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Inequalities in the utilization of maternal health care in the pre- and post-National Health Mission periods in India

Published online by Cambridge University Press:  24 June 2019

Balhasan Ali ,
Preeti Dhillon Open the ORCID record for Preeti Dhillon [Opens in a new window]  and
Sanjay K. Mohanty
Balhasan Ali
Affiliation:
Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
Preeti Dhillon*
Affiliation:
Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
Sanjay K. Mohanty
Affiliation:
Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
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Abstract

Since the implementation of the National Health Mission (NHM) in India there has been a noticeable improvement in the utilization of maternal care, namely antenatal care (ANC), skilled birth attendants (SBA) and postnatal care (PNC) in the country. The increase in utilization of these services is expected to reduce inequality across geographies and population sub-groups, but little is known about the extent of inequality in maternal care use across socioeconomic groups over time. Using data from the last two rounds of National Family Health Surveys conducted in 2005–06 and 2015–16, this study examined the extent of inequality in utilization of full ANC, SBA and PNC in India and its states. Descriptive statistics were used, a concentration index was computed and decomposition analyses performed to understand the pattern and change of inequality in use of maternal care. The results suggest that the gap in maternal care utilization across socioeconomic groups has reduced over time. The concentration index for SBA showed a decline from 0.49 in 2005–06 to 0.08 by 2015–16, while that of PNC declined from 0.36 to 0.13 over the same period. The reduction in inequality in utilization of full PNC was the least. The results of the decomposition analysis revealed that urban residence, education and belonging to Scheduled Caste and Scheduled Tribes positively contributed to the inequality. Based on these findings, it is suggested that the Janani Suraksha Yojana and Janani Sishu Suraksha Karyakaram schemes be continued and strengthened for poor mothers to reduce maternal health inequality, particularly in full ANC and PNC.

Keywords

InequalityMaternal careIndia
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 2 , March 2020 , pp. 198 - 212
Copyright
© Cambridge University Press 2019 

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