title: Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India.
abstract: OBJECTIVE
  To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India.
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  The study was located in Shivgarh, a rural block of Uttar Pradesh, India.
  
  
  METHODS
  One hundred and fifty-three households that utilized a healthcare provider for their sick neonates.
  
  
  METHODS
  None.
  
  
  METHODS
  Perceived neonatal health improvement after utilization of neonatal health services; satisfaction with aspects of neonatal health services: 'overall care', 'interaction with provider', 'waiting time' and 'explanations of immediate care and follow-up care'.
  
  
  RESULTS
  Unqualified allopathically oriented providers (UAOPs) were utilized by 110 households (71.8%), while qualified allopathically oriented providers (QAOPs) by 43 households (28.2%). The odds of perceived neonatal health improvement were significantly higher among households utilizing UAOPs (n = 88/110, 80.0%) than those using QAOPs (n = 23/43, 53.5%) [adjusted odds ratio (OR): 3.3, 95% confidence interval (CI): 1.5-7.5]. The median healthcare fee charged was higher for UAOPs (Rs. 25) than those for QAOPs (Rs. 1). Household satisfaction with 'overall care' of neonatal health service was significantly higher among households that utilized UAOPs compared with those that used QAOPs (OR: 2.4, 95% CI: 1.2-5.0).
  
  
  CONCLUSIONS
  Households that utilized UAOPs reported better perceived neonatal health outcomes and higher satisfaction levels than those that used QAOPs, despite higher costs for the former. Future research should assess what dimensions of neonatal care are important to households and identify incentive structures that promote healthcare providers to deliver better perceived care in high-mortality settings such as rural Uttar Pradesh, India.
authors.affiliation: International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Willis
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Kumar
authors.forename: Saroj
authors.initials: S
authors.lastname: Mohanty
authors.forename: Aarti
authors.initials: A
authors.lastname: Kumar
authors.forename: Jai V
authors.initials: JV
authors.lastname: Singh
authors.forename: Ramesh C
authors.initials: RC
authors.lastname: Ahuja
authors.forename: Rajendra P
authors.initials: RP
authors.lastname: Misra
authors.forename: Pramod
authors.initials: P
authors.lastname: Singh
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.forename: Sharleen
authors.initials: S
authors.lastname: Sidhu
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D007194:India; D007224:Infant Care / Q000191:economics / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011787:Quality of Health Care; D012424:Rural Population; D055815:Young Adult