Scholarlink

Background <p>A package of Maternal, Newborn and Child Health (MNCH) services are administered sequentially to mother–child dyads as Continuum of Care (CoC), but often each intervention is reviewed in silo in low-middle-income countries like India. Therefore, we aimed to examine the coverage of the entire package by computing composite CoC score of Indian mother–child dyads. We also aimed to estimate the <i>effect</i> of Indian <i>states</i> on CoC after adjusting for variations in socio-economic determinants; and then rank the Indian states based on their adjusted <i>effects</i>.</p> Methods <p>Women (15–49&#xa0;years) with most recently-born child (in last 5&#xa0;years) aged 12–23&#xa0;months (<i>n</i> = 40,687) from National Family Health Survey-5 (2019–21) of India were analysed. Nineteen CoC interventions (Y/N) were added (equally-weighted) to construct a composite CoC score. Multi-level models were used to study the <i>state effect</i> on CoC score after adjusting for individual-level wealth, education, caste, urban/rural residence and fertility. Indian states were ranked by their CoC performance using adjusted state residuals from the model.</p> Results <p>Only 3% dyads received all the 19 interventions, however, 50% received 14/19. Sterile delivery kit usage (94.4%), newborn weighing (92.4%) and skilled birth attendance (89.4%) were services with higher coverage, whereas early initiation of breastfeeding (43.7%) and appropriate iron-folate consumption (56.8%) had low coverage. The <i>state</i> factor explained 23% CoC score. Odisha, a comparatively less-developed state, was ranked first and also other less-developed states like Madhya Pradesh and Chhattisgarh outperformed richer counterparts. But many traditionally weaker Northern and North-Eastern states continued to lag behind.</p> Conclusion <p>Odisha and a few other less-developed Indian states demonstrated that good CoC coverage can be achieved even with restricted resources, perhaps through strengthening of public health system. Other states should emulate and help India as a nation achieve full CoC coverage of all its mother–child dyads and attain MNCH-related sustainable development goals.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Coverage of continuum of Maternal, Newborn and Child Health (MNCH) care in a nationally representative sample of 40,687 mother–child dyads of India: a report from NFHS-5

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月11日

查看全文
  • Jyoti Ghosal,
  • Anita Nanda,
  • Pallavi Behera,
  • Meena Som,
  • Madhusmita Bal,
  • Manoranjan Ranjit,
  • Srikanta Kanungo,
  • Shridhar Murlidharrao Kadam,
  • Sanghamitra Pati,
  • Ambarish Dutta

摘要

Background

A package of Maternal, Newborn and Child Health (MNCH) services are administered sequentially to mother–child dyads as Continuum of Care (CoC), but often each intervention is reviewed in silo in low-middle-income countries like India. Therefore, we aimed to examine the coverage of the entire package by computing composite CoC score of Indian mother–child dyads. We also aimed to estimate the effect of Indian states on CoC after adjusting for variations in socio-economic determinants; and then rank the Indian states based on their adjusted effects.

Methods

Women (15–49 years) with most recently-born child (in last 5 years) aged 12–23 months (n = 40,687) from National Family Health Survey-5 (2019–21) of India were analysed. Nineteen CoC interventions (Y/N) were added (equally-weighted) to construct a composite CoC score. Multi-level models were used to study the state effect on CoC score after adjusting for individual-level wealth, education, caste, urban/rural residence and fertility. Indian states were ranked by their CoC performance using adjusted state residuals from the model.

Results

Only 3% dyads received all the 19 interventions, however, 50% received 14/19. Sterile delivery kit usage (94.4%), newborn weighing (92.4%) and skilled birth attendance (89.4%) were services with higher coverage, whereas early initiation of breastfeeding (43.7%) and appropriate iron-folate consumption (56.8%) had low coverage. The state factor explained 23% CoC score. Odisha, a comparatively less-developed state, was ranked first and also other less-developed states like Madhya Pradesh and Chhattisgarh outperformed richer counterparts. But many traditionally weaker Northern and North-Eastern states continued to lag behind.

Conclusion

Odisha and a few other less-developed Indian states demonstrated that good CoC coverage can be achieved even with restricted resources, perhaps through strengthening of public health system. Other states should emulate and help India as a nation achieve full CoC coverage of all its mother–child dyads and attain MNCH-related sustainable development goals.