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Publications

Care seeking for postpartum morbidities in Murshidabad, rural India

Future Health Systems

Tuddenham S A, Rahman Ha, Singh S, Barman D, Kanjilal B Care seeking for postpartum morbidities in Murshidabad, rural India International Journal of Gynecology and Obstetrics, February 2010

Abstract

Worldwide, an estimated 536 000 maternal deaths occur each year. Of these, approximately 25% occur in India alone. Postpartum maternal morbidity, defined by the WHO as morbidity occurring in the first 6 weeks after delivery, is a serious problem in resource-poor settings that contributes to maternal death. Despite the high prevalence of postpartum morbidity and the danger of maternal mortality, women in low-resource settings such as rural India frequently fail to seek care from formal health providers. Understanding the factors that influence care-seeking behavior for postpartum health problems in India is vital to setting program priorities and designing appropriate interventions. Our study sought to elucidate these factors in the rural district of Murshidabad, India.

We conducted secondary data analysis using multinomial logistic regression methods, using data collected through a household survey involving interviews with 2114 mothers carried out in February 2008 in the Murshidabad district of India. IRB approval was obtained from Johns Hopkins University Bloomberg School of Public Health.

A total of 929 (43.9%) mothers were reported to have had postpartum morbidities in the 6 weeks after delivery and were included in our analysis. Of these women, 54 (5.8%) did not seek care, 457 (49.2%) sought care from informal providers, and 418 (45.0%) sought care from formal providers. Most mothers lived in rural areas, were of lower socioeconomic status, were unemployed, and did not deliver at health facilities. The majority of mothers (62.5%) were Muslim, and most women and household heads had low educational levels. The mean distance to the nearest healthcare facility from a household was 3.9 kilometers.