title: Differentials in the quality of antenatal care in India.
abstract: OBJECTIVE
  To investigate the socio-economic differentials in the quality (clinical and interpersonal) of antenatal care and also the correlation between differentials in the quality and utilization of antenatal care.
  
  
  METHODS
  The study uses cross-sectional, nationally representative data from National Family Health Survey (1998-99).
  
  
  METHODS
  Four south Indian states (Andhra Pradesh, Karnataka, Kerala and Tamil Nadu) and four north Indian states (Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh).
  
  
  METHODS
  More than four antenatal care visits for utilization, and index of clinical, information and interpersonal quality of care.
  
  
  RESULTS
  Lower than desired quality of antenatal care was observed in both north and south Indian states, though the quality was significantly better in south India compared with north India, especially among the disadvantaged women. Significant socio-economic differentials in the quality of care were evident in both north and south India, but were more glaring in north India. A significantly positive relationship was observed between the quality and utilization of antenatal care in the rural areas from village-level multivariate analysis.
  
  
  CONCLUSIONS
  Poor quality of antenatal care is likely to reduce its utilization. Policy and program interventions to improve the quality of care of antenatal care, especially for the poor and other disadvantaged population groups, more so in north India, are essential to improve maternal health outcomes. The India's National Rural Health Mission (NRHM), launched in 2005, should lay greater emphasis on improving the quality of antenatal care, among other things, to increase utilization of antenatal care and achieve better maternal health outcomes.
authors.affiliation: Western Pacific Regional Office, World Health Organization, Manila, Philippines. manju_rani@yahoo.com
authors.forename: Manju
authors.initials: M
authors.lastname: Rani
authors.forename: Sekhar
authors.initials: S
authors.lastname: Bonu
authors.forename: Steve
authors.initials: S
authors.lastname: Harvey
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007194:India; D008875:Middle Aged; D011295:Prenatal Care / Q000592:standards*; D011787:Quality of Health Care; D012923:Social Class