Factors influencing utilization of ASHA services under NRHM in relation to maternal health in rural Lucknow

BACKGROUND: Under National Rural Health Mission (NRHM), ASHA (accredited social health activist) has been identified as an effective link to address the poor utilization of maternal and child health (MCH) services by rural pregnant women. OBJECTIVE: To study the factors influencing utilization of ASHA services in relation to maternal health. STUDY DESIGN: Cross-sectional. SETTING: Primary Health Centre (PHC), Sarojininagar, Lucknow and its rural field area. STUDY PERIOD: September 2007 to August 2008. STUDY UNIT: RDW (recently delivered women) were considered as those who delivered a live newborn at PHC Sarojininagar, within a week of interview and belonged to villages within the confines of the PHC being served by ASHA. MATERIALS AND METHODS: 350 RDW were interviewed at their bedside, by a preformed and pretested schedule and then were followed-up after six weeks. RESULTS: Utilization of ASHA services for early registration was significantly associated with age and religion of RDW. Young, educated and socio-economic class III RDW utilized ASHA services the maximum for early registration. Utilization of ASHA services for adequate ANC or antenatal care (100 iron and folic acid tablets, 2 tetanus toxoid injection and ≥3 antenatal visits) was also inversely associated with age of RDW. Young, Hindu, scheduled caste, middle school pass, Class III RDW and those with birth order one had high odds for utilization of ASHA services for adequate ANC. With regard to postnatal check-up, again young RDW with birth order one, Hindu RDW in reference to Muslim and RDW in socio-economic class III had higher likelihood for utilization of ASHA services. Caste-wise scheduled caste (SC) and other backward caste (OBC) RDW had higher odds for utilization of ASHA services. Educated RDW and those with educated husband had higher odds for utilization of ASHA services for postnatal check-up. CONCLUSION: Young, educated RDW with low parity, educated husband and belonging to higher socio-economic class had higher odds of utilization of ASHA services.