AccScience Publishing / IJPS / Volume 2 / Issue 2 / DOI: 10.18063/IJPS.2016.02.001
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Utilization of maternal and child health care services in North and South India: does spousal violence matter?

Atreyee Sinha1* Aparajita Chattopadhyay2
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1 International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai- 400088, Maharashtra, India
2 Department of Development Studies, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai- 400088, Maharashtra, India
IJPS 2016, 2(2), 107–122;
© Invalid date by the Authors. Licensee AccScience Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( )

Spousal violence emerged as a major public health concern over the past few decades as its consequences on the health of victims are profound. Infliction of violence during pregnancy is even more detrimental as it might cause serious injuries to women and their unborn children. Violence during pregnancy can restrict access to proper health care and affect the health of mother and child. However, the role of spousal violence on utilization of pregnancy care services is not well explored in India where both fertility and spousal violence are high. In the present study, we used data of selected North and South Indian states from the National Family Health Survey (2005–2006) to examine the relationship between experience of spousal violence by young married women and utilization of maternal and child health care services. A marked regional variation was observed in MCH care utilization and levels of violence, where the South Indian states performed better than the North. Spousal violence was a significant factor determining MCH care use. Women who had experienced any form of physical/sexual violence were less likely to receive full ante natal care than non-abused women and the association was stronger in the South. Women experiencing any physical/sexual violence were also less likely to avail institutional delivery in the North. Emotional violence had similar constraining effects on MCH care use in the South. Integration of violence screening and counselling with MCH programs could be helpful to address the needs of abused pregnant women and provide essential care.

Spousal violence
Maternal and child health care services
Ante Natal Care
Institutional delivery

Allendorf K. (2010). The quality of family relationships and use of maternal health-care services in India, Studies in Family Planning, 41 (4): 263-276.


Bauer H, Rodriguez M, Quiroga S and Flores-Ortiz Y. (2000). Barriers to Health Care for Abused Latina and Asian Immigrant Women. Journal of Health Care for the Poor and Underserved, 11 (1): 33-44.


Bloom SS, Wypij D and Dasgupta M. (2001). Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian City. Demography, 38 (1): 67–78.


Campbell J C. (2002). Health consequences of intimate partner violence. The Lancet, 359 (9314): 1331–1336.


Campbell J C, Webster D, Koziol-Mclain J, et al. (2003). Risk factors for femicide in abusive relationship: Results from a multisite case control study. American Journal of Public Health, 93 (7): 1089-1097.


Celik Y and Hotchkiss D R. (2000). The socioeconomic determinants of maternal health-care utilization in Turkey. Social Science & Medicine, 50 (12): 1797–1806.


Chandrasekaran V, Krupp K, George R, et al. (2007) “Determinants of domestic violence among women attending a human immunodeficiency virus voluntary counselling and testing center in Bangalore, India.” Indian Journal of Medical Sciences, 61 (5): 253-262.


Chattopadhyay A. (2011). Men in maternal care: evidence from India. Journal of Biosocial Science, 44 (2): 129-153.


Dyson T and Moore M. (1983). On kinship structure, female autonomy, and demographic behaviour in India. Population and Development Review, 9 (1): 35–60.


Ellsberg M, Jansen H A, Heise L, et al. (2008). Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: An observational study. The Lancet, 371: 1165–1172.


Fawole A O, Shah A, Fabanwo A O, et al. (2012). Predictors of maternal mortality in institutional deliveries in Nigeria. African Health Science, 12 (1): 32-40.


Furuta M and Salway S. (2006). Women's position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspective, 32 (1): 17-27.


Heise L, Ellsberg M and Gottmoeller M. (2002). A global overview of gender-based violence. International Journal of Gynecology and Obstetrics, 78 (Suppl. 1): S5–S14.


Higgins C F. (2011). Self-esteem and battered women: Do violence shelters help? Thesis, Ohio State University. Retrieved on March 9, 2016 from


Hossain I and Hoque M H. (2005). Determinants of choices of delivery care in some urban slums of Shaka city. Pakistan Journal of Social Sciences, 3 (3): 469-475.


Hughes J. (2004). “Gender, Equity, and Indigenous Women’s Health in the Americas” prepared for Gender and Health Unit and Pan-American Health Organization, Washington DC.


Ibeh C C. (2008). Is poor maternal mortality index in Nigeria a problem of care utilization? A case study of Anambra State. African Journal of Reproductive Health, 12 (2): 132-140.


International Institute for Population Sciences (IIPS) and Macro International. (2007). National Family Health Survey (NFHS-3), India, 2005-06, Vol. 1, Mumbai: IIPS.


Jejeebhoy S J. (2000). “Women’s autonomy in rural India: Its dimensions, determinants, and the influence of context,” in Harriet B. Presser and Gita Sen (eds.), Women’s Empowerment and Demographic Processes: Moving Beyond Cairo, New York: Oxford University Press.


Jejeebhoy S J. and Sathar Z A. (2001). Women’s Autonomy in India and Pakistan: The Influence of Religion and Region. Population and Development Review, 27 (4): 687–671.


