Perceptions of quality of care during birth at private Chiranjeevi facilities in Gujarat: lessons for Universal Health Coverage

Iyer, Veena, Mavalankar, Dileep, Tolhurst, Rachel ORCID: https://orcid.org/0000-0002-3005-6641 and De Costa, Ayesha (2020) 'Perceptions of quality of care during birth at private Chiranjeevi facilities in Gujarat: lessons for Universal Health Coverage'. Sexual and Reproductive Health Matters, Vol 28, Issue 2, p. 1850199.

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Abstract

Abstract: The Indian national health policy encourages partnerships with private providers as a means to achieve universal health coverage. One of these was the Chiranjeevi Yojana (CY), a partnership since 2006 with private obstetricians to increase access to institutional births in the state of Gujarat. More than a
million births have occurred under this programme. We studied women’s perceptions of quality of care in the private CY facilities, conducting 30 narrative interviews between June 2012 and April 2013 with mothers who had birthed in 10 CY facilities within the last month. The commonly agreed upon characteristics of a “good (sari) delivery” were: giving birth vaginally, to a male child, with the shortest period of pain, and preferably free of charge. But all this mattered only after the primary outcome of being “saved” was satisfied. Women ensured this by choosing a competent provider, a “good doctor”. They wanted a quick delivery by manipulating “heat” (intensifying contractions) through oxytocics. There were instances of inadequate clinical care for serious morbidities although the few women who experienced poor quality of care still expressed satisfaction with their overall care. Mothers’ experiences during birth are more accurate indicators of the quality of care received by them, than the satisfaction they report at discharge. Improving health
literacy of communities regarding the common causes of severe maternal morbidity and mortality must be addressed urgently. It is essential that cashless CY services be ensured to achieve the goal of 100% institutional births.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84.4 Quality of Health Care W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WQ Obstetrics > Labor > WQ 300 General works
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1080/26410397.2020.1850199
Depositing User:	Rachel Dominguez
Date Deposited:	06 Jan 2021 16:59
Last Modified:	06 Jan 2021 16:59
URI:	https://archive.lstmed.ac.uk/id/eprint/16591

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