Determinants of maternal care utilization among young Muslim women in India

Indian Muslims, compared to their counterparts from other religions, lag behind on several yardsticks related to socioeconomic progress and the same is true with maternal health care utilization. Due to low age at marriage among Muslims, a majority of births is ascribed to young (15-24 years) mothers, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literatures on Muslim women’s maternal health care reveals that the research on the determinants of maternal health care utilization among Muslim women is almost absent. Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators [Full Antenatal Care (ANC), safe delivery and Postnatal Care (PNC)] among YMMW (15-24 years) in India. Bi-variate analysis and chi-square test was applied and variables which were found to be significant were further included in binary logistic regression. The findings of the study reveal abysmally low levels of utilization for all three indicators of maternal health care i.e. full ANC, safe delivery and PNC. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. The study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW. Existing government policies and programs should integrate YMMW who are poor and belong to backward states with poor demographic indicators.​

A Disaggregated Analysis of Change in Household Out-Of-Pocket Expenditure on Healthcare in India, 1995-2004

No study has yet attempted to measure mean out-of-pocket expenditure on health care at household level, separately for government and private health facilities in India. Therefore, this study analyses the change in the out-of-pocket expenditure between 1995-96 and 2004 for fifteen major states of India, separately for rural/urban sector and inpatient/outpatient care. Using data from the 52nd and 60th rounds of the National Sample Survey, we present a disaggregated analysis of the trends and patterns of inflation adjusted household expenditure on health care. The analysis of average household expenditure on health care demonstrated that the mean outpatient care expenditure in government health sector decreased marginally at the aggregate level in both rural and urban sector, whereas it showed a significant increase in private facilities. A substantial rural-urban differential was also observed regarding households’ mean hospitalization expenditure in private hospitals while the same was not true for government hospitals. Almost all states observed a very high growth in households’ mean hospitalization expenditure in the private sector, while it was quite low in the government sector and even negative in rural areas of some states. The same pattern was observed in the growth pattern of households’ outpatient care expenditure. The analyses indicated a little improvement in the performance of government health sector in terms of out-of pocket expenditure. The improvement was more visible in developed and less developed states than in least developed states. Similarly, the improvement was more visible in rural areas than in urban areas.