Pattern of obstetric morbidity, its correlates and treatment seeking behaviour in Bihar, India

Rajiv Ranjan, Independent Researcher

The demographic burden of the growing number of women and deliveries that are expected in the next 20 years will create heavy demand for provision of maternal health services. It would pose serious challenges for the healthcare delivery system. Both efforts and resources have to be enhanced to increase the coverage and improve the quality of maternal health services. Objective of the study is to examine the pattern and association of reported morbidity and care seeking behaviours in different regions of Bihar and to identify the regions of the state with high reported prevalence of obstetric morbidity. The present study is based on the DLHS-RCH (2002-2004) data. About one third of the women reported paleness, along with swelling of hands and feet and visual disturbance. More than half of the women reported obstructed labour with prolonged labour and excessive bleeding, while two-thirds reported fever with abdominal vaginal discharge and 50% reported fever with severe headache during the postpartum period. Reported complications were associated with women’s education, parity, birth-interval, standard of living, religion, and region. Most women who had a complication did not consult anyone, and when multiple complications developed, the proportion that sought treatment increased. Only one-third of the women sought treatment with one pregnancy complication, and it increased up to 50% when 3 or more complications had developed. The proportion of use of the public sector is performing poor; as 60% of the women preferred the private sector, while only 10% went to the public sector. Low quipped health sector may be one of the reasons to impede the public sector. The findings indicate that there is a strong need for awareness-raising efforts in the community about the complications of pregnancy, childbirth, and the postpartum period, and seeking medical help in imperative situation for obstetric complications is essential.