Factors associated with low institutional delivery in Kangpokpi block, Senapati district, Manipur, India.

Introduction: The medical attention received by the mothers at the time of delivery is an important factor in reducing maternal and infant mortality. In Kangpokpi block of Senapati district, Manipur, institutional delivery was as low as 24.3% (DLHS3) as compared to 65.1% in Imphal, East district and also compared to India which was 47% (NFHS3). Since there is a need to increase the number of Institutional deliveries at Kangpokpi block, this study has been taken up with the objective of determining the factors associated with low institutional delivery.

Method: We did unmatched case-control study taking random sample of 144 home deliveries (cases) and 144 Institutional deliveries (controls) from the list of home/institution deliveries registered separately during the period between 1st July and 31st December 2009. We collected the information on demographic, socio-economic and health service variables using the pre-tested semi-structured interview schedule. We studied the association of different exposure variables with place of delivery, with 95% CI. We carried out univariate and multivariate logistic regression analysis to identify significant modifiable risk factors.

Results: Univariate logistic regression analyses revealed that mothers education (class IX and below), OR=1.98 (P=0.008); husbands occupation (cultivation), OR= 2.47 (P= 0.0001); family monthly income (less than Rs 3000/- per month), OR 2.08 (P=0.002); not exposed to media, OR 1.67 (P=0.03); order of birth (more than 3), OR 2.07 (P=0.008); distance from health facility (more than 2 km), OR=1.14 (P=0.0001) and decision maker for place of delivery (husband and wife), OR=2.7 (P=0.001) were significantly associated with low institutional delivery. Multiple logistic regression analysis showed that husbands occupation (cultivation), OR=2.14 (P=0.007); distance to health facility, OR=1.26 (P=0.04) and decision maker for the place of delivery (husband and wife), OR=3.68 (P=0.02) were found significantly associated with low institutional delivery.

Conclusion: We suggested education on family planning, advocacy of institutional delivery among the mothers, provision of emergency obstetric transport facility in rural areas, and government policies meant to create jobs to raise the standard of living.

For more information, email the presenter at: drjtouthang@yahoo.com

Author (s): 

J. Touthang , S.Thilakavathi, MV Murhekar, BN.Murthy Master of Public Health Programme, National Institute of Epidemiology (ICMR), R127, Ayapakkam, Ambattur, Chennai-600 102, Tamil Nadu, India

Presenter (s): 
Dr. J Touthang
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