Advice given to pregnant women during antenatal sessions in India varies heavily depending on their socio–economic status.

This means that richer the pregnant woman the better advice she is likely to get from public health worker even at free health care facilities.

Richer women in India were 1.41 and 1.52 times more likely to receive advice on institution delivery and nutrition as compared to poor women. A study ‘Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India’ published in PloS One, an online journal of peer–reviewed scientific research, last month made this observation.

The study has been authored by Dr Abhishek Singh, assistant professor at department of public health and mortality studies at Mumbai’s International Institute for Population Sciences (IIPS) along with director (IIPS) Dr Ram Faujdar, Saseendran Pallikadavath and Rueben Ogollah from Global Health and Social Care Unit, School of Health Sciences and Social Work, University of Portsmouth, United Kingdom.

Researchers used data from the ‘District Level Household Survey’ round three conducted in 2007-08 in 601 districts from 34 states and union territories across the country.

The data was analysed to see if women were given adequate information on seven components i.e. breastfeeding, keeping the baby warm, spacing methods of family planning, limiting methods of family planning, nutrition, institutional delivery, and visiting a health facility in case of pregnancy complications .

The results showed women going to higher level community health centres, rural hospitals, first referral units and hospitals received better advice than women attending lower level health facility (health sub–centres or primary health centres). For example, 75% and 65% women received information on breastfeeding and keeping baby warm respectively in higher health facility centres as compared to 70% and 59% women in lower level centres.

The researchers have raised an alarm for policy makers stating need for training and sensitisation of public health workers to deliver appropriate and recommended care to clients irrespective of socio–economic status. The study concludes that if immediate attention is not given to these findings, it would fail to deliver required services to those who need it the most even if health infrastructure improves.