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Quality of Antenatal Care at the Public Health Facilities in India: Does Clients Background and Structural Attributes in Facilities Matter?

Vinod Joseph K J, international Institute for Population Sciences

The public sector is the primary source of maternal health care services in India. There are critical concerns over the quality of services provided, deaths, failures, and complications following delivery. In this paper, we study the complexities around the quality of maternal health care at public health facilities and identify strategies for improving such quality measurement. A better understanding of these issues could inform pragmatic strategies for enhancing quality. This study uses data from the National Family Health Survey (NFHS) 2015-16 and District Level Household and Facility Survey (DLHS) 2012-13. The study is limited to only districts whose data are available in both DLHS 2012-13 and NFHS 2015-16. The methods of analysis include bivariate statistics, Pearson chi-square test and two-level mixed-effects logistic regression. We found that the quality of care (QoC) received is associated with facility readiness and the socio-economic characteristics of the clients. This study provides evidence on the role of structural attributes in delivering quality services. The spatial analyses revealed the geographies in the country where the QoC and facility readiness is low. Quality should be an overriding priority to establish the credibility of any health care delivery system.

Keywords: Multi-level modeling, Sexual and Reproductive Health and Rights, Outcome and impact evaluations

See extended abstract.

  Presented in Session 95. Maternal Health Care and Associated Needs