can adversely affect women and newborns while inadequate observance of beneficial practices and high costs are likely to reduce the benefits of institutional delivery, especially for the poor. Government health agencies need to strengthen regulation of delivery care and, especially, monitor perinatal outcomes. Family preference for hastening delivery and early discharge also require educational efforts.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2761777Documentos Relacionados
- Pregnancy-related Deaths in Rural Rajasthan, India: Exploring Causes, Context, and Care-seeking Through Verbal Autopsy
- Obstetric Nursing in best practices of labor and delivery care
- Much health care in rural India comes from unqualified practitioners
- Use of Colon Cancer Testing in Rural Colorado Primary Care Practices
- Gender Differences in Perception and Care-seeking for Illness of Newborns in Rural Uttar Pradesh, India