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Maternal HealthMaternal Health
2005-06 National Family Health 2005-06 National Family Health Survey (NFHS-3)Survey (NFHS-3)
NFHS-3, India, 2005-06
Content
Antenatal Care and Use of Antenatal Care and Use of
Ultrasound Ultrasound
Delivery CareDelivery Care
Postnatal CarePostnatal Care
NFHS-3, India, 2005-06
Women* Who Received Antenatal Women* Who Received Antenatal CareCare
7277
91
Total Urban Rural
NFHS-1 NFHS-2 NFHS-3
* For last births in the past 3 years* For last births in the past 3 years
PercentPercent
NFHS-3, India, 2005-06
Women* Who Received Antenatal Women* Who Received Antenatal CareCare
65
83
5966 60
86
7277
91
Total Urban Rural
NFHS-1 NFHS-2 NFHS-3
* For last births in the past 3 years* For last births in the past 3 years
Up 11 ptsUp 11 pts Up 12 ptsUp 12 pts
PercentPercent
NFHS-3, India, 2005-06
Women* Who Received 3+ ANC VisitsWomen* Who Received 3+ ANC Visits
703744
7451 43
Total Urban Rural
NFHS-2
NFHS-3
* For last births in the past 3 years* For last births in the past 3 years
• Only two-thirds of women who receive any Only two-thirds of women who receive any ANC, have the recommended 3+ ANC visitsANC, have the recommended 3+ ANC visits
• The share receiving 3+ ANC visits among The share receiving 3+ ANC visits among women who have any ANC is nearly unchanged women who have any ANC is nearly unchanged since NFHS-2since NFHS-2
PercentPercent
NFHS-3, India, 2005-06
Women* Who Received ANC In the First Women* Who Received ANC In the First TrimesterTrimester
3356
2743
63
36
Total Urban Rural
NFHS-2
NFHS-3
* For last births in the past 3years* For last births in the past 3years
• 56% of women who receive any ANC, received 56% of women who receive any ANC, received ANC in the first trimester ANC in the first trimester
• The share receiving ANC in their first trimester The share receiving ANC in their first trimester among women who have any ANC is up by 6 among women who have any ANC is up by 6 percentage points since NFHS-2percentage points since NFHS-2
PercentPercent
NFHS-3, India, 2005-06
Are womenAre women** receiving receiving appropriate ANC?appropriate ANC?
76% of women received two or more 76% of women received two or more tetanus toxoid injectionstetanus toxoid injections
Among women who received ANC:Among women who received ANC: Less than two-thirds had weight, blood, or Less than two-thirds had weight, blood, or
urine taken, or blood pressure measuredurine taken, or blood pressure measured Three-fourths had their abdomen Three-fourths had their abdomen
examinedexamined 36% were told about pregnancy 36% were told about pregnancy
complicationscomplications
* For last births in the past 5 years* For last births in the past 5 years
NFHS-3, India, 2005-06
56% of married and 59% of pregnant women 56% of married and 59% of pregnant women are anaemic. So, are pregnant women* getting are anaemic. So, are pregnant women* getting iron and folic acid (IFA) supplementation?iron and folic acid (IFA) supplementation?
65
76
61
23
35
19
Total Urban Rural
Given or purchased IFA Consumed IFA for 90 days
PercentPercent
*For last births in the past 5 years*For last births in the past 5 years
NFHS-3, India, 2005-06
What are some notable differentials What are some notable differentials in access to ANC*?in access to ANC*?
Birth Order
8882
64
47
1 2-3 4-5 6+
Wealth Index
5969
8090
97
Lowest Highest
PercentPercent
**For last births in the past 5 yearsFor last births in the past 5 years
NFHS-3, India, 2005-06
Pregnancies with an UltrasoundPregnancies with an Ultrasound
16
44
24
9
65
4
62
Total Rural Urban None 12+ Lowest Highest
Percent of pregnancies in the past 5 years
Residence Wealth IndexEducationEducation
NFHS-3, India, 2005-06
Are ultrasounds being conducted for Are ultrasounds being conducted for sex-selection?sex-selection?
There is evidence of sex selection, There is evidence of sex selection, when the sex ratio at birth deviates when the sex ratio at birth deviates from the normal of about 960-970 from the normal of about 960-970 girls per 1,000 boysgirls per 1,000 boys
Thus, the question can be answered Thus, the question can be answered by examining the sex ratio of births by examining the sex ratio of births that result after a that result after a pregnancy with an pregnancy with an ultrasoundultrasound
NFHS-3, India, 2005-06
Are ultrasounds being conducted for Are ultrasounds being conducted for sex-selection?sex-selection?
