Utilization of maternal and child health care services in North and South India: does spousal violence matter?

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.