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Title: Antenatal Care Services, Practices and Utilisation : A Study among the Bodos of Assam
Authors: Islary, Jacob
Keywords: School of Social Work
Virginius Xaxa
Antenental Care Services - Bodos - Assam
Issue Date: 2018
Abstract: The study is located in a tribal and rural district of Assam. It captures the ANC services, practices and utilisation, besides constructing a socio-cultural narrative of the meaning and understanding of pregnancy and pregnancy care among a tribal community called the Bodos. The study is poised against the intensive and rigorous implementation of the WHO model of Focused Antenatal Care (FANC) service by NRHM/NHM with an aim of reducing maternal and child morbidity and mortality based on the assumption that antenatal Care (ANC) – (registration and regular visits) is essential and vital component of early diagnosis and treatment of pregnancy related complication and intervention. The implementation of the programme becomes even more urgent as annual statistical figure pregnancy related mortality is alarming both at global and national levels (globally 303,000 deaths in 2015 and India 45,000 deaths in 2016 as per report of WHO, 2016). Further, the report states that of the total global deaths due to complications related to pregnancy, 99 per cent deaths occurred in the developing countries of which 17 per cent is in India. This study however, does not deal with the study of morbidity and mortality rate or ratio related to pregnancy complications. On the other hand it attempts to understand 1) the level and relationship between Knowledge, Attitude and Practice of ANC among the study population; 2) types of services and service providers of ANC in the study area; 3) the meaning and understanding of pregnancy and pregnancy care among the Bodos from a socio-cultural perspective and 4) suggest strategies for improvement in the achievement of ANC service utilisation provided by the formal health system among the Bodos. The interest of the study arose out of experience from field – high dropout rate from ANC service in spite of high level of awareness and positive attitude among the people. This encounter in the field created a curiosity in the mind of the researcher to further understand the reasons and factors responsible for such outcome in relation to ANC service utilisation in the district of Chirang.In order to achieve the aim of the research, a literature review on the subject of study was carried out, keeping in mind the importance of aspects of understanding the historical as well as cultural perspectives of ANC along with an intensive fieldwork in the area of study. To capture the information required from various stake holders a semi-structured questionnaire; unstructured interview schedules and FGD guides were constructed and applied to various categories of respondents. Three frameworks were used in the study to help conceptualise, capture, and identify the various aspects of ANC in the study - namely 1) WHO model of four ANC visits (FANC) to define Full ANC, 2) Health Belief Model (HBM) to capturing Knowledge, Attitude and Practice of ANC and 3) Andersen and Newman’s Health Services Utilisation Framework to identify and capture the various aspects and the factors influencing ANC service utilisation by the pregnant Bodo women. The research used a mixed method with the aim of combining the strengths besides attempting to reduce the chance of missing out important information that can be captured by both the methods. Thus, there are statistical calculations and figures that show the level, nature and degree of relationships between the different variables, as well as thematic analysis based on the qualitative narratives by the respondents. The study arrives at an argument that ANC has to be understood not only from medical perspective especially obstetric and preventive; but also from the socio-cultural perspective of the community and context of study. The study puts forward this argument for the achievement of better ANC seeking behaviour among communities. Alternatively, it could be summarised in following words the discourse on the services, practices and factors influencing utilisation of ANC service among the people is an ongoing process and needs to be understood as embedded in the social and cultural life of the people. In India, while it is the responsibility of the state to ensure that the universalisation of ANC service is achieved by adopting different strategies (including incentive-based); the need for providing localised, and culturally acceptable practice; besides working on making the attitude and behaviour of the service providers friendly and sensitive towards the service utilisers would give a better outcome in practice and utilisation of ANC service by the pregnant women.
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01_Title Page.pdf279.21 kBAdobe PDFView/Open
02_Declaration.pdf579.84 kBAdobe PDFView/Open
03_Certificate.pdf579.78 kBAdobe PDFView/Open
04_Table of Contents.pdf587.84 kBAdobe PDFView/Open
05_List Of Abbreviations.pdf582.27 kBAdobe PDFView/Open
06_List Of Tables.pdf582.62 kBAdobe PDFView/Open
07_Acknowledgement.pdf580.64 kBAdobe PDFView/Open
08_Abstract.pdf585.4 kBAdobe PDFView/Open
09_Chapter 1.pdf636.76 kBAdobe PDFView/Open
10_Chapter 2.pdf758.26 kBAdobe PDFView/Open
11_Chapter 3.pdf637.15 kBAdobe PDFView/Open
12_Chapter 4.pdf655.64 kBAdobe PDFView/Open
13_Chapter 5.pdf654.07 kBAdobe PDFView/Open
14_Chapter 6.pdf662.71 kBAdobe PDFView/Open
15_Chapter 7.pdf644 kBAdobe PDFView/Open
16_Chapter 8.pdf583.71 kBAdobe PDFView/Open
17_Findings.pdf592.9 kBAdobe PDFView/Open
18_Annexure.pdf601.39 kBAdobe PDFView/Open
19_References.pdf617.26 kBAdobe PDFView/Open

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