Status of maternal care and immunisation services in a hilly state of north India: a cross sectional study

Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death. The objective of this study was to assess the utilisation of maternal health care services and coverage of maternal Tetanus immunisation in six districts of Himachal Pradesh, India.Methods: A cross-sectional study was conducted using the WHO cluster sampling method during the period October 2015 to January 2016 among children of 0-11 month age covering 1,260 children in total.Results: A total of 21,097 households were surveyed in 180 clusters. Card availability was 81.1% and 95.9% recalled receiving the antenatal card and tetanus immunisation during their respective pregnancies. Out of the total of 1,260 infants surveyed, 1,255 (99.6%) were found to be fully protected against neonatal tetanus and only 5 (0.39%) were found not to be fully protected. 1,241 (98.5%) of the mothers had undergone full Antenatal check-ups (ANC) during their pregnancy. 210 (100%) had at least one ANC. All had undergone the ANC at the nearest government health facility. 1055 (83.7%) deliveries were institutional deliveries and 201 (16%) were home deliveries. Overall, deliveries conducted by skilled personnel stood at 91.3%.Conclusions: Overall, the utilisation of maternal health services and immunisation against maternal and neonatal Tetanus are excellent in the state. The coverage targets for key RMNCH and A, an interventions have been well achieved in the state. Further, sustained efforts with Supportive Supervision are required to achieve 100% universal coverage of immunisation and full utilisation of maternal health care services