RESEARCH ARTICLE

Prenatal Healthcare among the Muria Tribe of Chhattisgarh

Priya Rani Neti, Shailendra Kumar*

School of Studies in Anthropology, Pt. Ravishankar Shukla University, Raipur (C.G.) India.

Authors Email- prani010596@gmail.com; shailverma48@gmail.com

*Corresponding Author Email- shailverma48@gmail.com

Introduction

Prenatal healthcare is the medical care provided to pregnant women by skilled healthcare professionals during pregnancy, with the aim of ensuring optimal health for both the mother and the baby. It includes regular health check-ups, vaccinations, nutritional advice, and monitoring of the health of both the mother and the baby. Pregnancy is a highly sensitive phase that requires special care for the expectant mother. Proper care can help reduce maternal and infant mortality rates, as a healthy mother is essential for giving birth to a healthy baby. Through prenatal check-ups, conditions such as anemia, diabetes, and high blood pressure, as well as issues regarding fetal growth and other health concerns, can be detected in a timely manner (Mumbare & Rege, 2011).

Three of the eight Millennium Development Goals are specifically related to health. WHO recommends a minimum of 8 contacts (visits) during a routine pregnancy to reduce perinatal mortality and detect complications early. (This replaced the older minimum standard of 4 visits). Their primary objective is to reduce child mortality, improve maternal health, and combat various serious diseases. Maternal health plays a crucial role in the overall development of any country, as a healthy mother is the cornerstone of a healthy society and a healthy future. There are numerous factors that influence maternal health, with social, cultural, and economic status, the availability of health services, and access to and utilization of health facilities being key among them. Additionally, education levels, awareness, and family support also impact maternal health (Mehta, Chakravarty & Venugopal, 2018). High-quality prenatal healthcare services are considered the most effective means of reducing maternal morbidity and mortality. The government is implementing various national health programs aimed at improving maternal health and reducing mortality rates. Despite this, the situation regarding maternal and infant mortality and morbidity remains a cause for concern (Mumbare & Rege, 2011). Several social and economic factors are responsible for this problem, such as early marriage, malnutrition, illiteracy, lack of awareness, absence of health services, and a lack of transport facilities (Koen, Lemson, Sampathkumar & Abel, 1992); (Okafor, 2000); (Bamji, Murthy, Williams, Vishnu & Rao, 2008); (Govindasamy & Ramesh, 1997). Additionally, a major reason is that many women—particularly adolescent girls and those from tribal areas—do not adequately utilize maternal health services or hesitate to avail themselves of them. Consequently, the full benefits of health services fail to reach the target communities, and maternal health issues persist (Nayak & Babu 2001). Various studies have clarified that the utilization of maternal health services depends largely on the socio-economic conditions of a community. In areas where health facilities are accessible and awareness levels are high, maternal health services are utilized more effectively (Chandraker, Chakrabarty, Mitra & Bharti 2009; Basu, 1993; Negi, Sekhar & Ganguly, 2010; Verma, Yadlapalli & Babu, 2011; Susuman, 2012; Mutreja & Kumar, 2015).

Muria Tribe: The Muria tribe is one of the prominent tribes of Chhattisgarh state and is considered a significant sub-tribe of the Gond tribe. Members of the Muria community prefer to call themselves "Koytor." They exhibit Proto-Australoid racial characteristics and speak the Gondi dialect, which belongs to the Dravidian language family. The primary habitat of this tribe comprises the Bastar, Narayanpur, and Kondagaon districts, where their population is concentrated in large numbers (Abidi, 2020). Among the Muria tribe, childbirth is considered an act of God's will. Traditionally, delivery takes place at home, assisted by a traditional midwife (*Suin Dai* = *Suin* or *Dai*: The terms *Suin* or *Dai* refer to a local woman considered an expert in childbirth-related matters. Typically, a *Dai* or *Suin* is an older woman whose guidance is sought for the care of both the mother and the child, spanning the period from the onset of labor to the time after the baby is born) and elderly women of the family (Vaishnav, 2017).

