Arnab Dey|Katherine Hay|Bilal Afroz|Dharmendra Chandurkar|Kultar Singh|Nabamallika Dehingia|Anita Raj|Jay G. Silverman
Understanding intersections of social determinants of maternal healthcare utilization in Uttar Pradesh, India
Sambodhi Research and Communications|Bill & Melinda Gates Foundation|Sambodhi Research and Communications|Sambodhi Research and Communications|Sambodhi Research and Communications|Sambodhi Research and Communications|Center for Health and Gender Equity|University of California, San Diego|Center for Health and Gender Equity|University of California, San Diego
objective explore intersections social determinants maternal healthcare utilization using classification regression trees cart algorithm machinelearning method used construct prediction models methods institutional review board approval study granted public health serviceethical review board phserb health ministry screening committee hmsc facilitated indian council medical research icmr irb review approval current analyses obtained university california san diego crosssectional data collected women children aged 011 months n 5565 rural households 25 districts uttar pradesh india participants surveyed maternal healthcare utilization including registration pregnancy model1 receipt antenatal care anc pregnancy model2 delivery health facilities model 3 social determinants health including wealth social group literacy religion early age marriage captured survey classification regression tree cart algorithm used explore intersections social determinants healthcare utilization results cart analyses highlight intersections particularly wealth literacy maternal healthcare utilization uttar pradesh model1 documents women poorer illiterate muslim less likely pregnancies registered 714 vs 860 overall sample model2 documents poorer illiterate women lowest anc coverage 377 vs 45 overall sample model3 developed deliveries health facilities highlighted illiterate poor women lowest representation among facility deliveries 596 vs 69 overall sample conclusion paper explores interactions determinants maternal healthcare utilization indicators findings paper highlights interaction wealth literacy play strong role accentuating diminishing healthcare utilization among women study also reveals religion womens age marriage also interact wealth literacy create substantial disparities utilization study provides insights effect intersections determinants highlights importance using nuanced understanding impact cooccurring forms marginalization effectively tackle inequities healthcare utilization