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Socio-economic and spatial inequalities in delivery care in UP, India

Author Affiliations

  • 1Centre for the Study of Regional Development (CSRD), Jawaharlal Nehru University (JNU), New Delhi-110067, India

Int. Res. J. Social Sci., Volume 6, Issue (9), Pages 23-34, September,14 (2017)


India accounts for 19 percent of global maternal deaths, with the most recent statistics showing an average maternal mortality ratio of 167 per 100 000 live births at the national level. Uttar Pradesh is one of the largest contributors of maternal deaths (285 per 100000 lb) (SRS, 2013). The low utilization of delivery care services is main cause of poor maternal health status in state. Moreover, the statistics shows much difference across socio-economic strata of population. Despite the rigorous governmental and non-governmental effort the prevalence of inequality across various socio-economic groups of women is matter of worry for researchers. The present study explores why huge socio-economic inequality exist in utilization of institutional delivery care and what are the main contributing factors of delivery care inequality? The data on the utilization of delivery care has been taken from the two rounds of District Level Household Survey (DLHS 2nd and 3rd). The methods which employ to measure inequality are computation of ratio, concentration index, binary logistic regression and decomposition analysis. The entire state has divided in to four regions for capturing more detailed picture of delivery care. The results reveal that the inequality in utilization of delivery care has reduced across caste, religion, education of women. However, the highest wealth based inequality in non- institutional and unsafe delivery is concentrated in western and eastern region. Furthermore, illiteracy of women, rural place of residence, not received ANC and poor wealth status of household are leading contributors in women not going for institutional delivery.


  1. WHO (2010)., Trends in Maternal Mortality : 1990 to 2010., World Health Organization.
  2. MHFW (2011)., Ministry of Health and Family Welfare., Annual Report to the People On Health.
  3. Gottlieb P. and Lindmark G. (2002)., WHO indicators for evaluation of maternal health care services, applicability in least developed countries: a case study from Eritrea., Afr. J. Reprod. Health , 13-22.
  4. DLHS-3 (2007)., District Level Household and Facility Survey.,
  5. Registrar General of India (2013)., Special bulletin on maternal mortality in India 2010–12., Government of India.
  6. Dasgupta R. and Qadeer I. (2005)., The National Rural Health Mission (NRHM): a critical overview., Indian J. Public Health, 49(3), 138-140.
  7. International Institute for Population Sciences (2007)., India National Family Health Survey (NFHS-3), 2005-06.,
  8. Kumar C., Singh P.K. and Rai R.K. (2013)., Coverage gap in maternal and child health services in India: Assessing trends and regional deprivation during 1992-2006., J. Public Heal. (United Kingdom), 35(4), 598-606.
  9. Mohanty S.K. and Pathak P.K. (2009)., Rich-poor gap in utilization of reproductive and child health services in India, 1992-2005., J. Biosoc. Sci., 41, 381-98.
  10. Tiwari M. and Kumar K. (2001)., Women ’ s Autonomy and Utilization of Maternal and Child Health Care Services in India., 1-4.
  11. Malhotra C. and Do Y.K. (2013)., Socio-economic disparities in health system responsiveness in India., Health Policy Plan., 28(2), 197-205.
  12. Ononokpono D.N. and Odimegwu C.O. (2014)., Determinants of Maternal Health Care Utilization in Nigeria: a multilevel approach., Pan African Medical Journal, 17.
  13. Rao P.S. and Richard J. (1984)., Socioeconomic and demographic correlates of medical care and health practices., J. Biosoc. Sci., 16(3), 343-355.
  14. Furuta M. and Salway S. (2006)., Women’s position within the household as a determinant of maternal health care use in Nepal., Int. Fam. Plan. Perspect., 32(1), 17-27.
  15. Rowe Meredith L., Kumar Bijaya Thapa, Levine Robert, Levine Sarah and Tuladhar Sumon K. (2005)., How Does Schooling Influence Maternal Health Practices ? Evidence from Nepal., Comp. Educ. Rev. 49(4), 512-533.
  16. Bhatia J.C. and Cleland J. (1995)., Determinants of maternal care in a region of South India., Heal. Transit. Rev., 5, 127-142.
  17. Drèze J. and Sen A. (1996)., India: Economic Development and Social Opportunity., Canadian Journal of Development Studies, 17, 554-557.
  18. Baru R., Acharya A., Acharya S., Kumar K.S. and Nagaraj K. (2010)., Inequities in Access to Health Services in India., Econ. Polit. Wkly., xlv, 49-58.
  19. Patra S., Arokiasamy P. and Goli S. (2014)., Relevance of Health Knowledge in Reporting Maternal Health Complications and Use of Maternal Health Care in India., Health Care Women Int., 1-19. doi:10.1080/07399332.2014.946509
  20. Falkingham J. (2003)., Inequality and changes in women’s use of maternal health-care services in Tajikistan., Stud. Fam. Plann., 34, 32-43 .
  21. Bronstein J.M. and Morrisey M.A. (1990)., Determinants of rural travel distance for obstetrics care., Med. Care, 28(9), 853-866.
  22. Chen M.K. (1982)., Health Care Services and Health Status in a Rural Setting: The Utility of Some Predictors., Inquiry, 19(3), 257-261.
  23. Arokiasamy P. and Pradhan J. (2013)., Maternal health care in India : access and demand determinants., 14(4), 373-393. doi:10.1017/S1463423612000552
  24. Ram F. and Singh A. (2006)., Is antenatal care effective in improving maternal health in rural uttar pradesh? Evidence from a district level household survey., J. Biosoc. Sci., 38(4), 433-448.
  25. Registrar General of India.(2013)., Special Bulletin on Maternal Mortality: 2010-2012., 11-14.
  26. Wagstaff A., Paci P. and Van Doorslaer E. (1991)., On the Measurement of inequalities in Health., Soc. Sci. Med., 33(5), 545-557.
  27. Gupta A., Kumar P. and Dorcas O.A. (2016)., Decomposing the Socio-economic Inequalities in Utilization of Full Antenatal Care in Jharkhand State, India., International Journal of Population Studies, 2(2), 92-106.
  28. Wagstaff Adam, Doorslaer Eddy Van and Watanabe Naoko (2003)., On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam., J. Econom., 112(1), 207-223.
  29. Singh R.K. and Patra S. (2013)., Differentials in the Utilization of Antenatal Care Services in EAG states of India., 2, 28-32.
  30. World Bank (2012)., Education and health: Where do gender differences really matter?., World Dev. Rep., 104-148.
  31. Martin Sandra L., Moracco Kathryn E., Garro Julian, Tsui Amy Ong, Kupper Lawrence L., Chase Jennifer L. and Campbell Jacquelyn C. (2002)., Domestic violence across generations : findings from northern India., 31(3), 560-572.
  32. Yadav A. and Kesarwani R. (2016)., Effects of Individual and Community factors on Maternal Health Care Services Use in India: A multilevel Approch., J. Biosoc. Sci, 48, 1-19.