Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India
Abstract Background Expansion of maternal health service coverage is crucial for the survival and wellbeing of both mother and child. To date, limited literature exists on the measurement of maternal health service coverage at the sub-national level in India. The prime objectives of the study were t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-022-05080-5 |
| _version_ | 1817983950688092160 |
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| author | Tanvi Kiran K. P. Junaid Vineeth Rajagopal Madhu Gupta Divya Sharma |
| author_facet | Tanvi Kiran K. P. Junaid Vineeth Rajagopal Madhu Gupta Divya Sharma |
| author_sort | Tanvi Kiran |
| collection | DOAJ |
| description | Abstract Background Expansion of maternal health service coverage is crucial for the survival and wellbeing of both mother and child. To date, limited literature exists on the measurement of maternal health service coverage at the sub-national level in India. The prime objectives of the study were to comprehensively measure the maternal health service coverage by generating a composite index, map India by categorizing it into low, medium and high zones and examine its incremental changes over time. Methods Utilising a nationally representative time series data of 15 key indicators spread across three domains of antenatal care, intranatal care and postnatal care, we constructed a novel ‘Maternal Health Service Coverage Index’ (MHSI) for 29 states and 5 union territories of India for the base (2017–18) and reference (2019–20) years. Following a rigorous procedure, MHSI scores were generated using both arithmetic mean and geometric mean approaches. We categorized India into low, medium and high maternal health service coverage zones and further generated geospatial maps to examine the extent and transition of maternal health service coverage from base to reference year. Results India registered the highest mean percentage coverage (93.7%) for ‘institutional delivery’ and the lowest for ‘treatment for obstetric complications’ (9.3%) among all the indicators. Depending on the usage of arithmetic mean and geometric mean approaches, the maternal health service coverage index score for India exhibited marginal incremental change (between 0.015—0.019 index points) in the reference year. West zone exhibited an upward transition in the coverage of maternal health service indicators, while none of the zones recorded a downward movement. The states of Mizoram (east zone) and the Union Territory of Puducherry (south zone) showed a downward transition. Union territories of Dadra & Nagar Haveli (west zone) and Chandigarh (north zone), along with the states of Maharashtra (west zone), Assam, as well as Jharkhand (both from the east & north east zone), showed upward transition. Conclusion Overall, maternal health service coverage is increasing across India. Our study offers a novel summary measure to comprehensively quantify the coverage of maternal health services, which can momentously help India identify lagged indicators and low performing regions, thereby warranting the targeted interventions and concentrated programmatic efforts to bolster the maternal health service coverage at the sub-national level. |
| first_indexed | 2024-04-13T23:38:39Z |
| format | Article |
| id | doaj.art-1931270a69d94fc9a06ccd3d334a8f8c |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T23:38:39Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-1931270a69d94fc9a06ccd3d334a8f8c2022-12-22T02:24:36ZengBMCBMC Pregnancy and Childbirth1471-23932022-10-0122111710.1186/s12884-022-05080-5Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in IndiaTanvi Kiran0K. P. Junaid1Vineeth Rajagopal2Madhu Gupta3Divya Sharma4Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)Abstract Background Expansion of maternal health service coverage is crucial for the survival and wellbeing of both mother and child. To date, limited literature exists on the measurement of maternal health service coverage at the sub-national level in India. The prime objectives of the study were to comprehensively measure the maternal health service coverage by generating a composite index, map India by categorizing it into low, medium and high zones and examine its incremental changes over time. Methods Utilising a nationally representative time series data of 15 key indicators spread across three domains of antenatal care, intranatal care and postnatal care, we constructed a novel ‘Maternal Health Service Coverage Index’ (MHSI) for 29 states and 5 union territories of India for the base (2017–18) and reference (2019–20) years. Following a rigorous procedure, MHSI scores were generated using both arithmetic mean and geometric mean approaches. We categorized India into low, medium and high maternal health service coverage zones and further generated geospatial maps to examine the extent and transition of maternal health service coverage from base to reference year. Results India registered the highest mean percentage coverage (93.7%) for ‘institutional delivery’ and the lowest for ‘treatment for obstetric complications’ (9.3%) among all the indicators. Depending on the usage of arithmetic mean and geometric mean approaches, the maternal health service coverage index score for India exhibited marginal incremental change (between 0.015—0.019 index points) in the reference year. West zone exhibited an upward transition in the coverage of maternal health service indicators, while none of the zones recorded a downward movement. The states of Mizoram (east zone) and the Union Territory of Puducherry (south zone) showed a downward transition. Union territories of Dadra & Nagar Haveli (west zone) and Chandigarh (north zone), along with the states of Maharashtra (west zone), Assam, as well as Jharkhand (both from the east & north east zone), showed upward transition. Conclusion Overall, maternal health service coverage is increasing across India. Our study offers a novel summary measure to comprehensively quantify the coverage of maternal health services, which can momentously help India identify lagged indicators and low performing regions, thereby warranting the targeted interventions and concentrated programmatic efforts to bolster the maternal health service coverage at the sub-national level.https://doi.org/10.1186/s12884-022-05080-5Maternal healthService coverageIndian statesComposite indexAntenatal careIntrapartum care |
| spellingShingle | Tanvi Kiran K. P. Junaid Vineeth Rajagopal Madhu Gupta Divya Sharma Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India BMC Pregnancy and Childbirth Maternal health Service coverage Indian states Composite index Antenatal care Intrapartum care |
| title | Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India |
| title_full | Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India |
| title_fullStr | Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India |
| title_full_unstemmed | Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India |
| title_short | Measurement and mapping of maternal health service coverage through a novel composite index: a sub-national level analysis in India |
| title_sort | measurement and mapping of maternal health service coverage through a novel composite index a sub national level analysis in india |
| topic | Maternal health Service coverage Indian states Composite index Antenatal care Intrapartum care |
| url | https://doi.org/10.1186/s12884-022-05080-5 |
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