Menarche, Marriage, and Conception: Their Influence on Maternal Health Services Utilization in the Juang Tribe of Odisha

Background: Puberty is a natural biological process, yet it can have adverse effects, particularly on rural and tribal girls in India. Early menarche makes them vulnerable to adolescent marriage and early conception, leading to a cascade of negative social and health outcomes. Objectives: This study examines the influence of three key life-course events- age at menarche, marriage, and first conception, on maternal health service utilisation, specifically antenatal care (ANC) and institutional deliveries, among Juang tribal women in Odisha. Materials and Methods: A cross-sectional study was conducted among 158 Juang mothers aged 15-49 (youngest child under five) from eight villages in Banspal block, Keonjhar, Odisha. Data were collected using a pretested interview schedule. Descriptive statistics were used to evaluate socio-demographic, reproductive, and maternal health indicators. Results: The mean age at menarche among Juang women was 12.38 years. Early marriage (67.5%; mean: 16.35 ± 4.12 years) correlated with early conception (mean: 18.47 ± 2.35 years). ANC registration was high (95.6%), the highest rate reported in Odisha and eastern India. However, 50% of the participants reported home delivery, despite 98.1% of women receiving financial benefits. Despite willingness, 77% of participants denied using contraceptives. Caesarean births were rare (8.2%), and no cases of breastfeeding deprivation were reported. Child immunisation coverage was moderate (57.5%). Conclusion: Juang women show reproductive patterns aligning more with eastern India than with northern or southern regions. Despite high ANC uptake, gaps in institutional delivery and contraception persist. Culturally sensitive, community-based interventions are essential for improving maternal and child health outcomes.