Trends in Maternal Care Utilization in Urban India

Abstract

The present study attempts to observe the recent changes in the Indian health care utilization pattern based on secondary data from three National Sample Survey Organisation (NSSO) rounds. The study focuses on urban households across different classes of towns emphasizing the most recent births to married women within a recall of period 365 days. Three dimensions of maternal care services have been discussed in this study, namely, prenatal care services, delivery services and postnatal care services. It is found that the utilization of prenatal, postnatal and delivery services are positively correlated with the economic status of households as measured by the per capita monthly consumption expenditure (MPCE). It is also noted that the household educational and employment index are correlated with the level of prenatal and postnatal care utilization and the dimension of correlation is positive and statistically significant. But in case of delivery services the degree of correlation has changed from being highly positive to negative, specifically in case of household employment index. This study also attempts to understand the changes in utilization of maternal health care services with respect to public health infrastructure. It is found that the use of public health facilities has significantly reduced over time. The correlation between household economic status and the use of public facilities for the prenatal, postnatal and delivery care present a strong negative and the degree of correlation becomes stronger over time. A similar dimension of association is found in the case of household educational index. It may be the improvement in utilizing public health infrastructure among households from the formal sector. The discrepancy in access to health facilities among different classes of cities can be cited as one of the reasons for lower utilization of maternal health care services. Such discrepancies are relatively lower in case of small towns especially in the case of delivery and prenatal care services.