PMID- 21048964
OWN - NLM
STAT- MEDLINE
DCOM- 20110307
LR  - 20220409
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 5
IP  - 10
DP  - 2010 Oct 27
TI  - Economic inequalities in maternal health care: prenatal care and skilled birth 
      attendance in India, 1992-2006.
PG  - e13593
LID - 10.1371/journal.pone.0013593 [doi]
LID - e13593
AB  - BACKGROUND: The use of maternal health care is limited in India despite several 
      programmatic efforts for its improvement since the late 1980's. The use of 
      maternal health care is typically patterned on socioeconomic and cultural 
      contours. However, there is no clear perspective about how socioeconomic 
      differences over time have contributed towards the use of maternal health care in 
      India. METHODOLOGY/PRINCIPAL FINDINGS: Using data from three rounds of National 
      Family Health Survey (NFHS) conducted during 1992-2006, we analyse the trends and 
      patterns in utilization of prenatal care (PNC) in first trimester with four or 
      more antenatal care visits and skilled birth attendance (SBA) among poor and 
      nonpoor mothers, disaggregated by area of residence in India and three 
      contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In 
      addition, we investigate the relative contribution of public and private health 
      facilities in meeting the demand for SBA, especially among poor mothers. We also 
      examine the role of salient socioeconomic, demographic and cultural factors in 
      influencing aforementioned outcomes. Bivariate analyses, concentration curve and 
      concentration index, logistic regression and multinomial logistic regression 
      models are used to understand the trends, patterns and predictors of the two 
      outcome variables. Results indicate sluggish progress in utilization of PNC and 
      SBA in India and selected provinces during 1992-2006. Enormous inequalities in 
      utilization of PNC and SBA were observed largely to the disadvantage of the poor. 
      Multivariate analysis suggests growing inequalities in utilization of the two 
      outcomes across different economic groups. CONCLUSIONS: The use of PNC and SBA 
      remains disproportionately lower among poor mothers in India irrespective of area 
      of residence and province. Despite several governmental efforts to increase 
      access and coverage of delivery services to poor, it is clear that the poor (a) 
      do not use SBA and (b) even if they had SBA, they were more likely to use the 
      private providers.
FAU - Pathak, Praveen Kumar
AU  - Pathak PK
AD  - International Institute for Population Sciences, Mumbai, Maharashtra, India. 
      pkp_pathak@rediffmail.com
FAU - Singh, Abhishek
AU  - Singh A
FAU - Subramanian, S V
AU  - Subramanian SV
LA  - eng
GR  - K25 HL081275/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20101027
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - *Delivery, Obstetric
MH  - Female
MH  - Humans
MH  - India
MH  - Maternal Health Services/*statistics & numerical data
MH  - Pregnancy
MH  - Prenatal Care/*statistics & numerical data
MH  - *Social Justice
PMC - PMC2965095
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2010/11/05 06:00
MHDA- 2011/03/08 06:00
PMCR- 2010/10/27
CRDT- 2010/11/05 06:00
PHST- 2010/06/30 00:00 [received]
PHST- 2010/09/15 00:00 [accepted]
PHST- 2010/11/05 06:00 [entrez]
PHST- 2010/11/05 06:00 [pubmed]
PHST- 2011/03/08 06:00 [medline]
PHST- 2010/10/27 00:00 [pmc-release]
AID - 10-PONE-RA-20472R1 [pii]
AID - 10.1371/journal.pone.0013593 [doi]
PST - epublish
SO  - PLoS One. 2010 Oct 27;5(10):e13593. doi: 10.1371/journal.pone.0013593.