Jejeebhoy S J. (2002). Convergence and Divergence in Spouses’ Perspectives on Women’s Autonomy in Rural India. Studies in Family Planning, 33 (4): 299-308.


Jewkes R. (2002). Intimate partner violence: Causes and Prevention. The Lancet, 359 (9315): 1423-1429.


Karve I. (1965). Kinship Organization in India, Bombay: Asia Publishing House.


Koenig M A, Stephenson R, Ahmed S, et al. (2006). Individual and contextual determinants of domestic violence in North India. American Journal of Public Health, 96: 132–138.


Koski A D, Stephenson R and Koenig M R. (2011). Physical violence by partner during pregnancy and use of prenatal care in rural India. Journal of Health, Population and Nutrition, 29 (3): 245-254.


Krug E G, Dalhberg L L, Mercy J A, et al. (2002). World report on violence and health. Geneva: World Health Organization.


McCloskey L A, Williams C M, Lichter E, et al. (2007). Abused women disclose partner interference with health care: An unrecognized form of battering. Journal of General Internal Medicine, 22: 1067–1072.


Mohanty S K and Pathak P K. (2009). Rich–poor gap in utilization of reproductive and child health services in India, 1992–2005. Journal of Biosocial Science, 41 (3): 381–398.


Monemi K A, Pena R, Ellsberg M C, et al. (2003). Violence against women increases the risk of infant death and child mortality: a case – referent study in Nicaragua. Bulletin of the World Health Organization, 81 (1): 10-17.


Navaneetham K and Dharmalingam A. (2002). Utilization of maternal health-care services in southern India. Social Science & Medicine, 55 (10): 1849–1869.


Nigussie M, Mariam D H and Mitike G. (2004). Assessment of safe delivery service utilization among women of childbearing age in North Gondar Zone, North West Ethiopia. Ethiopian Journal of Health Development, 18 (3): 1-8.


Olufunmilayo I F and Adeoye I A. (2015). Women’s status within the household as a determinant of maternal health care use in Nigeria. African Health Sciences, 15 (1): 217-225.


Ononokpono D N and Azfredrick E C. (2014). Intimate Partner Violence and the Utilization of Maternal Health Care Services in Nigeria. Health Care for Women International, 35 (7-9): 973-989.


Parish W L, Wang T, Lauman E O, et al. (2004). Intimate partner violence in China: National prevalence, risk factors and associated health problems. International Family Planning Perspectives, 30 (4): 174-181.


Rahman M, Nakamura K, Seino K and Kizuki M. (2012). Intimate partner violence and use of reproductive health services among married women: Evidence from a national Bangladeshi sample. BMC Public Health, 12 (913): 1-12 doi:10.1186/1471-2458-12-913.


Raj A, Saggurti N, Balaiah D, et al. (2009). Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross sectional, observational study. The Lancet, 373(9678): 1883–1889.


Ram F and Singh A. (2006). Is antenatal care effective in improving maternal health in rural Uttar Pradesh: Evidence from a district level household survey? Journal of Biosocial Science, 38 (4): 433–448.


Santhya K G, Jejeebhoy S J and Ghosh S. (2008). Early Marriage and Sexual and Reproductive Health Risks: Experiences of Young Women and Men in Andhra Pradesh and Madhya Pradesh, India, Population Council, New Delhi.


Silverman J G, Decker M R, Gupta J, et al. (2009). Maternal experiences of intimate partner violence and child morbidity in Bangladesh: Evidence from a national Bangladeshi sample. Archives of Pediatrics and Adolescent Medicine, 163: 700–705.


Singh A, Mahapatra B and Dutta S. (2008). Spousal abuse and infant and child mortality in India. Asia-Pacific Population Journal, 23 (2): 33-54.


Singh L, Rai R K and Singh P K. (2012). Assessing the utilization of maternal and child health care among married adolescent women: Evidence from India. Journal of Biosocial Science, 44: 1-26.


Stephenson R, Koenig M A and Ahmed S. (2006). Domestic violence and symptoms of gynaecologic morbidity among women in North India. International Family Planning Perspective, 32: 201–208.


United Nation’s Children’s Fund (UNICEF). (2008). The state of the world’s children: Maternal and newborn health, viewed on 9 March, 2016,


Visaria L. (2000). Violence against women: A field study. Economic and Political Weekly, 35 (20): 1742-1751.


Visaria L. (2008). Violence against women in India: Is empowerment a protective factor? Economic and Political Weekly, 43 (48): 60-66.


World Bank. (2012). World development report: Gender equity and development, World Bank, Washington, DC.


World Health Organization. (2001). Putting women first: Ethical and safety recommendations for research on domestic violence against women. Department of Gender and Women’s Health, Family and Community Health, WHO, Geneva, Switzerland.


World Health Organization. (2006). Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Standards for Maternal and Neonatal care (1.6), Department of Making Pregnancy Safer, Geneva, Switzerland. pregnancy_safer/publications/Standards1.6N.pdf.


World Health Organization. (2012). Intimate partner violence: Understanding and addressing violence against women, viewed 16 November 2015, <>


World Health organization. (2014). Maternal Mortality, Fact Sheet, viewed on 9 March, 2016,

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International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing