PMID- 31720361
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2352-8273 (Print)
IS  - 2352-8273 (Electronic)
IS  - 2352-8273 (Linking)
VI  - 9
DP  - 2019 Dec
TI  - Universalisation versus targeting in maternal and child health care provisioning: 
      Evidence from India.
PG  - 100502
LID - 10.1016/j.ssmph.2019.100502 [doi]
LID - 100502
AB  - To eradicate the persistent inequality in utilisation of Maternal Health Care 
      Services (MHCS), India's Government has adopted various programmes under the 
      National Rural Health Mission (NRHM) in 2005. The Janani Suraksha Yojana (JSY), a 
      demand-side intervention, is one of the flagship programmes under the NRHM. Using 
      two rounds of the nationally representative National Family Health Survey (NFHS) 
      data collected in 2005-06 and 2015-16, respectively, we attempt to map the extent 
      to which inequality in MHCS utilisation has changed over time across states after 
      the implementation of NRHM; analyse whether there are differences in the patterns 
      of inequality prevalent in the universal and targeted states; and find evidence 
      to decide whether universalisation is more effective than targeting in reducing 
      inequality in MHCS utilisation. We measure relative inequality and use the 
      difference in difference technique to answer the research questions. For 
      analysis, we have considered five outcome variables spanning across three stages 
      of the continuum of care in maternal health. We find that relative inequality in 
      MHCS utilisation declined across states during the period 2006-16, though in 
      varying degrees. Universal states experienced a higher level of inequality as 
      compared to the targeted states. However, universal states observed a higher 
      decline in inequality over time relative to the targeted states controlling for 
      other state-level characteristics. The study establishes that the programme 
      implementation strategy and conditional cash transfer programmes influence the 
      reduction of inequality in MHCS utilisation. This study makes an important 
      contribution to the literature on public health policy and inequality in health 
      care utilisation by highlighting the differential impact of universalisation and 
      targeting on reducing inequality in the use of MHCS.
CI  - (c) 2019 The Authors. Published by Elsevier Ltd.
FAU - Paul, Sohini
AU  - Paul S
AD  - Population Council, India Habitat Centre, Zone 5A, Ground Floor Lodi Road, New 
      Delhi, 110003, India.
FAU - Paul, Sourabh
AU  - Paul S
AD  - Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
FAU - James, K S
AU  - James KS
AD  - International Institute of Population Sciences, Govandi Station Road, Deonar, 
      Opposite Sanjona Chamber, Mumbai, Maharashtra, 400088, India.
LA  - eng
PT  - Journal Article
DEP - 20191017
PL  - England
TA  - SSM Popul Health
JT  - SSM - population health
JID - 101678841
PMC - PMC6838526
OTO - NOTNLM
OT  - Indian states
OT  - Inequality
OT  - Janani suraksha yojana
OT  - Maternal health care services
OT  - Targeting
OT  - Universalisation
COIS- None.
EDAT- 2019/11/14 06:00
MHDA- 2019/11/14 06:01
PMCR- 2019/10/17
CRDT- 2019/11/14 06:00
PHST- 2019/03/21 00:00 [received]
PHST- 2019/07/26 00:00 [revised]
PHST- 2019/10/13 00:00 [accepted]
PHST- 2019/11/14 06:00 [entrez]
PHST- 2019/11/14 06:00 [pubmed]
PHST- 2019/11/14 06:01 [medline]
PHST- 2019/10/17 00:00 [pmc-release]
AID - S2352-8273(19)30103-X [pii]
AID - 100502 [pii]
AID - 10.1016/j.ssmph.2019.100502 [doi]
PST - epublish
SO  - SSM Popul Health. 2019 Oct 17;9:100502. doi: 10.1016/j.ssmph.2019.100502. 
      eCollection 2019 Dec.