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Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis

OBJECTIVES: To examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India. DESIGN: Data for the present...

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Autores principales: Awasthi, Ashish, Pandey, C M, Chauhan, Rajesh K, Singh, Uttam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985800/
https://www.ncbi.nlm.nih.gov/pubmed/27496225
http://dx.doi.org/10.1136/bmjopen-2015-009885
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author Awasthi, Ashish
Pandey, C M
Chauhan, Rajesh K
Singh, Uttam
author_facet Awasthi, Ashish
Pandey, C M
Chauhan, Rajesh K
Singh, Uttam
author_sort Awasthi, Ashish
collection PubMed
description OBJECTIVES: To examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India. DESIGN: Data for the present study are taken from the Annual Health Survey (AHS), 2010–2013 and Census of India, 2011. SETTINGS: This study used secondary data from states having higher mortality and fertility rates, termed as high focus states in India. PARTICIPANTS: District-level information regarding children aged 12–23 months and ever married women aged 15–49 years has been extracted from the AHS (2010–2013), and household amenities, female literacy and main workforce information has been obtained from the Census of India 2011. MEASURES: 2 summary indexes were calculated first for maternal and child health services and another for socioeconomic and development status, using data from AHS and Census. Cronbach's α was used to assess the internal consistency of the items used in the index. RESULTS: The result shows that the coverage gap is highest in Uttar Pradesh (37%) and lowest in Madhya Pradesh (21%). Converge gap and socioeconomic development are negatively correlated (r=−0.49, p=0.01). The average coverage gap was highest in the lowest quintile of socioeconomic development. There was an absolute change of 1.5% per year in coverage gap during 2009–2013. In regression analysis, the coefficient of determination was 0.24, β=−30.05, p=0.01 for a negative relationship between socioeconomic development and coverage gap. CONCLUSIONS: There is a significant disparity in the usage of maternal and child healthcare services in the districts of India. Resource-rich people (urban residents and richest quintile) are way ahead of marginalised people (rural residents and poorest quintile) in the usage of healthcare services.
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spelling pubmed-49858002016-08-19 Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis Awasthi, Ashish Pandey, C M Chauhan, Rajesh K Singh, Uttam BMJ Open Global Health OBJECTIVES: To examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India. DESIGN: Data for the present study are taken from the Annual Health Survey (AHS), 2010–2013 and Census of India, 2011. SETTINGS: This study used secondary data from states having higher mortality and fertility rates, termed as high focus states in India. PARTICIPANTS: District-level information regarding children aged 12–23 months and ever married women aged 15–49 years has been extracted from the AHS (2010–2013), and household amenities, female literacy and main workforce information has been obtained from the Census of India 2011. MEASURES: 2 summary indexes were calculated first for maternal and child health services and another for socioeconomic and development status, using data from AHS and Census. Cronbach's α was used to assess the internal consistency of the items used in the index. RESULTS: The result shows that the coverage gap is highest in Uttar Pradesh (37%) and lowest in Madhya Pradesh (21%). Converge gap and socioeconomic development are negatively correlated (r=−0.49, p=0.01). The average coverage gap was highest in the lowest quintile of socioeconomic development. There was an absolute change of 1.5% per year in coverage gap during 2009–2013. In regression analysis, the coefficient of determination was 0.24, β=−30.05, p=0.01 for a negative relationship between socioeconomic development and coverage gap. CONCLUSIONS: There is a significant disparity in the usage of maternal and child healthcare services in the districts of India. Resource-rich people (urban residents and richest quintile) are way ahead of marginalised people (rural residents and poorest quintile) in the usage of healthcare services. BMJ Publishing Group 2016-08-05 /pmc/articles/PMC4985800/ /pubmed/27496225 http://dx.doi.org/10.1136/bmjopen-2015-009885 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Global Health
Awasthi, Ashish
Pandey, C M
Chauhan, Rajesh K
Singh, Uttam
Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title_full Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title_fullStr Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title_full_unstemmed Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title_short Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis
title_sort disparity in maternal, newborn and child health services in high focus states in india: a district-level cross-sectional analysis
topic Global Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985800/
https://www.ncbi.nlm.nih.gov/pubmed/27496225
http://dx.doi.org/10.1136/bmjopen-2015-009885
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