Multiple Vulnerabilities in Access to and Utilizing of Maternal and Child Health Care Services in India: A Spatial-Regional Analysis

Prem Shankar Mishra , Institute for Social and Economic Change, Bengaluru, India

Although there are multiple-vulnerabilities in access to MCH services in India, the research has always been focussing on single dimension vulnerabilities like economic vulnerabilities or social vulnerabilities. Individuals who are poor may also face other types of vulnerabilities that together affect access to health services. This paper, therefore, investigates the linkages between multiple-vulnerabilities and utilization of maternal and child-care services. Data from DHS (2015-16) for India and states were used for analyzing the key outcomes variables namely women received four antenatal care (ANC), institutional-delivery-care, post-natal care (PNC) and full-immunization for children age-groups 12-23 months. Bivariate analysis and binomial-logistic regression analysis were employed to examine the multiple-vulnerabilities on utilizing MCH care services across three-dimensions of vulnerabilities such as education, wealth, and caste. Paper identifies strong linkages between multiple-vulnerabilities and the utilization of MCH services. Women with multiple-vulnerabilities were less likely to utilize essential maternal and child health care services. The utilization of antenatal care and postnatal care services declines with increasing vulnerabilities. Women who face vulnerabilities in all the three-dimensions were less likely to have received full-ANC and postnatal care than those who were not deprived of any (0.3 vs. 0.9 and 0.4 vs. 0.8). They were also less likely to deliver in health facilities and for child-immunization (0.5 vs. 0.8 and 0.3 vs. 0.7). In India, 34 percent of the ever-married women were not deprived of any of the three dimensions. A multi-sectoral approach is therefore required to dealing with the issues of low-access and under-utilization of MCH in India.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality