PMID- 35033087
OWN - NLM
STAT- MEDLINE
DCOM- 20220404
LR  - 20231102
IS  - 1475-9276 (Electronic)
IS  - 1475-9276 (Linking)
VI  - 21
IP  - 1
DP  - 2022 Jan 15
TI  - Horizontal inequity in the utilisation of Continuum of Maternal Health care 
      Services (CMHS) in India: an investigation of ten years of National Rural Health 
      Mission (NRHM).
PG  - 7
LID - 10.1186/s12939-021-01602-3 [doi]
LID - 7
AB  - BACKGROUND: Continuum of Maternal Health Care Services (CMHS) has garnered 
      attention in recent times and reducing socio-economic disparity and geographical 
      variations in its utilisation becomes crucial from an egalitarian perspective. In 
      this study, we estimate inequity in the utilisation of CMHS in India between 2005 
      and 06 and 2015-16. METHODS: We used two rounds of National Family Health Survey 
      (NFHS) - 2005-06 and 2015-16 encompassing a sample size of 34,560 and 178,857 
      pregnant women respectively. The magnitude of horizontal inequities (HI) in the 
      utilisation of CMHS was captured by adopting the Erreygers Corrected 
      Concentration indices method. Need-based standardisation was conducted to 
      disentangle the variations in the utilisation of CMHS across different wealth 
      quintiles and state groups.  Further, a decomposition analysis was undertaken to 
      enumerate the contribution of legitimate and illegitimate factors towards health 
      inequity. RESULTS: The study indicates that the pro-rich inequity in the 
      utilisation of CMHS has increased by around 2 percentage points since the 
      implementation of National Rural Health Mission (NRHM), where illegitimate 
      factors are dominant. Decomposition analysis reveals that the contribution of 
      access related barriers plummeted in the considered period of time. The results 
      also indicate that mother's education and access to media continue to remain 
      major contributors of pro-rich inequity in India. Considering, regional 
      variations, it is found that the percentage of pro-rich inequity in high focus 
      group states increased by around 3% between 2005 and 06 and 2015-16. The 
      performance of southern states of India is commendable. CONCLUSIONS: Our study 
      concludes that there exists a pro-rich inequity in the utilisation of CMHS with 
      marked variations across state boundaries. The pro-rich inequity in India has 
      increased between 2005 and 06 and high focus group states suffered predominantly. 
      Decentralisation of healthcare policies and  granting greater power to the states 
      might lead to equitable distribution of CMHS.
CI  - (c) 2022. The Author(s).
FAU - Gandhi, Sumirtha
AU  - Gandhi S
AUID- ORCID: 0000-0003-3047-2810
AD  - Bengaluru Dr. B.R. Ambedkar School of Economics, Bengaluru, Karnataka, India. 
      sumirtha@gmail.com.
FAU - Dash, Umakant
AU  - Dash U
AD  - Institute of Rural Management, Anand, Gujarat, India.
FAU - Suresh Babu, M
AU  - Suresh Babu M
AD  - Department of Humanities and Social Sciences, Indian Institute of Technology, 
      Chennai, India.
LA  - eng
PT  - Journal Article
DEP - 20220115
PL  - England
TA  - Int J Equity Health
JT  - International journal for equity in health
JID - 101147692
SB  - IM
MH  - Female
MH  - Health Services Accessibility
MH  - Healthcare Disparities
MH  - Humans
MH  - India
MH  - Maternal Health
MH  - *Maternal Health Services
MH  - Pregnancy
MH  - *Rural Health
MH  - Socioeconomic Factors
PMC - PMC8760767
OTO - NOTNLM
OT  - Continuum of maternal health care services
OT  - Erreygers corrected concentration indices
OT  - Horizontal inequity
OT  - National Rural Health Mission
COIS- The authors declare that they have no competing interests.
EDAT- 2022/01/17 06:00
MHDA- 2022/04/05 06:00
PMCR- 2022/01/15
CRDT- 2022/01/16 20:31
PHST- 2021/06/08 00:00 [received]
PHST- 2021/12/08 00:00 [accepted]
PHST- 2022/01/16 20:31 [entrez]
PHST- 2022/01/17 06:00 [pubmed]
PHST- 2022/04/05 06:00 [medline]
PHST- 2022/01/15 00:00 [pmc-release]
AID - 10.1186/s12939-021-01602-3 [pii]
AID - 1602 [pii]
AID - 10.1186/s12939-021-01602-3 [doi]
PST - epublish
SO  - Int J Equity Health. 2022 Jan 15;21(1):7. doi: 10.1186/s12939-021-01602-3.