Objectives of the study

The objectives of the present research paper are as follows:

1. To determine the utilization rate of antenatal care (ANC) services.

2. To identify the problems faced by women during pregnancy.

Research Method and Technique

The present research study employs a descriptive research design. Primary data were collected using non-participant observation¹ and interview schedules. A total of 210 Muria women of reproductive age (15 to 49 years) were selected as respondents—using the purposive sampling method²—from Muria-dominated villages across the Bijapur, Bhairamgarh, and Usur development blocks of Bijapur district. Internet websites, published books/dissertations, and published research papers have been used for the collection of secondary data.

Results

Table 1 presents the general profile of the respondents; the majority (39%) belonged to the 20–25 age group, while the smallest proportion (1%) fell into the category of those over 40 years of age. An analysis based on education revealed that the majority of respondents were uneducated, whereas 14.8% and 10% had studied up to the primary and secondary levels, respectively, and only 2.3% had attained education up to the higher secondary level. This situation indicates that access to higher education for women in the study area remains limited. Regarding family type, the majority of the respondents lived in joint families, while the rest lived in nuclear families. This demonstrates that the traditional family structure still prevails in the study area and that women are more likely to receive support from their families during pregnancy. In terms of occupation, agriculture is the primary occupation for the majority (97.2%) of the respondents—with some women also engaged in agricultural wage labor—while the remaining respondents are employed in private or government jobs. Fieldwork observations revealed that Muria women continue to perform agricultural tasks alongside household chores even during pregnancy; they walk long distances to local markets to procure daily necessities and carry heavy loads of firewood from the forest on their heads—demonstrating that they effectively fulfill their share of responsibilities even while pregnant. Table 2 illustrates the utilization of antenatal services by Muria women; the study found that 97.1 percent of the women availed themselves of antenatal care (ANC) services, while the remaining 2.9 percent did not undergo antenatal check-ups. These results indicate that the majority of pregnant women in the study area are aware of antenatal health services and are connected to health institutions.

However, some women did not utilize antenatal check-up services; specifically, this applied to women who had conceived before the age of 18 and those for whom a mother-and-child health card had not been issued. The study also found that the majority of women who underwent antenatal check-ups (76.0 percent) had 2 to 3 visits, whereas a relatively small proportion (2.5 percent) had more than 5 visits. This situation indicates that although women are accessing health services, there remains a shortfall in the number of antenatal check-ups undertaken as recommended. An analysis of immunization status revealed that 97.2 percent of women received vaccinations during pregnancy; this reflects the reach of maternal and child health programs. The fact that 2.9 percent of women did not get vaccinated is a matter of concern, given that vaccination during pregnancy is considered essential for safeguarding the health of both the mother and the infant. Regarding the intake of iron, calcium, and folic acid tablets, it was found that only 5 percent of women completed the full course, whereas the majority (95 percent) did not. These findings indicate a need to improve nutritional counseling and adherence. The study found that most women do not complete the full course of medication (180 tablets) because they dislike the taste. A positive sign is that the majority of women availed themselves of essential antenatal care services, such as weight checks, blood pressure monitoring, and blood tests; specifically, 97.1 percent of the women underwent these examinations. This indicates that women receiving antenatal care (ANC) services are being provided with the necessary health check-ups. Regarding sonography, it was found that only 26.2 percent of women underwent the procedure, while 73.8 percent did not. The reasons for this include financial constraints, limited availability at health facilities, and distance; additionally, the study revealed that sonography was primarily undergone by women who experienced significant complications during pregnancy. Table 3 presents details regarding the health problems experienced by Muria women during pregnancy. The study reveals that 49 percent of the women encountered health issues during pregnancy, while the majority—51 percent—did not face any such problems. Furthermore, 57.2 percent of the women experienced one type of problem, 39.8 percent faced two types, and a small proportion (3 percent) suffered from more than three types of problems. Graph No. 1 illustrates the types of health issues experienced during pregnancy; the majority of women suffered from swollen feet, anemia, and weakness, while a smaller number faced issues such as a deficiency of amniotic fluid and abdominal pain.

Table No. 01: General Information of Respondents

Graph No. 01: Types of health problems during pregnancy

Table No. 02: Status of utilization of antenatal care services

Table No. 03: Health problems during pregnancy