Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India

Jeffrey R. Willis; Vishwajeet Kumar; Saroj Mohanty; Aarti Kumar; Jai V. Singh; Ramesh C. Ahuja; Rajendra P. Misra; Pramod Singh; Vivek Singh; Abdullah H. Baqui; Sharleen Sidhu; Mathuram Santosham; Gary L. Darmstadt

doi:10.1093/intqhc/mzr030

Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India

Jeffrey R. Willis, Vishwajeet Kumar, Saroj Mohanty, Aarti Kumar, Jai V. Singh, Ramesh C. Ahuja, Rajendra P. Misra, Pramod Singh, Vivek Singh, Abdullah H. Baqui, Sharleen Sidhu, Mathuram Santosham, Gary L. Darmstadt

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objective: To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India. Design: A prospective observational study. Setting: The study was located in Shivgarh, a rural block of Uttar Pradesh, India. Participants: One hundred and fifty-three households that utilized a healthcare provider for their sick neonates. Intervention(s): None. Main Outcome Measure: 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). Conclusion: 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.

Original language	English (US)
Article number	mzr030
Pages (from-to)	487-494
Number of pages	8
Journal	International Journal for Quality in Health Care
Volume	23
Issue number	4
DOIs	https://doi.org/10.1093/intqhc/mzr030
State	Published - Aug 2011

Keywords

Health expenditures
Health services
Newborn
Patient satisfaction
Quality of health care

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health

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10.1093/intqhc/mzr030

Cite this

Willis, J. R., Kumar, V., Mohanty, S., Kumar, A., Singh, J. V., Ahuja, R. C., Misra, R. P., Singh, P., Singh, V., Baqui, A. H., Sidhu, S., Santosham, M., & Darmstadt, G. L. (2011). Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India. International Journal for Quality in Health Care, 23(4), 487-494. Article mzr030. https://doi.org/10.1093/intqhc/mzr030

Willis, JR, Kumar, V, Mohanty, S, Kumar, A, Singh, JV, Ahuja, RC, Misra, RP, Singh, P, Singh, V, Baqui, AH, Sidhu, S, Santosham, M & Darmstadt, GL 2011, 'Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India', International Journal for Quality in Health Care, vol. 23, no. 4, mzr030, pp. 487-494. https://doi.org/10.1093/intqhc/mzr030

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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. Design: A prospective observational study. Setting: The study was located in Shivgarh, a rural block of Uttar Pradesh, India. Participants: One hundred and fifty-three households that utilized a healthcare provider for their sick neonates. Intervention(s): None. Main Outcome Measure: 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). Conclusion: 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.",

keywords = "Health expenditures, Health services, Newborn, Patient satisfaction, Quality of health care",

author = "Willis, {Jeffrey R.} and Vishwajeet Kumar and Saroj Mohanty and Aarti Kumar and Singh, {Jai V.} and Ahuja, {Ramesh C.} and Misra, {Rajendra P.} and Pramod Singh and Vivek Singh and Baqui, {Abdullah H.} and Sharleen Sidhu and Mathuram Santosham and Darmstadt, {Gary L.}",

note = "Funding Information: This work was supported by the United States Agency for International Development (USAID) Mission in India (Delhi) and the Office of Health, Infectious Diseases, and Nutrition, Global Bureau through the Global Research Activity Cooperative Agreement with the Johns Hopkins Bloomberg School of Public Health (No. GHS-A-00 – 03-00019-00); and the Saving Newborn Lives program of Save the Children-USA through a grant from the Bill & Melinda Gates Foundation. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID.",

year = "2011",

month = aug,

doi = "10.1093/intqhc/mzr030",

language = "English (US)",

volume = "23",

pages = "487--494",

journal = "International Journal for Quality in Health Care",

issn = "1353-4505",

publisher = "Oxford University Press",

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T1 - Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India

AU - Willis, Jeffrey R.

AU - Kumar, Vishwajeet

AU - Mohanty, Saroj

AU - Kumar, Aarti

AU - Singh, Jai V.

AU - Ahuja, Ramesh C.

AU - Misra, Rajendra P.

AU - Singh, Pramod

AU - Singh, Vivek

AU - Baqui, Abdullah H.

AU - Sidhu, Sharleen

AU - Santosham, Mathuram

AU - Darmstadt, Gary L.

N1 - Funding Information: This work was supported by the United States Agency for International Development (USAID) Mission in India (Delhi) and the Office of Health, Infectious Diseases, and Nutrition, Global Bureau through the Global Research Activity Cooperative Agreement with the Johns Hopkins Bloomberg School of Public Health (No. GHS-A-00 – 03-00019-00); and the Saving Newborn Lives program of Save the Children-USA through a grant from the Bill & Melinda Gates Foundation. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID.

PY - 2011/8

Y1 - 2011/8

N2 - Objective: To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India. Design: A prospective observational study. Setting: The study was located in Shivgarh, a rural block of Uttar Pradesh, India. Participants: One hundred and fifty-three households that utilized a healthcare provider for their sick neonates. Intervention(s): None. Main Outcome Measure: 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). Conclusion: 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.

AB - Objective: To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India. Design: A prospective observational study. Setting: The study was located in Shivgarh, a rural block of Uttar Pradesh, India. Participants: One hundred and fifty-three households that utilized a healthcare provider for their sick neonates. Intervention(s): None. Main Outcome Measure: 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). Conclusion: 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.

KW - Health expenditures

KW - Health services

KW - Newborn

KW - Patient satisfaction

KW - Quality of health care

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Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India

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