Deepak Saxena|Ruchi Vangani|Dileep Mavalankar|Sarah Thomsen
Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data
Indian Institute of Public Health Gandhinagar|Karolinska Institutet|Indian Institute of Public Health Gandhinagar|Indian Institute of Public Health Gandhinagar|Karolinska Institutet
background two decades launch safe motherhood campaign india still accounts least quarter maternal death globally gujarat one economically developed states india progress social sector commensurate economic growth purpose study use districtlevel data gain better understanding equity access maternal health care draw attention policy planers monitor equity maternal care methods secondary data analyses performed among 7534 evermarried women delivered since january 2004 district level household facility survey dlhs3 carried 20072008 gujarat india based conceptual framework designed commission social determinants health associations assessed three outcomes institutional delivery antenatal care anc use modern contraception selected intermediary structural determinants health using multiple logistic regression results inequities maternal health care utilization persist gujarat structural determinants like caste group wealth education significantly associated access minimum three antenatal care visits institutional deliveries use modern method contraceptive significant relationship poor access less utilization anc services independent caste category residence discussion conclusions poverty important determinant nonuse maternal health services gujarat addition social position ie caste strong independent effect maternal health service use focused targeted efforts towards disadvantaged groups needs taken policy level order achieve targets goals laid per mdgs particular government gujarat invest basic education infrastructural development begin remove structural causes nonuse maternal health services