Page 98 - IJPS-2-2

International Journal of Population Studies

RESEARCH ARTICLE

Decomposing the Socio-economic Inequalities

in Utilization of Full Antenatal Care in Jharkhand

State, India

2
3
1*
Abha Gupta , Pushpendra Kumar and Olalemi Adewumi Dorcas
1 Jawaharlal Nehru University, New Delhi, India
2 International Institute for Population Sciences, Mumbai, India
3 University of Ibadan, Ibadan, Nigeria

Abstract: It is widely evidenced that low socio-economic status is significantly associated with poor
health, but inequalities caused by social and economic factors are poorly quantified. This paper attempts
to measure contributions of selected factors to the differences in full antenatal care (ANC) utilization in
the state of Jharkhand, India, based on the third wave of District Level Household and Facility Survey
(DLHS-3) data in 2007–2008. Full ANC is defined as having a minimum of three antenatal visits, at least
two tetanus toxoid injections and receiving folic acid tablets for at least 90 days or more during the last
pregnancy. Multivariate and decomposition statistical techniques were employed to examine the factors
associated with utilization of ANC services and their contributions to inequalities in utilization. Results
show that the factors with the largest contribution to utilization of ANC services were poor economic sta-
tus of women (37.53%), mass media exposure (30.71%), and residence in a rural area (15.56%). The rela-
tive contributions of region, mothers’ education, age, and birth order of the women in generating inequali-
ties were small. Therefore, to improve maternal health and to reduce socio-economic gaps in the state,
more focus is needed on vulnerable sections of society and regions where the effects of government
health programs hardly reach.
Keywords: socio-economic inequality, decomposition, antenatal care, Jharkhand, DLHS, India

*Correspondence to: Abha Gupta, Jawaharlal Nehru University, New Delhi, India; Email: abhagupta14@gmail.com

Received: June 27, 2016; Accepted: August 19, 2016; Published Online: August 25, 2016
Citation: 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, vol.2(2): 92–106.
http://dx.doi.org/10.18063/IJPS.2016.02.003.
Copyright: © 2016 Abha Gu-
1. Introduction pta, Pushpendra Kumar and
Olalemi Adewumi Dorcas.
This is an Open Access arti-
Antenatal care (ANC) is one of the essential components of maternal health; its contribution to cle distributed under the ter-
addressing the problem of maternal mortality and morbidity has been widely recognized (Oyerinde, ms of the Creative Commons
2013). Global estimates show that maternal deaths mostly occur due to complication during preg- Attribution-NonCommercial 4.0
International License (http://
nancy (WHO/UNICEF/UNFPA/The World Bank, 2007) such as haemorrhage, sepsis, unsafe induced creativecommons.org/licen-
abortion, a hypertensive disorder of pregnancy, or an obstructed labour (WHO, 2005). More recent ses/by-nc/4.0/), permitting all
estimates also demonstrate that about 830 women die from pregnancy or childbirth-related compli- non-commercial use, distribu-
tion, and reproduction in any
cations around the world every day. By the end of 2015, roughly 303,000 women died during and medium, provided the origi-
following pregnancy and child birth. Almost all of these deaths occurred in low-resource settings, nal work is properly cited.

92 International Journal of Population Studies | 2016, Volume 2, Issue 2