Utilization of Maternal Health Care Services in India: A Community Based Cross-sectional Study in Rural Belgaum

Introduction: Sub Centre (SC) is the peripheral unit of the existing health care delivery system under the allopathic system of medicine in India. These basically provide preventive, promotive and the curative services and are facilitated by Female Health Workers (ANM) and Male Health Workers (MHW). They are the integral part of health care delivery system. Also, key to achieve a goal of health for all and to promote the community people for their overall development.

Methods: A community based descriptive cross-sectional study was conducted from August 2011 to February 2013 in all 9 sub centers of Kinaye PHC of Belgaum district, all 14 maternal health care workers were selected and 272 beneficiaries were selected from catchments area of these sub-centers were interviewed by administering structured, pretested interview schedule. Data were analyzed by SPSS (20 Version).

Results: Study revealed that (85%) of the workers had correct knowledge but could not transform it into practice completely. This is due to multiple problems that encounter such as include lack of equipments(85.71%), transport facilities (77.78%), delay in decision-making by community to seek care (77.78%), lack of supportive supervision (>20%). Besides these, they were lacking in career development opportunities. There are no promotional avenues and low remuneration and benefits. The acceptance of service provided through sub centers was satisfactory (>90%) among beneficiaries and ANMs (98%) were most accepted than MHW. Beneficiaries faced many problems to access services such as lack of need based services (60%), poor attention by health service provider towards the need of consumers (5.2%) and difficulty in reaching to sub health post (21%).

Conclusion: The regular supply of necessary equipments and medicines needs to be ensured at the sub centre and frequent in-service trainings and career development opportunities to be given to health workers to maintain the enthusiasm and devotion towards the profession. Also there is a need to provide skill development opportunities and ensure the convenience of service at all sub centers and communication between health workers and beneficiaries to be emphasized.