Page 100 - GHES-3-1

Global Health Economics and
Sustainability

ORIGINAL RESEARCH ARTICLE
Income inequalities in maternal health-care

service utilization in India: Applying the
Blinder–Oaxaca decomposition method

Madhurima Ghosh 1 , Arvind Kumar Yadav * , and Bhavna Sahni 3
2
1 Department of Economics, CHRIST (Deemed to be University), Yeshwantpur Campus, Bangalore,
Karnataka, India
2 Department of Economics, School of Economics and Commerce, Kalinga Institute of Industrial
Technology, KIIT, Deemed to be University, Bhubaneswar, Khordha, Odisha, India
3 Department of Community Medicine, ASCOMS and Hospitals, Sidhra, Jammu, Jammu and
Kashmir, India

Abstract

Maternal health-care service (MHCS) utilization is a crucial indicator of a country’s
progress in protecting the health and well-being of its women and children. This
paper examines trends, patterns, determinants, and disparities in MHCS utilization
between the poorest and richest women in India’s Empowered Action Group. The
Academic editor: study used data from the second (1998 – 1999), third (2005 – 2006), fourth (2015 –
Mihajlo Jakovljevic M.D. Ph.D. MAE
2016), and fifth (2019 – 2021) rounds of the National Family Health Survey. A logistic
*Corresponding author: regression model was applied to assess MHCS utilization, and the Blinder–Oaxaca
Arvind Kumar Yadav
(arvind.yadavfcm@kiit.ac.in) decomposition method (BODM) was used to explain inequalities in utilization
between the poorest and richest women. The findings indicate that MHCS utilization
Citation: Ghosh, M., Yadav, A.K.,
& Sahni, B. (2025). Income has increased over the years among both groups. However, the utilization rate is
inequalities in maternal health-care higher among the poorest women. Furthermore, rural women are less likely to utilize
service utilization in India: Applying MHCS compared to urban women. Key determinants include women’s education,
the Blinder–Oaxaca decomposition
method. Global Health Econ their partners’ education, mass media exposure (MME), and women’s empowerment.
Sustain, 3(1):92-101. The BODM results show that although MHCS utilization has increased among both
https://doi.org/10.36922/ghes.3324 groups, inequalities persist, largely explained by coefficient effects. A trend analysis
Received: March 29, 2024 reveals a reduction in discrimination between the poorest and richest women
over time. Women’s education, MME, and autonomy are the key factors driving the
Revised: June 1, 2024
reduction of inequalities. There is a need for comprehensive strategies to enhance
Accepted: June 20, 2024 education among disadvantaged women, increase MME, and promote health
Published online: September 30, awareness. The government should empower women through incentives, such as
2024 cash benefits, to ensure higher MHCS utilization among poorer women.
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: Antenatal care; Skilled birth attendance; Postnatal care; Blinder–Oaxaca
Creative Commons Attribution decomposition method; Empower action group states
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with Maternal mortality, a persistent issue globally, particularly in poor countries, refers
regard to jurisdictional claims in
published maps and institutional to deaths from complications during pregnancy or childbirth. According to the
affiliations. United Nations inter-agency projections, the global maternal mortality ratio (MMR)

Volume 3 Issue 1 (2025) 92 https://doi.org/10.36922/ghes.3324