Elsevier

Health Policy

Volume 103, Issues 2–3, December 2011, Pages 290-296
Health Policy

Maternal health care in Indian districts

https://doi.org/10.1016/j.healthpol.2011.09.007Get rights and content

Abstract

Health plays an important role in economic well-being. The relationship between poor health and poverty is multifaceted. Globally, reproductive health conditions are the second highest cause of ill health. This study uses district-level data from India to investigate how an index of maternal health care is impacted by the rate of poverty, and a development index based on the performance in electrification, sanitation and safe drinking water. The initial results from a linear regression model show that maternal health care improves by 0.617 percentage point for every 1 percentage point increase in development intervention but by only 0.078 percentage point for every 1 percentage point decline in poverty rate. After checking for possible simultaneity problem between maternal health care index (MHCI) and poverty rate, it is revealed that the low negative relationship between poverty and MHCI at the initial stage does not hold any more while the district development index continues to show the considerable and statistically significant impact. The findings underscore the need for direct government intervention in improving maternal health care in Indian districts.

Introduction

The Planning Commission as the nodal agency in the Government of India has been estimating the number and percentage of poor at national and state levels. As per the methodology of poverty estimate recommended by an expert committee set up by the Planning Commission, the percentage of population below the official poverty line was 37.2 percent nationally and 41.8 percent in rural India in 2004–2005. It is revealed that more than one-third of the Indian population is living below the poverty line with an unequally higher burden placed on rural residents [1].

A decisive reduction in poverty and an expansion in economic opportunity for all sectors of the population is the goal of the eleventh five-year plan [2]. This goal is consistent with the objective of improving population health by ensuring better sanitary and living conditions for all and greater access to nutrition and health care for the economically disadvantaged population. Health is also an important dimension of well-being. Life expectancy or adult survival rate, which is a broad measure of population health, has significant effects on economic growth rates for low-income countries [16]. Improvement in people's health in general and women's health, in particular, is crucial for the attainment of the twin developmental goals of poverty reduction and economic growth.

Section snippets

Health and economic well-being at micro level

The role of health in influencing economic outcomes has been well understood at the micro level. Healthier workers are likely to be able to work longer because they are generally more productive than their relatively less healthy counterparts. As a result, they are able to secure higher earnings. Better health has a positive effect on the learning abilities of children and leads to better educational outcomes and increases the efficiency of human capital formation by individuals and households (

Women health and economic well-being

Reproductive health problems are the leading cause of women's ill health and death world-wide. When both women and men are taken into account, reproductive health conditions are the second highest cause of ill health globally after communicable diseases [8].

Women play an important role in household management. They are the health producer in the family. Poor maternal health has a direct negative impact on the well-being of infants and children [27], [35]. The same factors that cause maternal

Methodology and database

The study uses the data set of the District Level Household and Facility Survey-3 (DLHS-3) under the Reproductive Child Health (RCH) interventions that are being implemented by the Government of India. DLHS-3 was initiated in 2007 with a view to assess the utilisation of services provided by government health care facilities and people's perception about the quality of services. DLHS-3 covered 720,320 sample households in the country.

Chaudhuri and Gupta presented a profile of levels of living,

Results

Fig. 3 presents the box plots based on the data set of the DLHS-3 covering all districts of Indian States. The box plots illustrate the present scenario of women's reproductive health and provide a summary based on the median, quintile and extreme values and represent the inter-quartile range that contains the middle 50 percent of the values.

The box plots show the lowest value (the bottom horizontal line on each plot) and the highest value (the top horizontal line of each plot).

MHCI is as low

Discussion

In economic terms, health and education are the two cornerstones of human capital, which Nobel Laureates Theodore Shultz and Gary Becker have demonstrated to be the basis of an individual's economic productivity. As with the economic well-being of individual households, good population health is a critical input into poverty reduction, economic growth, and long-term economic development at the scale of whole societies [11].

Improved health contributes to the economic growth in four ways: it

Acknowledgement

The author acknowledges the guidance provided by Dr. Sajal Chattopadhyay, Economic Advisor, Centers for Disease Control and Prevention, Atlanta, Georgia in preparing this paper.

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