Underutilization of Maternal Healthcare Services amongst Tribal Women in Maharashtra: A Study of Two Blocks in Nandurbar

Abstract

Nandurbar is the only district in Maharashtra which has the highest outlier tribal population and the maternal mortality ratio amongst this community has been higher as compared to the average state. Maximum number of women belonging to the tribal blocks of Dhadgaon and Akkalkuwa receive inadequate maternal healthcare services, even though these services are available to them either free of cost or at a subsidized rate. This study tries to unearth the specific problems, to examine the individual responses and the reasons which result in underutilization of these services. Twenty women from Dhadgaon and Akkalkuwa, that is ten from each were interviewed regarding the pattern in which they utilize maternal healthcare services, to understand the individual barriers towards the application of these services. Apart from this, other respective stakeholders were also interviewed to understand the supply side barriers which results in improper utilization of these services. Conclusion of this study is inclusive of the observational analysis at the Anganwadi centres, Primary Healthcare Centre and the Government Hospital.

There were various barriers which resulted in underutilization of maternal healthcare services however, the most relevant being a) Remoteness, cultural practices and belief in local leading to a situation wherein there is a reluctance in using modern healthcare practices b) Lack of awareness amongst the women themselves regarding the rights that they are entitled to c) lack of adequate infrastructure and improper behaviour of healthcare workers to provide maternal healthcare services. There is no individual barrier which results in underutilization of maternal healthcare services. They are always embedded within each other. Thus, it is crucial to address all these barriers with their own specific interventions. This can only happen when these interventions are innovative to cater to the specific needs of the population and are implemented at grass-root level to ensure that the benefits of the services are accrued by the women. Lastly, there is a need for the rights of these tribal women to be guaranteed and respected in an efficient manner by providing these relevant services in a well-organized manner.