Maternal and Child Health in Districts of India: Deprivation and Disparities
Attaining health-related Sustainable Development Goals (SDGs) requires compliance with the continuum of four basic maternal and child (MCH) cares, antenatal care (ANC), skilled birth attendance (SBA), postnatal care (PNC) and child immunization. The progress in these maternal and child health services is uneven and large across geographies, economic and social classes in states of India. Little is known on extent of inequality in these services in districts of India. An assessment of disparities and inter-dependence across these four milestones of MCH care in the districts of India would be helpful for effective planning and programme implementation. At the same time, the extent of deprivation from the ideal of full compliance on all four fronts situates the study of inter-regional differences. Using the recent round of data from National Family and Health Survey 4, this paper examines the state of maternal and child health across 640 districts in India. A composite index of MCH care based on antenatal care, skilled birth attendance, postnatal care and child immunization is computed and compared across the districts of India and districts within each state. A deprivation index is computed to understand the shortfall in MCH care.
Results suggest that there is considerable inter district variation in maternal and child health across the districts. The MCH index in India, found to be 0.43, varies from Mon district of Nagaland to Kapurthala district of Punjab. Out of 640 districts, 238 districts had MCH index less than 0.4, 235 districts between 0.4 and 0.6 and 122 districts higher than 0.6. Similarly, the deprivation score in India shows enormous variations among the districts. A total of 391 districts had a deprivation score of 1.5 and more. The present pattern of MCH care infers large disparity in MCH care among districts. Reduction of inequality in MCH care is important for achieving Sustainable Development Goals.
Understanding the pattern of MCH at the district level is of considerable relevance for evolving policies and programme interventions. Targeted interventions in high-focussed districts can reduce interdistrict disparity in maternal and child healthcare in India.
KeywordsMaternal and child health Disparity Deprivation distance Interdependence India Districts
- Alkema, L., Chou, D., Hogan, D., Zhang, S., Moller, A.-B., Gemmill, A., Fat, D.M., Boerma, T., Temmerman, M., & Mathers, C. (2016). Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet, 387(10017), 462–474.Google Scholar
- Hug, L., Sharrow, D., You, D. (2017). Levels & trends in child mortality: Report 2017. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation.Google Scholar
- International Institute for Population Sciences and ICF. (2017). India National Family Health Survey (NFHS-4), 2015–16. Mumbai: International Institute for Population Sciences.Google Scholar
- Ministry of Statistics and Programme Implementation. (2015). Millennium development goals India country report 2015. New Delhi: Government of India.Google Scholar
- Office of the Registrar General of India (ORGI). (2018). Special bulletin on maternal mortality in India 2014–16. Registrar General of India. New Delhi.Google Scholar
- Planning Commission. (2014). Report of the expert group to review the methodology for measurement of poverty. New Delhi: Government of India.Google Scholar
- United Nation. (2016). Report of the inter-agency and expert group on sustainable development goal indicators. (E/CN.3/2016/2/Rev.1).Google Scholar
- World Health Organization. (2016). World health statistics 2016: Monitoring health for the SDGs sustainable development goals. World Health Organization. http://www.who.int/-gho/publications/world_health-_statistics/2016/en.
- You, D., Hug, L., Ejdemyr, S., Beise, J. (2015). Levels and trends in child mortality. Report 2015. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation.Google Scholar