Tej Ram Jat|Nawi Ng|Miguel San Sebastián
Factors affecting the use of maternal health services in Madhya Pradesh state of India: a multilevel analysis
United Nations Children's Fund India|Umeå University|Umeå University|Umeå University
improving maternal health one eight millennium development goals widely accepted use maternal health services helps reducing maternal morbidity mortality utilization maternal health services complex phenomenon influenced several factors therefore factors different levels affecting use services need clearly understood objective study estimate effects individual community district level characteristics utilisation maternal health services special reference antenatal care anc skilled attendance delivery postnatal care pncthis study designed cross sectional study data 15782 ever married women aged 1549 years residing madhya pradesh state india participated district level household facility survey dlhs3 200708 used study multilevel logistic regression analysis performed accounting individual community district level factors associated use maternal health care services type residence community level ratio primary health center population percent tribal population district included district level variables studythe results study showed 617 respondents used anc least recent pregnancy whereas 374 women received pnc within two weeks delivery last delivery 498 mothers assisted skilled personnel considerable amount variation use maternal health services community district levels 40 14 total variance use anc 29 8 total variance use skilled attendance delivery 28 85 total variance use pnc attributable differences across communities districts respectively controlled individual community district level factors variances use skilled attendance delivery attributed differences across communities districts reduced 15 43 respectively marginal reductions observed variance community district level anc pnc use household socioeconomic status mothers education important factors associated use anc skilled attendance delivery community level variable significant anc skilled attendance delivery pnc none district level variables used study found influential factors use maternal health serviceswe found sufficient amount variations community district residence three indicators use maternal health services increasing utilisation services state addition individuallevel strong need identify focus community districtlevel interventions