Page 107 - GHES-3-1

Global Health Economics and
Sustainability
Maternal health-care service utilization

80.00 (Bhusal, 2021). Overall, this study observes that the utilization
60.00 of MHCS has been improving over the years. The findings
also indicate that inequality in MHCS utilization between the
40.00
poorest and richest women in India is decreasing.
20.00
0.00 5. Conclusions
-20.00 Wedu Pedu Sector MME Autonomy Caste Religion Agegrp Birth Despite improvements in MMR since 1998, there are

1998-1999 2005-2006 2015-2016 2019-2021 still challenges that need to be overcome. Bridging the
gap between the poorest and richest mothers could be
Figure 1. Percentage contribution of each predictor in ANC4+ visits achieved by uplifting the poor. The government has
(authors’ estimation based on the BODM)
Abbreviations: Wedu: Women’s education; Pedu: Partner’s education, introduced schemes to promote MHCS utilization. The
MME: Mass media exposure; BODM: Blinder–Oaxaca decomposition National Health Mission aims to ensure universal access to
method. affordable and quality health-care services. Initiatives such
as the Labor Room and Quality Improvement Initiative and
80.00 Surakshit Matritva Anushasan strive to provide expectant
60.00 mothers with a positive childbirth experience and ensure
40.00 the delivery of quality health-care services at no cost.
20.00
The Janani Suraksha Yojana (JSY) initiative, introduced
0.00 by the Indian government in 2005, aims to encourage low-
Wedu Pedu Sector MME Caste Religion Agegrp income mothers to give birth in public health facilities
-20.00 Birth
-40.00 Autonomy by offering a cash transfer on their release. The JSY
1998-1999 2005-2006 2015-2016 2019-2021 program provides conditional cash transfers to incentivize
Figure 2. Percentage contribution of each predictor in SBA (authors women to give birth in medical facilities. However, the
estimation based on the BODM) government’s intense focus on institutional deliveries and
Abbreviations: Wedu: Women’s education; Pedu: Partner’s education, SBA has led to a decreased emphasis on ANC. Schemes
MME: Mass media exposure; BODM: Blinder–Oaxaca decomposition addressing maternal mortality will only be successful if
method.
they significantly address ANC services. The Pradhan
80.00 Mantri Surakshit Matritva Abhiyan aims to increase the
60.00 accessibility and standard of ANC, including counseling
40.00 and diagnostic services. In addition, an initiative has been
introduced to improve the quality of care in maternity
20.00
operation theaters and labor rooms.
0.00
Wedu Pedu MME Caste Birth The success of programs such as Janani Shishu Suraksha
-20.00 Sector Autonomy Religion Agegrp Karyakram and JSY is evident. However, reducing MMR

1998-1999 2005-2006 2015-2016 2019-2021 requires further enhancing female health, literacy, and
prenatal care, as well as providing high-quality emergency
Figure 3. Percentage contribution of each predictor in PNC (authors’ obstetric care with trained delivery attendants.
estimation based on the BODM)
Abbreviations: Wedu: Women’s education; Pedu: Partner’s education, Acknowledgments
MME: Mass media exposure; BODM: Blinder–Oaxaca decomposition
method. None.

education, and MME are major contributing factors to the Funding
increasing inequality in MHCS utilization (Figure 1).
None.
Moreover, partner education is reducing inequalities
in the case of SBA (Figure 2). However, the education of Conflict of interest
women and their partners, as well as sectorial differences,
are increasing inequalities between the poorest and richest The authors declare that they have no competing interests.
women in the case of PNC (Figure 3). This finding is similar
to a current study conducted in Nepal, which observed that Author contributions
women’s education and MME are the highest contributors to Conceptualization: Arvind Kumar Yadav, Bhavna Sahni
MHCS utilization between the richest and poorest women Investigation: Madhurima Ghosh

Volume 3 Issue 1 (2025) 99 https://doi.org/10.36922/ghes.3324