{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T18:39:41Z","timestamp":1766428781704,"version":"3.37.3"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,8,22]],"date-time":"2014-08-22T00:00:00Z","timestamp":1408665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["5\/7\/236\/2007-RHN"],"award-info":[{"award-number":["5\/7\/236\/2007-RHN"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the quality of maternity care in an Indian metropolitan city.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Three\u2010stage cluster randomised cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sixty selected colonies of Delhi.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>One thousand eight hundred and one subjects (of 2286 eligible) were enrolled from 118\u00a0446 houses. Women who had delivered a live viable birth in the past 6\u00a0months were selected for the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In stage 1, 20 wards (of 150) were selected using a probability\u2010proportionate\u2010to\u2010size systematic method. In stage 2, one colony from each income stratum (high, middle and low) was selected from each ward by simple random sampling. In stage 3, a house\u2010to\u2010house survey was conducted to recruit 30 women for administering a peer\u2010reviewed and pilot\u2010trialled questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Caesarean section rate, induction rate and episiotomy rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>National health targets such as iron supplementation advice (&gt;96%), tetanus vaccination (&gt;81%), and \u22653 antenatal visits (&gt;90%) were largely achieved across health care facilities but not in home deliveries. Interventions were lower in public than private hospitals: caesarean section [23.7% (20.2\u201327.7) versus 53.8% (49.3\u201358.3)], induction [20.6% (17.5\u201324.25) versus 30.8% (26.8\u201333.2)] and episiotomy [57.8% (52.3\u201363.1) versus 79.4% (71.0\u201385.9)]. Private hospitals achieved better labour support rates [1.1% (0.5\u20132.2) versus 14.6% (8.5\u201324.1)] and pain relief [0.9% (0.4\u20132.0) versus 9.9 (6.5\u201314.8)]. Pubic hair shaving [16.2% (11.5\u201322.5) versus 36.4% (29.9\u201343.4)], enema [20.2% (15.5\u201326.0) versus 57.3% (49.5\u201364.8)], and <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> fluids during labour [44.0% (36.2\u201352.2) versus 38.7% (29.3\u201349.1)] were widely prevalent in public and private hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Present practices fall short of evidence\u2010based guidelines, with relative overuse of interventions in private hospitals and deficiency of patient\u2010centred practices such as labour support in public hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13054","type":"journal-article","created":{"date-parts":[[2014,8,22]],"date-time":"2014-08-22T08:45:29Z","timestamp":1408697129000},"page":"238-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Widespread non\u2010adherence to evidence\u2010based maternity care guidelines: a population\u2010based cluster randomised household survey"],"prefix":"10.1111","volume":"122","author":[{"given":"J","family":"Nagpal","sequence":"first","affiliation":[{"name":"Sitaram Bhartia Institute of Science and Research New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Sitaram Bhartia Institute of Science and Research New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Sengupta Dhar","sequence":"additional","affiliation":[{"name":"Sitaram Bhartia Institute of Science and Research New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VL","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Sitaram Bhartia Institute of Science and Research New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Bhartia","sequence":"additional","affiliation":[{"name":"Sitaram Bhartia Institute of Science and Research New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,8,22]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"HultonL MatthewsZ StonesRW.A Framework for the Evaluation of Quality of Care in Maternity Services.Southampton UK:University of Southampton 2000."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0783"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.1998.00085.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1054\/midw.2002.0306"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7254.137"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2007.03.011"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"vi","DOI":"10.1891\/1058-1243.12.1.vi","article-title":"Listening to Mothers \u2013 The First National U.S. Survey of Women's Childbearing Experiences","volume":"12","author":"Lothian JA","year":"2003","journal-title":"J Perinat Educ"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v6i0.19145"},{"key":"e_1_2_6_10_1","unstructured":"International Institute for Population Sciences.India National Family Health Survey (NFHS\u20103) 2005\u201006 (Vol. 1).2007. 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