INTRODUCTION:

Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period¹. Maternal Health is an important aspect for the development of any country in terms of increasing equity & reducing poverty. The survival and well-being of mothers is not only important in their own right but are also central to solving large broader, economic, social and developmental challenges².

According to recent updates there is several maternal health and child health programmes has been launched in India. Some of the programmes are Pradhan Mantri Surakshit Matrutava Abhiyan (PMSMA), Janani Surakha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK) etc. These programmes are providing adequate services to mothers to improve the maternal health prevent complications during child birth and also provide welfare schemes to mothers under slow socio-economic status or from weaker section³.

The WHO estimates show that out of the 536 000 maternal deaths globally each year, 117 000 (22%) occur in India⁴. In addition to these, millions suffer pregnancy related morbidity. According to Global Burden of Disease estimates for 2004, India contributes 21% of the disability adjusted life years (DALYs) lost due to maternal conditions⁵.

Public health initiatives over the last two to three decades have helped India to improve health indicators such as life expectancy and total fertility rate to a great extent, but some crucial indicators like Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR) have stagnated at around 400/100 000 live births and 60/1000 live births, respectively, in the 1990s⁶.

NEED FOR THE STUDY:

India’s maternal mortality rate reduced from 212 deaths per 100,000 live births in 2007 to 167 deaths in 2013. It is largely due to key government interventions such as the Janani Shishu Suraksha Karyakaram (JSSK) scheme which encompasses free maternity services for women and children, a nationwide scale-up of emergency referral systems and maternal death audits, and improvements in the governance and management of health services at all levels. However, adolescent and illiterate mothers and those living in hard-to-reach areas still have a much greater risk of dying in childbirth. Adolescent girls outside the cities are especially vulnerable as teenage marriage and pregnancies are very high in rural and remote areas of the country⁷.

Karnataka State continues to have the highest rates of maternal mortality in south India at 144/100,000 live births, but lower than the national estimates of 190–220/100,000 live births. Various barriers exist to timely and appropriate utilization of services during pregnancy, childbirth and postpartum⁸.

Poor access and utilization of antenatal and other health services continue to contribute to high maternal mortality rate along with other socioeconomic factors²¹. Improving utilization of maternal health care services is a global challenge for the health system in low- and middle-income countries. The goal set by United Nations, Millennium Developmental goals to reduce the maternal mortality ratio by three quarters during the period 1990-2015⁹.

OBJECTIVES:

1. To assess the level of utilization of maternal health services among pregnant mothers.

2. To identify the factors, determine the utilization of maternal health services among pregnant mothers.

3. To determine the association between level of utilization of maternal health services among pregnant mothers and their selected demographic variable.

HYPOTHESIS:

H1: There is a significant association between level of utilization of maternal health services among pregnant mothers and their selected demographic variable.

METHODOLOGY:

Research Design:

The research design selected for study was Non-experimental descriptive survey design.

Sampling technique:

Non-probability Convenient sampling.

Sample:

Sample size was 60 pregnant mothers who teach from 1^st standard to 4^th standards in selected Government Primary Schools of Davanagere.

Variables:

Research variable: Utilization of maternal health services among pregnant mothers.

Demographic variables:

Age, religion, family type, educational status, occupational status, family income, gravida and source of information regarding maternal health services.

Setting:

The present study was conducted in Aluru, Nagarakatte, Kadajji, Putaganaalu, Mallapura, Rampura and Yelebethur villages under Aluru PHC at Davangere, Karnataka state

DATA COLLECTION TECHNIQUE.

Part I: Consists of items on demographic variables such as age, Religion, family type, educational status, occupational status, family income, gravida and source of information regarding maternal health services.

Part II: consists of 20 items on the structured checklist to assess the level of utilization of maternal health services.

Part III: consists of 15 items on the structured checklist to assess the factors determining the utilization of maternal health services.

RESULTS:

Section 1: Selected personal variables of the pregnant mothers.

Table 1: Frequency and percentage distribution of pregnant mothers in selected demographic characteristics n = 60

Demographic Characteristics of samples		Frequency	Percentage
Age	18-22 years	11	18.3
	23-27 years	17	28.3
	28-32 years	26	43.3
	33 years and above	6	10.0
Religion	Hindu	49	81.7
	Muslim	5	8.3
	Christian	6	10.0
Type of family	Nuclear family	53	88.3
Type of family	Joint family	7	11.7
Education	No formal education	11	18.3
	Primary education	13	21.7
	Secondary education	11	18.3
	PUC	19	31.7
	Degree and above	6	10.0
Occupation	Housewife	39	65.0
	Coolie/Daily wages	7	11.7
	Private employees	10	16.7
	Government employees	4	6.7
Income	Less than Rs.5000	5	8.3
	Rs. 5001-10000	18	30.0
	Rs. 10001-15000	29	48.3
	Rs. 15001 and above	8	13.3
Gravida status	Primi gravida	41	68.3
Gravida status	Multi gravida	19	31.7
Source of information	Mass media	4	6.7
	Health Personnel	19	31.7
	Family/Friends	19	31.7
	Others	18	30.0

Section 2: Utilization of pregnant mothers regarding maternal health services.

