How far is universal coverage of antenatal care (ANC) in India? An evaluation of coverage and expenditure from a national survey

IntroductionIndia along with Nigeria is estimated to account for over 1/3rd of all maternal deaths worldwide in the year 2015. However, among all the maternal deaths, most of the deaths can be prevented. But for that all women need access to antenatal care (ANC) during pregnancy.ObjectiveThe present study aims to highlight the current status of ANC coverage in India. Further this study examines the extent of expenditure incurred for seeking ANC.Materials and methodsData for the analyses are drawn from the 71st round of the National Sample Survey Office conducted between January to June 2014. Bivariate and logistic regression analyses have been used to fulfil the objectives of this paper.ResultsDespite having a vast public health infrastructure and several safe motherhood programmes, overall 9.2% pregnant women did not consume IFA supplements, 6.6% did not receive TT dose and 10.3% pregnant women could not receive any ANC during pregnancy in India. Among the states, Uttar Pradesh accounted for a large number (16.7%) of pregnant women who neither did consume IFA tablets nor received any ANC (22.4%) during pregnancy. However, a woman had to spend a large amount of money to seek ANC from both public and private health care facilities.ConclusionAfter a tremendous emphasis given to delivery of free ANC services throughout the country, India is still very far from achieving universal coverage of ANC.