Authors: BM Ramesh, Bidyadhar Dehury, Shajy Isac, Vikas Gothalwal, Ravi Prakash, Vasanthakumar Namasivayam, Shivalingappa Halli, James Blanchard, Ties Boerma

ABSTRACT

Background

In 2001, India prioritized eight most socioeconomically disadvantaged states known as Empowered Action Group (EAG) states and in 2013, it prioritized 190 of the 718 as high priority districts (HPDs) to accelerate the decline in maternal and newborn mortality. This paper assesses whether the HPDs achieved a greater coverage of maternal and newborn health interventions than the non-HPDs and HPDs in EAG states achieved greater coverage than those in non-EAG states.

Methods

We used data from the Sample Registration System to assess rural neonatal mortality trends in EAG states and all India. We computed a co-coverage index based on seven maternal and newborn health interventions from the 2015/16 National Family Health Survey. Difference in differences (DID) analyses were used to examine the contribution of district prioritization, considering the HPDs and the illiterate as treatment groups and 2013 as the time cut-off for the pre- and post-treatment.

Results

Neonatal mortality declined in rural India from 36 to 27 per 1000 live births during 2010-2016 at 4.5% per year. Four EAG states experienced faster rates of decline than the national rate. From 2013, the co-coverage index increased significantly more in the HPDs compared to non-HPDs (DID = 0.11, P ≤ 0.005). The district prioritization effect on co-coverage was statistically significant in only EAG states (DID = 0.13, P ≤ 0.05). The coverage gains for illiterate mothers were greater than for literate mothers, especially in the HPDs.

Conclusions

The district prioritization in India is associated with greater improvements in the coverage of maternal and newborn health services in EAG states and the HPDs, including reductions in inequalities within those states and districts. There are however still large gaps between states and districts and within districts by the mother’s literacy status that need further prioritization to make progress towards the SDG targets by 2030.

Citation: Ramesh BM, Dehury B, Isac S, Gothalwal V, Prakash R, Namasivayam V, Halli S, Blanchard J, Boerma T. The contribution of district prioritization on maternal and newborn health interventions coverage in rural India. J Glob Health. 2020 Jun;10(1):010418. doi: 10.7189/jogh.10.010418. PMID: 32373334; PMCID: PMC7182352.

Read More
SHARE:

Recent Post

Gender-Responsive Healthcare: A Case Study

The SBA trainings are designed to enhance the capabilities of ANM and Staff Nurses (SNs) at District Hospitals, Community Health Centers (CHCs), and Primary Health Centers (PHCs) to improve the quality of intrapartum and newborn care and achieve better maternal and newborn health outcomes. In November 2022, a gender e-module was integrated into the SBA training to ensure gender-responsive service provision.
The video aims to capture the impact of the gender e-module training from Uma Shankar Dixit Women’s Hospital in Unnao and the steps taken by the staff and leadership to make the facility more gender-responsive, inclusive and equitable. 

PAHAL Issue 23

PAHAL Issue 23 highlights UPTSU’s contributions to improving healthcare in Uttar Pradesh. The key interventions include facilitating newborn care initiatives, launching training programs for healthcare staff, supporting ICDS in training Mukhya Sevikas, and improving vaccine coverage. These efforts demonstrate UP TSU’s commitment to making healthcare more accessible and effective across the state. The issue also highlights the activities conducted by the State Technical Support Unit TB – Uttar Pradesh, which includes the strategic push adopted to enhance the presumptive TB examination rate and also the training and pilot launch of the  Pharmacy app.

PAHAL Issue 22

The summer edition of this year’s PAHAL newsletter, highlights the remarkable progress UP-TSU has made in supporting the Health Department to advance public health across community, facility, and system levels in Uttar Pradesh.