Perspectives of women and community workers regarding maternal and newborn care among tribal areas of Maharashtra, India: a qualitative study

Background: Tribal populations are vulnerable; have lower health and social indicators as compared to the general population. The objectives of this paper were to know the awareness and perceptions about maternal and newborn care, treatment-seeking behaviour, constraints faced by reproductive age group women while accessing services and by the auxiliary nurse midwives (ANMs) and accredited social health activists (ASHAs), while providing the services. Methods: A qualitative study was conducted in two blocks of Palghar district (Dahanu and Jawhar) in Maharashtra, India from February 2021 to September 2021.Twenty-four focus group discussions (FGDs) were conducted among three groups: Reproductive age group women (18-45 years), ASHAs and ANMs in the study area. A textual and contextual analysis was done manually with the help of the prepared FGD guide. Results: Majority of the women were aware of early registration and danger signs of pregnancy. They had certain misconceptions about diet in the postnatal period and consumption of iron and folic acid tablets. Prelacteal feeding was not practiced; exclusive breastfeeding and weaning practices were reported to be satisfactory. All three delays were reported by the women and the health care workers. Conclusions: Misconceptions related to MCH care and nutrition among tribal women can be addressed through health education messages. Infrastructure, facilities, manpower, and transport facilities need to be strengthened in tribal areas, especially below the subdistrict level. The study findings indicate the need to address three delays by the health authorities in the study areas to reduce maternal and perinatal mortality and morbidity.