Maternal Health-Care in India: The Case of Tetanus Toxoid Vaccination

Prenatal-care is one of the important elements of maternal health-care. In this paper an attempt has been made to examine the socioeconomic determinants of Tetanus Toxoid (TT) vaccination as a component of prenatal-care by the women in the age group of 15-49 years. Micro-data having 25847 observations from Indian Demographic and Health Survey (IDHS) has been used. To estimate the probability of TT vaccination binary logistic regression has been utilized. The explanatory variables categorized into socio-demographic characteristics of the woman, household characteristics, health-related characteristics, community characteristics and regional characteristics have been included in the analysis. The results explained that probability to have TT vaccination increases by woman’ education, woman’ age at marriage, husband’s age, husband’s education, husband’s living within household, husband’s presence at prenatal visit and household wealth. The woman’s living in small city, town and country side as well as final say on woman’s health-care by woman and husband collectively, and husband alone decrease the probability of TT vaccination. The study proposed targeted approach to enhance the TT vaccination in Indian women. The marginalized households should be targeted through cash transfer programs. Furthermore, the small cities and country sides should also be focused. The awareness and education of woman along with husband’s participation in maternal health-care cannot be ignored in policy making.

[1]  R. Ogollah,et al.  Maternal Tetanus Toxoid Vaccination and Neonatal Mortality in Rural North India , 2012, PloS one.

[2]  K. Putman,et al.  Predisposing, Enabling and Pregnancy-Related Determinants of Late Initiation of Prenatal Care , 2011, Maternal and Child Health Journal.

[3]  Prabhat Jha,et al.  Causes of neonatal and child mortality in India: a nationally representative mortality survey , 2010, The Lancet.

[4]  C. Sudfeld,et al.  Causes of Child Deaths in India, 1985–2008: A Systematic Review of Literature , 2010, Indian journal of pediatrics.

[5]  K. Putman,et al.  Determinants of the number of antenatal visits in a metropolitan region , 2010, BMC public health.

[6]  N. Habibov.  On the socio-economic determinants of antenatal care utilization in Azerbaijan: evidence and policy implications for reforms , 2010, Health Economics, Policy and Law.

[7]  S. Cousens,et al.  Tetanus toxoid immunization to reduce mortality from neonatal tetanus , 2010, International journal of epidemiology.

[8]  Christine Y. Lu,et al.  The views of stakeholders on controlled access schemes for high-cost antirheumatic biological medicines in Australia , 2007, Australia and New Zealand health policy.

[9]  S. Hasnain,et al.  Causes of low tetanus toxoid vaccination coverage in pregnant women in Lahore district, Pakistan. , 2007, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[10]  F. Rodríguez‐Artalejo,et al.  Gender differences in the utilization of health-care services among the older adult population of Spain , 2006, BMC public health.

[11]  C. Jinks,et al.  A prospective study of the consulting behaviour of older people with knee pain. , 2006, The British journal of general practice : the journal of the Royal College of General Practitioners.

[12]  A. Thind.  Determinants of tetanus toxoid immunization in pregnancy in rural Bihar , 2005, Tropical doctor.

[13]  Z. Baykan,et al.  Tetanus immunization in pregnant women: evaluation of maternal tetanus vaccination status and factors affecting rate of vaccination coverage. , 2001, Public health.

[14]  K. Nakae,et al.  Factors associated with TT (tetanus toxoid) immunization among pregnant women, in Saparua, Maluku, Indonesia. , 2000, The Southeast Asian journal of tropical medicine and public health.

[15]  P. Keyl,et al.  Effectiveness of prenatal tetanus toxoid immunization against neonatal tetanus in a rural area in India. , 1998, The Pediatric infectious disease journal.

[16]  R. Gilman,et al.  Rates of tetanus protection and transplacental tetanus antibody transfer in pregnant women from different socioeconomic groups in Peru , 1996, Clinical and diagnostic laboratory immunology.

[17]  M. Koenig.  Mortality reductions from measles and tetanus immunization: a review of the evidence , 1992 .

[18]  R. Andersen,et al.  Societal and individual determinants of medical care utilization in the United States. , 1973, The Milbank Memorial Fund quarterly. Health and society.

[19]  M. Grossman.  On the Concept of Health Capital and the Demand for Health , 1972, Journal of Political Economy.

[20]  M. Dibley,et al.  Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007 , 2010, BMC public health.

[21]  F. Gasse,et al.  Progress towards the global elimination of neonatal tetanus. , 1992, World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales.

[22]  J. Stanfield,et al.  Neonatal tetanus in the world today. , 1984, Bulletin of the World Health Organization.

[23]  M. Rahman,et al.  Use of tetanus toxoid for the prevention of neonatal tetanus. 1. Reduction of neonatal mortality by immunization of non-pregnant and pregnant women in rural Bangladesh. , 1982, Bulletin of the World Health Organization.

[24]  R. Black,et al.  Reduction of neonatal tetanus by mass immunization of non-pregnant women: duration of protection provided by one or two doses of aluminium-adsorbed tetanus toxoid. , 1980, Bulletin of the World Health Organization.