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...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/15617/51538_CE[Ra1]_F(SHU)_PF1(JY_SS_KM)_PN(KM).pdf |
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| author | Srikanta Chakraborty Sukumar Mitra Nibedita Banerjee Avilash Mondal Arup Chakraborty Saptarshi Ghosh |
| author_facet | Srikanta Chakraborty Sukumar Mitra Nibedita Banerjee Avilash Mondal Arup Chakraborty Saptarshi Ghosh |
| author_sort | Srikanta Chakraborty |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T23:37:22Z |
| format | Article |
| id | doaj.art-72eb973e72e94893b2cb5d6e668f4f89 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-21T23:37:22Z |
| publishDate | 2021-11-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-72eb973e72e94893b2cb5d6e668f4f892022-12-21T18:46:19ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-11-011511111510.7860/JCDR/2021/51538.15617Towards 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, IndiaSrikanta Chakraborty0Sukumar Mitra1Nibedita Banerjee2Avilash Mondal3Arup Chakraborty4Saptarshi Ghosh5Assistant Chief Medical Officer of Health, Department of Health and Family Welfare, South 24 Parganas, Kolkata, West Bengal, IndiaAssociate Professor, Department of Gynaecology and Obstetrics, Medical College, Kolkata, West Bengal, India.Counsellor, Department of Blood Bank, Institute of Child Health, Kolkata, West Bengal, IndiaMedical Officer, Department of Cardiology, Ramakrishna Mission Sevapratisthan, Kolkata, West Bengal, IndiaAssociate Professor, Department of Community Medicine, Medical College, Kolkata, West Bengal, IndiaMBBS Student, Department of Community Medicine, Medical College, Kolkata, 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 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.https://jcdr.net/articles/PDF/15617/51538_CE[Ra1]_F(SHU)_PF1(JY_SS_KM)_PN(KM).pdfaccessibilitybarrierscommunity healthhealthcare servicesutilisation |
| spellingShingle | Srikanta Chakraborty Sukumar Mitra Nibedita Banerjee Avilash Mondal Arup Chakraborty Saptarshi Ghosh 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 Journal of Clinical and Diagnostic Research accessibility barriers community health healthcare services utilisation |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | accessibility barriers community health healthcare services utilisation |
| url | https://jcdr.net/articles/PDF/15617/51538_CE[Ra1]_F(SHU)_PF1(JY_SS_KM)_PN(KM).pdf |
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