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Institutional Delivery: Social cultural
barrier towards achieving better
MNCHN Indicators
Gnanaranjan Das
BOT,MBA, PGDPHM (contd)
Pregnant Woman
ASHA/ANM- ANC
AWW-Nutrition
Institutional Delivery
Saturday, August 15, 2015 2
3 Delays
1. Delay
• In decision to seek care
2. Delay
• In reaching appropriate Health Facility
3. Delay
• In receiving quality care
Saturday, August 15, 2015 3Source: A strategic approach to RMNCH+A in India Chapter-3, Page-7
Decision for Place of Delivery
Husband 35%
Mother in
Law 24%
Self 15%
Saturday, August 15, 2015 4
Source:www.ncbi.nlm.nih.gov/pmc/articles
/PMC2781114/table/T0001/
Social Cultural Barrier
Community
Process
Women
empowerment
Accessibility
Availability
Affordability
Malnutrition
Myths &
Misconception
Saturday, August 15, 2015 5Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287253/
Reasons for not delivering in HF
No time to go (time constraint)
Not necessary
Better care at home
Cost too much
Too far/No transport
Family did not allow
Lack of knowledge
Poor quality
Saturday, August 15, 2015 6
Source: National factsheet Coverage
Evaluation survey UNICEF 2009
Structural , Environmental & Individual
intervention to social & cultural barrier
•Cultural norms,
use of health
service
•Health,
Nutritional
status.Human
Rights
•Accessibility,
availability,
price, quality,
water, sanitat.
•Macro, Micro
level – infra.,
Road, Energy
Govt
Policies &
action
Health
System &
related
sector
Household
&
Community
Individual
Saturday, August 15, 2015 7
4th & 5th Millennium development goal
Saturday, August 15, 2015 8
Source:http://www.un.org/millenniumgoal
s/
Programs
• CSSM 1992-1996
• RCH 1997-2004
• JSY 2005
• JSSK 2011
• IGMSY 2011
Saturday, August 15, 2015 9
Indicators of MNCHN
•MMR
•NMR
Reduce
•ANC visit
•ID
Enhance
Saturday, August 15, 2015 10
Reference
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287253/
• Program Document: A strategic approach to RMNCH+A in India January’13
• Journal of Vector Ecology 23(1): 47-53
• National factsheet Coverage Evaluation Survey UNICEF 2009
• http://www.hindawi.com/journals/tswj/2013/423403/
• www.ncbi.nlm.nih.gov/pmc/articles/PMC2781114/table/T0001/
• http://www.un.org/millenniumgoals/
Saturday, August 15, 2015 11

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ID Sociocultural barrier MNCHN

  • 1. Institutional Delivery: Social cultural barrier towards achieving better MNCHN Indicators Gnanaranjan Das BOT,MBA, PGDPHM (contd)
  • 2. Pregnant Woman ASHA/ANM- ANC AWW-Nutrition Institutional Delivery Saturday, August 15, 2015 2
  • 3. 3 Delays 1. Delay • In decision to seek care 2. Delay • In reaching appropriate Health Facility 3. Delay • In receiving quality care Saturday, August 15, 2015 3Source: A strategic approach to RMNCH+A in India Chapter-3, Page-7
  • 4. Decision for Place of Delivery Husband 35% Mother in Law 24% Self 15% Saturday, August 15, 2015 4 Source:www.ncbi.nlm.nih.gov/pmc/articles /PMC2781114/table/T0001/
  • 5. Social Cultural Barrier Community Process Women empowerment Accessibility Availability Affordability Malnutrition Myths & Misconception Saturday, August 15, 2015 5Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287253/
  • 6. Reasons for not delivering in HF No time to go (time constraint) Not necessary Better care at home Cost too much Too far/No transport Family did not allow Lack of knowledge Poor quality Saturday, August 15, 2015 6 Source: National factsheet Coverage Evaluation survey UNICEF 2009
  • 7. Structural , Environmental & Individual intervention to social & cultural barrier •Cultural norms, use of health service •Health, Nutritional status.Human Rights •Accessibility, availability, price, quality, water, sanitat. •Macro, Micro level – infra., Road, Energy Govt Policies & action Health System & related sector Household & Community Individual Saturday, August 15, 2015 7
  • 8. 4th & 5th Millennium development goal Saturday, August 15, 2015 8 Source:http://www.un.org/millenniumgoal s/
  • 9. Programs • CSSM 1992-1996 • RCH 1997-2004 • JSY 2005 • JSSK 2011 • IGMSY 2011 Saturday, August 15, 2015 9
  • 10. Indicators of MNCHN •MMR •NMR Reduce •ANC visit •ID Enhance Saturday, August 15, 2015 10
  • 11. Reference • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287253/ • Program Document: A strategic approach to RMNCH+A in India January’13 • Journal of Vector Ecology 23(1): 47-53 • National factsheet Coverage Evaluation Survey UNICEF 2009 • http://www.hindawi.com/journals/tswj/2013/423403/ • www.ncbi.nlm.nih.gov/pmc/articles/PMC2781114/table/T0001/ • http://www.un.org/millenniumgoals/ Saturday, August 15, 2015 11