Table 2: Level of utilization of the maternal health services among pregnant mothers n = 60

Level of Utilization	Frequency	Percentage
a. Low utilization (1-50%)	20	33.3
b. Moderate utilization (51-75%)	17	28.3
c. Good utilization (>76%)	23	38.3
Total	60	100.0

Table 3: Mean, Mean percentage and standard deviation for utilization scores of the pregnant mothers n = 60

Utilization Scores	No. of Items	Max Score	Mean	Mean%	Med-ian	SD
Utilization of maternal health services score	20	20	12.85	64.25	13	4.445

Table 4: Frequency distribution of factors determining the utilization of maternal health services

S.No	ITEM	Frequency	%
1.	Availability of emergency services	43	71.7
2.	Getting appropriate reference in case of health problem	40	66.7
3.	Good attitude of health care provider	37	61.7
4.	Anganwadi workers helps to utilize the health services	46	76.7
5.	Family members motivates to go utilize maternal health services	47	78.3
6.	Family members accompany during visit to health centre	47	78.3
7.	Regularity of immunization sessions	50	83.3
8.	Availability of immunization as per National immunization schedule	42	70.0
9.	Availability of different family planning services for choice	41	68.3
10.	Maintenance of Cleanliness at health care facility	43	71.7
11.	Provision of privacy during examination	41	68.3
12.	Availability of laboratory facilities	37	61.7
13.	Respect for the individuality of client	40	66.7
14.	Length of waiting time	47	78.3
15.	Good way of continuity/follow up care	44	73.3

Section 3: Association between utilization of pregnant mothers on maternal health services with their selected personal variables

The selected personal variables such as age, religion, education and gravida status were having significant association with the utilization scores of pregnant mothers on maternal health services at 0.05 level.

CONCLUSION:

· The findings of the study revealed that the mean utilization of maternal health services score obtained by the subjects was 12.85 (64.25%) with the standard deviation of 4.445, found to be moderate level of utilization of maternal health services.

· The above findings of the study showed that 38.3% of the subjects had good utilization of maternal health services, 28.3% of them had moderate utilization and 33.3% of them had low level of utilization.

· The findings of the study also revealed that There was a statistically significant association between the utilization of maternal health services score of pregnant mothers with demographic variables such as age, religion, education and gravida status at the probability level of p<0.05.

RECOMMENDATIONS:

The following recommendations were made based on the results of the study.

1. A similar study can be replicated on a larger sample with similar demographical characters.

2. A similar study can be replicated using a larger population of the community.

3. A comparative study can be conducted on urban and rural pregnant mothers.

4. An experimental study can be conducted to assess the effectiveness of interventions to reduce utilization of maternal health services among pregnant mothers.

REFERENCES:

1. Maternal Health Programme. Ministry of Health and Family Welfare: Government of India. Annual Report 2013-14. P.51-8. Available from: https://mohfw.gov.in/sites/default/files/Chapter415.pdf

2. Global Citizen. Introduction to the challenges for maternal health. Global Poverty Project. Oct 2012; Available from: https://www.globalcitizen.org/en/content/introduction-to-the-challenges-for-maternal-health/

3. Maternal Health. National Health Mission: State Health Society, Health and family welfare Department: Government of Gujarath. Accessed on 18.01.2020. Available from: https://nrhm.gujarat.gov.in/maternal-health1.htm

4. Hill K, Thomas K, Abou Zahr C, Walker N, Say L, Inoue M, et al. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet. 2007; 370:1311–1319. doi: 10.1016/S0140-6736(07)61572-4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17933645

5. World Health Organization. Global Burden of Disease 2004 update. Geneva, Switzerland: Health Statistics and Informatics Department, WHO, 2008. Available at: http://www.who.int/evidence/bod

6. Government of India. Child Health Programme in India. New Delhi: Government of India, 2004. Available from: http://mohfw.nic.in/showfile.php?lid=539

7. UNICEF India. Maternal health. Accessed on 18.01.2020. Available from: http://unicef.in/whatwedo/1/maternal-health

8. Goudar SS, Goco N, Somannavar MS, Vernekar SS, Mallapur AA, Moore JL, Wallace DD, Sloan NL, Patel A, Hibberd PL, Koso-Thomas M. Institutional deliveries and perinatal and neonatal mortality in Southern and Central India. Reproductive Health. 2015:12(Suppl 2): S13.

9. United Nations. The Millennium Development Goals Report. The United Nations Department of Economic and Social Affairs, New York; 2009 July. p.1- 56

Received on 27.09.2024 Revised on 26.10.2024

Accepted on 15.11.2024 Published on 25.02.2025

Available online from March 24, 2025

A and V Pub J. of Nursing and Medical Res. 2025;4(1):9-12.

DOI: 10.52711/jnmr.2025.03

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