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Does the preference for location of childbirth change for successive births? Evidence from the states and regions of India

Published online by Cambridge University Press:  16 April 2020

Bidyadhar Dehury Open the ORCID record for Bidyadhar Dehury [Opens in a new window]  and
Mithlesh Chourase
Bidyadhar Dehury*
Affiliation:
India Health Action Trust, Lucknow, India
Mithlesh Chourase
Affiliation:
Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India
*
*Corresponding author. Email: [email protected]
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Abstract

Universal health coverage is central to the development agenda to achieve maternal and neonatal health goals. Although there is evidence of a growing preference for institutional births in India, it is important to understand the pattern of switching location of childbirth and the factors associated with it. This study used data from the fourth round of the National Family and Health Survey (NFHS-4) conducted in India in 2015–16. The study sample comprised 59,629 women who had had at least two births in the five years preceding the survey. Bivariate and multivariate logistic regression analyses were applied to the data. About 16.4% of the women switched their location of childbirth between successive births; 9.1% switched to a health facility contributing to a net increment of 1.9% in institutional delivery, varying greatly across states and regions. There was at least a 4 percentage point net increment in institutional births in Chhattisgarh, Bihar, Punjab and Haryana, but the shift was more in favour of home births in Madhya Pradesh, Odisha and West Bengal. Women with high parity and a large birth interval had higher odds of switching their place of childbirth, and this was in favour of a health facility, while women with higher education, from lower social groups, living in urban areas, who had not received four antenatal care visits, and who belonged to a higher wealth quintile had higher odds of switching their place of childbirth to a health facility, despite having lower odds of switching their childbirth location. The study provides evidence of women in India switching their location of childbirth for successive births, and this was more prevalent in areas where the rate of institutional delivery was low. Only a few states showed a higher net increment in favour of a health facility. This suggests that there is a need for action in specific states and regions of India to achieve universal health coverage.

Keywords

Successive birthsSwitching location of childbirthInstitutional delivery
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 2 , March 2021 , pp. 266 - 289
Copyright
© Cambridge University Press 2020

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