Are the Poor Catching Up with the Rich in Utilising Reproductive, Maternal, New Born and Child Health Services: An Application of Delivery Channels Framework in Indian Context

Abstract

The article is aimed to assess trends in wealth-related inequalities in coverage of reproductive, maternal, neonatal and child health (RMNCH) interventions using delivery channels framework in Indian context, at national level as well as at state level—Tamil Nadu (TN) and Chhattisgarh (CG)—a better off and poorer state, respectively. We used National Family Health Survey—3rd (2005–2006) and 4th (2015–2016) to study the trends and differentials of inequalities in the RMNCH coverage. We have used two summary indices—absolute inequalities using the slope index of inequality (SII) and relative inequalities using the concentration index (CIX). Culturally driven interventions had pro-poor inequalities in TN, CG and in India, but the coverage has improved significantly for the women from wealthier households recently. Environmental interventions were highly inequal in distribution, particularly for the ‘use of clean fuels’. Inequalities in the coverage of health facilities-based interventions has reduced in TN, CG and overall India, but more so in TN. The inequalities in coverage of community-based interventions have reduced over the period of ten years in TN, CG as well as at national level. Adopting RMNCH delivery channel framework could be useful for assessing and monitoring the progress of public health programmes. Policy makers can gain insights from the success of coverage of various interventions and determine specific implementation strategies to reduce inequalities in the coverage and its effectiveness.