Poverty and maternal health care utilisation in Maharashtra: associated influences on infant mortality and morbidity

Kausar, Farah, Griffiths, Paula L. and Matthews, Zoë (2000) Poverty and maternal health care utilisation in Maharashtra: associated influences on infant mortality and morbidity. 128th Annual Meeting of APHA, Boston, USA. 12 - 16 Nov 2000.

Abstract

This paper explores the effects of poverty on access to maternal health care services (MHC), linking the use of MHC to two outcomes for the infant; mortality and nutritional status. The paper therefore falls under the overall theme of the international health strand; eliminating disparities in health outcomes. The paper establishes disparities in health outcomes between socio-economic groups in both urban and rural areas. Previous literature has documented an urban-rural dichotomy in infant survival and utilisation of MHC in India but little is known about the variations among socio-economic groups within urban areas. Rates of infant mortality are much higher in poorer sectors of the urban areas, suggesting that some differential utilisation of MHC exist between socio-economic groups. In this paper the Indian National Family Health Survey (1992/93) for Maharashtra is used to model use of antenatal and delivery care and associated influences on infant mortality and morbidity. A composite index is created to examine the influence of standard of living on use of MHC. Findings show that those living in poorer households in rural and urban areas have a lower utilisation of MHC services than those in the higher socio-economic strata. The low level of use of these services is associated with increased neonatal mortality. In addition, infants living in lower socio-economic groups in rural and urban areas have an increased risk of poor nutritional status and neonatal mortality.
Learning Objectives: By the end of this session, the participant will be able to: 1. Create a standard of living index based upon socio-economic data collected in standard cross-sectional surveys such as the demographic and health surveys(DHS). 2. Compare maternal and child health outcomes across socio-economic groups within rural and urban settings in Maharashtra. 3. Recognise the barriers to health care utilisation by the poorest socio-economic groups in urban areas. 4. Understand how standard of living influences use of maternal health care and its associated influences with infant nutrition and mortality outcomes in Maharashtra.

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Contributors

Author: Zoë Matthews

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