751
988849
570
876
665
908
Total 0 sons 1 son 0 sons 2 sons 0 sons 2-3 sons
Girls per 1,000 boys born in the past 5 years (for pregnancies with an ultrasound)
1 child 3 children2 children2 children
NFHS-3, India, 2005-06
Content
Antenatal Care and Use of Antenatal Care and Use of
Ultrasound Ultrasound
Delivery CareDelivery Care
Postnatal CarePostnatal Care
NFHS-3, India, 2005-06
Trends in Delivery CareTrends in Delivery Care
Institutional Delivery
41
34
26
NFHS-3NFHS-2NFHS-1
Delivery assisted by health personnel
4942
35
NFHS-3NFHS-2NFHS-1
**For live births in the past 5 yearsFor live births in the past 5 years
PercentPercent
Only about 1 in 7 Only about 1 in 7 home deliveries home deliveries are assisted by a are assisted by a skilled providerskilled provider
NFHS-3, India, 2005-06
Percentage point change Percentage point change between NFHS-2 and NFHS-3between NFHS-2 and NFHS-3 StatesStates
Remained unchanged Remained unchanged
(2 states)(2 states)Arunachal Pradesh, NagalandArunachal Pradesh, Nagaland
Increased less than 7 percentage Increased less than 7 percentage pointpoint
(7 states)(7 states)
Assam, Chhattisgarh, Delhi, Assam, Chhattisgarh, Delhi, Goa, Goa, JharkhandJharkhand, Tripura, West , Tripura, West BengalBengal
Increased by 7-14 percentage Increased by 7-14 percentage pointspoints
(10 states)(10 states)
BiharBihar, Gujarat, Maharashtra, , Gujarat, Maharashtra, Madhya PradeshMadhya Pradesh, Meghalaya, , Meghalaya, RajasthanRajasthan, Tamil Nadu, , Tamil Nadu, Kerala, Kerala, Uttar PradeshUttar Pradesh , , MizoramMizoram
Increased by 15 or more Increased by 15 or more percentage points percentage points
(10 states)(10 states)
Andhra Pradesh, Haryana, Andhra Pradesh, Haryana, Himachal Pradesh, Jammu & Himachal Pradesh, Jammu & Kashmir, Karnataka, Manipur, Kashmir, Karnataka, Manipur, OrissaOrissa, Punjab, Sikkim, , Punjab, Sikkim, UttaranchalUttaranchal
Trends in Institutional Deliveries by StateTrends in Institutional Deliveries by State
NFHS-3, India, 2005-06
Selected Differentials in Selected Differentials in Institutional Deliveries*Institutional Deliveries*
18
33
84
13
29
68
39
Total Urban Rural Lowest Highest SC ST
*For live births in the past five years*For live births in the past five years
ResidenceResidence Wealth indexWealth index Caste/tribeCaste/tribe
Percent
NFHS-3, India, 2005-06
Are women* using the public sector Are women* using the public sector for their deliveries?for their deliveries?
1829
148
24 1912
Total Urban Rural Lowest Highest SC ST
*For live births in the past 5 years*For live births in the past 5 years
ResidenceResidence Wealth indexWealth index Caste/tribeCaste/tribe
3939
6868
2020
1313
8484
3333
1818
Percent
NFHS-3, India, 2005-06
How common are caesarean-How common are caesarean-section deliveries?section deliveries?
9% of live births in the past 5 years were 9% of live births in the past 5 years were delivered by c-sectiondelivered by c-section
16% of 16% of first birthsfirst births are delivered by a c- are delivered by a c-sectionsection
C-sections C-sections increaseincrease sharply with women’s sharply with women’s education and wealtheducation and wealth
C-sections are almost twice as common C-sections are almost twice as common for deliveries in the private sector than in for deliveries in the private sector than in the public sector: 28 vs. 15 percentthe public sector: 28 vs. 15 percent
NFHS-3, India, 2005-06
Content
Antenatal Care and Use of Antenatal Care and Use of
Ultrasound Ultrasound
Delivery CareDelivery Care
Postnatal CarePostnatal Care
NFHS-3, India, 2005-06
Are women receiving postnatal Are women receiving postnatal care?care?
42
66
3437
61
29
Total Urban Rural
Any Within 2 days
PercentPercent
**For last births in the past 5 yearsFor last births in the past 5 years
For births whose mothers For births whose mothers received postnatal care, received postnatal care,
care was provided:care was provided:-By doctors for 72% -By doctors for 72%
-By ANMs and other -By ANMs and other health personnel by 20% health personnel by 20%
-By -By daisdais or TBAs by 8% or TBAs by 8%
• For only 20% of home For only 20% of home births was there any births was there any postnatal carepostnatal care
NFHS-3, India, 2005-06
Postnatal CarePostnatal Care
1113 14 16 17
23
28 29 29 29 30 32 3337
4143 45 46 48
5156 57 58 59 59
62 64
76
8587
0
20
40
60
80
100
120
NA
UP
AS
BH JH AR
CH
MP
MG
RJ
TR UT
OR IN
WB
HP
SK
MN
JK MZ
HR GJ
DL
KA
MH
PJ
AP
GA
KE
TN
Institutional Deliveries
Percent
NFHS-3, India, 2005-06
SummarySummary Any ANC increased by 11 percentage points and 3+ Any ANC increased by 11 percentage points and 3+
ANC visits by 7 percentage points between NFHS-2 ANC visits by 7 percentage points between NFHS-2 and NFHS-3and NFHS-3
Still, half or less than half of women get ANC in the Still, half or less than half of women get ANC in the first trimester and get 3+ ANC visits first trimester and get 3+ ANC visits
Institutional deliveries increased by 7 percentage Institutional deliveries increased by 7 percentage points between NFHS-2 and NFHS-3points between NFHS-2 and NFHS-3
Nonetheless, more than half the deliveries still Nonetheless, more than half the deliveries still take place at home; half are not assisted by health take place at home; half are not assisted by health personnelpersonnel
The majority of mothers with a recent delivery did The majority of mothers with a recent delivery did not receive any postnatal carenot receive any postnatal care
NFHS-3, India, 2005-06
ConclusionConclusion
Despite improvements in the provision Despite improvements in the provision of maternal health care, at the current of maternal health care, at the current
rate of change at no more than one rate of change at no more than one percentage point a year, women’s percentage point a year, women’s reproductive health will continue to reproductive health will continue to
suffer well into this century.suffer well into this century.