Towards Universal Health Coverage: Access to Maternal and Child Health Services in Hardto-Reach Areas in a Community Development Block of a Health District, West Bengal, India
Introduction: It is well established that poor economic condition is an important contributor of barrier to accessibility. However, non financial barriers also constitute significant constraints to the equitable access of full range of health services included under national Universal Health Cov...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15617/51538_CE[Ra1]_F(SHU)_PF1(JY_SS_KM)_PN(KM).pdf |
| Summary: | Introduction: It is well established that poor economic condition
is an important contributor of barrier to accessibility. However,
non financial barriers also constitute significant constraints to
the equitable access of full range of health services included
under national Universal Health Coverage (UHC) policies.
Aim: To study the accessibility of Maternal and Child Health
Services in remote and hard-to-reach areas towards UHC and
also to identify and synthesise non financial access barriers
to accessibility of Maternal and Child Health Services and to
distinguish them from financial barriers.
Materials and Methods: A retrospective, observational study
was done using a mixed method approach in the Institute of Public
health, Kalyani, Kolkata, West Bengal, India from December
2016 to May 2017. Quantitative analysis of Health Management
Information System (HMIS) data along with qualitative study by
Focused Group Discussion (FGD) and In-depth Interview (IDI)
was performed. Two FGDs were conducted among antenatal
mothers and Accredited Social Health Activist (ASHA) workers
and IDI was conducted with female health supervisor of that
block. The mothers who attended the Subcentre (SC) for
checkup on a particular day were asked to participate, and 10
ASHA workers who had come to the rural hospital on that day
for monthly meeting were chosen for another FGD, with the help
of a structured questionnaire.
Results: Quantitative analysis of HMIS reports revealed decreasing
trend in utilisation of Maternal and Child Health Services. There
were 3048 antenatal registrations in the year 2012-2013, whereas
it was 2771 in the year 2016-2017. The number of institutional
deliveries was 1166 in the year 2012-2013, whereas it was 471
in the year 2016 to 2017. The number of health service providers
also decreased than that of the previous year. Number of skilled
birth healthcare providers were 11 in the year 2012-2013, whereas
it become reduced to zero in the year 2016-2017. The qualitative
analysis showed financial and non financial barriers played role
in service accessibility. Regarding the non financial barrier, poor
communication due to inaccessible geography was the key player
in accessibility.
Conclusion: The lack of skilled human resources as well as the
poor communication due to inaccessible geographical location is
the most important reason behind the poor UHC in the block. |
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| ISSN: | 2249-782X 0973-709X |