A multilevel analysis of factors affecting maternal care utilization among adolescent mothers in Urban India, 2007-08

The proportion of adolescent deaths (9%) due to pregnancy or during child birth to total maternal mortality is very high in India. Although some studies on local scale are available, no study as yet has explored the factors affecting maternal health care utilization in adolescent mothers at national level. Using the data from third wave of District Level Household Survey (2007 -08), this paper examines the factors associated with the utilization of maternal healthcare services among adolescent women (aged 13 -19 years) in urban India. Bi-variate analyses including chi -square test was used to determine the difference in proportion, and multilevel binary logistic regression models were applied to understand the net effect of predictor variables on selected outcomes. About 23% of all adolescent mothers in India availed full ANC; 70% had a safe delivery and 64% had postnatal care in 2007 -08.After controlling for a number of factors, we find that the women, who are rich, older, highly educated, exposed to mass media , were more likely to utilize prenatal and natal care. These groups may be small portion of population but contribute significantly to maternal and child mortality, therefore, it is imperative to focus on such vulnerable groups in the policy.