Factors affecting maternal health care seeking behaviour in northeast states, India: evidence from district level household survey-4 (2012-2013)


  • Kh. Jitenkumar Singh National Institute of Medical Statistics, ICMR, New Delhi, India
  • Kanika Grover Department of Statistics, Amity University, Noida, Delhi NCR, India




Delivery care, Health facility, Maternal, Northeast states


Background: In context of reducing maternal mortality ratio, Government of India has implemented various programs and public health facility centres in order to provide quality services at the time of delivery. In this paper, we assessed the factors for home, private and public health facility sector utilization of delivery care in Northeast state, India. District Level Household Survey fourth round was used to carried out analysis and data was extracted for the childbirth during the last five years preceding the survey.

Methods: The outcome variable was categorical, thus multinomial logistic regression was used to assess the factors of each variable independently on the predictor variables. To check the collinearity, variance inflation factor (VIF) was computed for all variables prior to inclusion of multilevel logistic regression.

Results: This shows that equal proportion of delivery was conducted at home (45%) and public health facility (45.2%) in comparison with private health facility (9.8%). For the choice set of public versus home, women with higher number of living children, wealth quintile and living in urban areas were associated with greater odds of delivering at public health facility centres.

Conclusions: The initiative programs can be implemented by the government by sending trained professionals with supplements required by pregnant women at each and every district in order to promote maternal health and recruit more interdisciplinary team, which will be responsible for maintaining women and infant health, and thus providing appropriate medical advice.


World Health Organisation, Global Health Observatory (GHO) data; http://www.who.int/ gho/ maternal_health/ mortality/ maternal_mortality _text/en/.

Progress towards Millennium Development Goal 4 and 5, Building the future for women and children; 2012 report: http://www.who.int/ pmnch/topics/ part_publications/progress_towards_mdg.pdf.

Sustainable Development Goal Knowledge Platform; transforming our world: the 2030 agenda for sustainable development; https:// docs.google.com/ gview? url= http:// sustainabledevelopment.un.org/ content/ documents/ 21252030% 20Agenda% 20for% 20Sustainable% 20Development%20web.pdf&embedded=true.

Saxena D, Vangani R, Mavalankar DV, Thomsen S. Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data. Glob Health Action. 2013;6:1-9.

Tsegay Y, Gebrehiwot T, Goicolea I, Edin K, Lemma H, Sebastian MS. Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: a cross-sectional study. Int J Equity Health. 2013;12:30.

World Health Organization, Trends in maternal mortality: 1990 to 2010. http://www.who.int, 15 December (2012).

Sialubanje C, Massar K, Hamer DH, Ruiter RAC. Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study. BMC Pregnancy and Childbirth. 2015;15:216.

International Institute for Population Sciences. District Level Household and Facility Survey, 2012-13. Mumbai. Available at http://www.rchiips.org.

Ministry of Health and Family Welfare, Government of India- National Family Health Survey Report (2005-06). http://dhsprogram.com/ pubs/ pdf/ FRIND3/FRIND3-Vol1andVol2.pdf

Thind A, Mohani A, Banerjee K, Hagigi F. Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health. 2008;8:29.

Navaneetham K, Dharmalingam A. Utilization of maternal healthcare services in Southern India. SocSci Med. 2002;55(10):1849-69.

Basu AM, Stephenson R. Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. SocSci Med. 2005,60(9):2011-23.

Matthews Z, Ramakrishna J, Mahendra S, Kilaru A, Ganapathy S. Birth rights and rituals in rural south India: care seeking inthe intrapartum period. J BiosocSci. 2005;37(4):385-411.

Jayaraman A, Chandrasekhar S, Gebreselassie T. Factors affecting Maternal Health Care Seeking Behavior in Rwanda. USAID. 2008:59.

Kumar S. Challenges of maternal mortality reduction andopportunities under National Rural Health Mission – a criticalappraisal. Indian J Public Health. 2005;49(3):163-7.

Kumar S, Bhawani L. Women friendly health services-a definitestep to reduce maternal morbidity and mortality. IndianJ Public Health. 2005;49(2):45-7.




How to Cite

Singh, K. J., & Grover, K. (2016). Factors affecting maternal health care seeking behaviour in northeast states, India: evidence from district level household survey-4 (2012-2013). International Journal of Research in Medical Sciences, 4(11), 4949–4956. https://doi.org/10.18203/2320-6012.ijrms20163797



Original Research Articles