Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India

Jeffrey R. Willis, Vishwajeet Kumar, Saroj Mohanty, Aarti Kumar, Jai V. Singh, Ramesh C. Ahuja, Rajendra P. Misra, Pramod Singh, Vivek Singh, Abdullah H. Baqui, Sharleen Sidhu, Mathuram Santosham, Gary L. Darmstadt

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India. Design: A prospective observational study. Setting: The study was located in Shivgarh, a rural block of Uttar Pradesh, India. Participants: One hundred and fifty-three households that utilized a healthcare provider for their sick neonates. Intervention(s): None. Main Outcome Measure: Perceived neonatal health improvement after utilization of neonatal health services; satisfaction with aspects of neonatal health services: 'overall care', 'interaction with provider', 'waiting time' and 'explanations of immediate care and follow-up care'. Results: Unqualified allopathically oriented providers (UAOPs) were utilized by 110 households (71.8%), while qualified allopathically oriented providers (QAOPs) by 43 households (28.2%). The odds of perceived neonatal health improvement were significantly higher among households utilizing UAOPs (n = 88/110, 80.0%) than those using QAOPs (n = 23/43, 53.5%) [adjusted odds ratio (OR): 3.3, 95% confidence interval (CI): 1.5-7.5]. The median healthcare fee charged was higher for UAOPs (Rs. 25) than those for QAOPs (Rs. 1). Household satisfaction with 'overall care' of neonatal health service was significantly higher among households that utilized UAOPs compared with those that used QAOPs (OR: 2.4, 95% CI: 1.2-5.0). Conclusion: Households that utilized UAOPs reported better perceived neonatal health outcomes and higher satisfaction levels than those that used QAOPs, despite higher costs for the former. Future research should assess what dimensions of neonatal care are important to households and identify incentive structures that promote healthcare providers to deliver better perceived care in high-mortality settings such as rural Uttar Pradesh, India.

Original languageEnglish (US)
Article numbermzr030
Pages (from-to)487-494
Number of pages8
JournalInternational Journal for Quality in Health Care
Volume23
Issue number4
DOIs
StatePublished - Aug 2011

Keywords

  • Health expenditures
  • Health services
  • Newborn
  • Patient satisfaction
  • Quality of health care

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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