Reproductive health and its bio-cultural correlates among Rai and Bhutia women of rural Sikkim: a micro level study.

This study addresses the relationship between utilization of maternal health services in terms of antenatal care, delivery care, and contraceptive use, and current prevalence of gynecological problems mediated through socioeconomic, demographic and biological correlates, in two ethnic communities of Sikkim. Study participants included 506 parous, nonpregnant women of Rai and Bhutia communities. Information on morbidity status and utilization of maternal health care facilities were collected using appropriate pretested questionnaires. Bivariate and multivariate analyses were used. Anthropometric measurements were taken and blood tests were carried out for estimating hemoglobin concentration, and erythrocyte sedimentation rate (ESR). Logistic regression showed significant association between participant's education, parity, husband's cooperation and maternal health care utilization on one hand and prevalence of gynecological problems, hemoglobin concentration, ESR and parity on the other. Study results reinforce an interrelation between prevalence of gynecological problems and maternal health care utilization during pregnancy and delivery. A single effective health care program can be launched to meet the needs of these two ethnic groups.