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Improving use of maternal care services among married adolescent girls: an intervention study in rural India

Published online by Cambridge University Press:  24 April 2020

Ashok Dyalchand ,
Rohini Prabha Pande Open the ORCID record for Rohini Prabha Pande [Opens in a new window] ,
Gopal Kulkarni  and
Manisha Khale
Ashok Dyalchand
Affiliation:
Institute of Health Management, Pachod (IHMP), Maharashtra, India
Rohini Prabha Pande*
Affiliation:
Institute of Health Management, Pachod (IHMP), Maharashtra, India
Gopal Kulkarni
Affiliation:
Institute of Health Management, Pachod (IHMP), Maharashtra, India
Manisha Khale
Affiliation:
Institute of Health Management, Pachod (IHMP), Maharashtra, India
*
*Corresponding author. Email: rohinipande@jhu.edu
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Abstract

This study examined the effect of the Safe Adolescent Transition and Health Initiative (SATHI) programme on the use of maternal care services among rural, pregnant adolescents in India. This was an intensive community-based, multi-site intervention project conducted in Maharashtra state between 2008 and 2011. Its aims were to improve the reproductive health of married adolescent girls and avert the adverse consequences of early motherhood. It had a quasi-experimental, case-control, pre-post design to enable rigorous evaluation. This study used cross-sectional data from 644 married girls aged under 19 years at baseline and 802 at endline to assess the maternal care outcomes of antenatal care, delivery and postnatal services and nutrition during pregnancy. Difference-in-differences analysis showed that all outcomes improved significantly in the study sites between baseline and endline, and the improvement in study sites was significantly larger than in the control sites. Multivariate analysis showed a statistically significant dose–response effect of intervention participation for antenatal care, pregnancy nutrition and postnatal care. Study participation was not statistically significantly associated with higher rates of safe or institutional delivery. The analysis suggests that training and supporting community health workers to work with married adolescent girls using interpersonal communication and interacting frequently with them and their families and communities can significantly improve the use of maternal care services among this population. With almost a million community health workers and 200,000 auxiliary nurse midwives at the community level providing primary level care in India, this intervention offers a proven strategy to replicate and scale-up to reach large numbers of married adolescent girls who do not currently use maternal care services.

Keywords

Adolescent reproductive healthMarried adolescentsIndia maternal health
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 3 , May 2021 , pp. 336 - 355
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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