Skip to main content
Top
Published in: Journal of Urban Health 2/2011

01-04-2011

Intra-urban Differentials in the Utilization of Reproductive Healthcare in India, 1992–2006

Authors: Abhishek Kumar, Sanjay K. Mohanty

Published in: Journal of Urban Health | Issue 2/2011

Login to get access

Abstract

This paper examines trends in three reproductive healthcare indicators— namely, antenatal care, medical assistance at delivery, and contraceptive use among the urban poor and non-poor in India using data from the National Family Health Surveys, 1992–1993 and 2005–2006. The urban poor and non-poor are derived from composite wealth indices based on a set of economic proxies. Results indicate that the estimates of poor and non-poor are reliable. During the last 14 years, the service coverage in all three indicators has increased in the country, among both the urban poor and non-poor. However, the utilization of reproductive health services is concentrated among the urban non-poor cutting across the states, with the exception of Kerala. While the non-poor/poor gap in antenatal care and medical assistance at delivery remained large over the years, the gap in contraceptive use has narrowed down cutting across states. After adjusting for other confounders, household poverty was found to be a significant barrier in the utilization of reproductive healthcare services across the states. It has been observed that the utilization of reproductive healthcare services followed a continuum of rural total, urban poor, and urban non-poor.
Appendix
Available only for authorised users
Literature
1.
go back to reference World Urbanization Prospects. The 2007 Revision Population Database, World Population Prospects: the 2006 Revision and World Urbanization Prospects. World Urbanization Prospects. The 2007 Revision Population Database, World Population Prospects: the 2006 Revision and World Urbanization Prospects.
2.
go back to reference Wratten E. Conceptualizing urban poverty. Environ Urban. 1995; 7(1): 11–38.CrossRef Wratten E. Conceptualizing urban poverty. Environ Urban. 1995; 7(1): 11–38.CrossRef
3.
go back to reference United Nations Population Fund. The state of the world population 1996. Changing places: population, development and the urban poor. New York: United Nations; 1996. United Nations Population Fund. The state of the world population 1996. Changing places: population, development and the urban poor. New York: United Nations; 1996.
5.
go back to reference Rossi-Espagnet A, Goldstein GB, Tabibzadeh I. Urbanization and health in developing countries: a challenge for health for all. World Health Stat Q. 1991; 44(4): 186–244. Rossi-Espagnet A, Goldstein GB, Tabibzadeh I. Urbanization and health in developing countries: a challenge for health for all. World Health Stat Q. 1991; 44(4): 186–244.
6.
go back to reference Monica MA, Zulu EM, Brockerhoff M. The inequality of maternal health care in urban sub-Saharan Africa in the 1990s. Pop Stud. 2003; 57(3): 347–366.CrossRef Monica MA, Zulu EM, Brockerhoff M. The inequality of maternal health care in urban sub-Saharan Africa in the 1990s. Pop Stud. 2003; 57(3): 347–366.CrossRef
7.
go back to reference Montgomery MR, Hewett PC. Urban poverty and health in developing countries: household and neighborhood effects. Demography. 2005; 42(3): 397–425.PubMedCrossRef Montgomery MR, Hewett PC. Urban poverty and health in developing countries: household and neighborhood effects. Demography. 2005; 42(3): 397–425.PubMedCrossRef
8.
go back to reference Monica M. Maternal and child health among the urban poor in Nairobi, Kenya. African Pop Stud. 2004; 19(2): 179–198. Monica M. Maternal and child health among the urban poor in Nairobi, Kenya. African Pop Stud. 2004; 19(2): 179–198.
9.
go back to reference Harpham T, Lusty T, Vaughan P. In the shadow of the city: community health and the urban poor. Oxford: Oxford University Press; 1998. Harpham T, Lusty T, Vaughan P. In the shadow of the city: community health and the urban poor. Oxford: Oxford University Press; 1998.
10.
go back to reference Bradley D, Stephens C, Harpham T, Cairncross S. A review of environmental health impacts in developing countries. Urban management program discussion paper 6. Washington: World Bank; 1992. Bradley D, Stephens C, Harpham T, Cairncross S. A review of environmental health impacts in developing countries. Urban management program discussion paper 6. Washington: World Bank; 1992.
11.
go back to reference Timaeus I, Lush L. Intra-urban differentials in child health. Health trans Rev. 1995; 5: 163–190. Timaeus I, Lush L. Intra-urban differentials in child health. Health trans Rev. 1995; 5: 163–190.
12.
go back to reference Atkinson AM. Rural and urban families’ use of child care. Family Relations. 1994; 43(1): 16–22.CrossRef Atkinson AM. Rural and urban families’ use of child care. Family Relations. 1994; 43(1): 16–22.CrossRef
13.
go back to reference Brockerhoff M, Brennan E. The poverty of cities in developing countries. Pop Develop Rev. 1998; 24(1): 75–114.CrossRef Brockerhoff M, Brennan E. The poverty of cities in developing countries. Pop Develop Rev. 1998; 24(1): 75–114.CrossRef
15.
go back to reference de Poel EV, O’Donnell O, Doorslaer EV. Are urban children really healthier? Evidences from 47 developing countries. Soc Sci Med. 2007; 65: 1986–2003.CrossRef de Poel EV, O’Donnell O, Doorslaer EV. Are urban children really healthier? Evidences from 47 developing countries. Soc Sci Med. 2007; 65: 1986–2003.CrossRef
16.
go back to reference Office of the Registrar General & Census Commissioner. Census of India, 2001, Final Population Totals, Series-1, Registrar General, Government of India, New Delhi; 2004. Office of the Registrar General & Census Commissioner. Census of India, 2001, Final Population Totals, Series-1, Registrar General, Government of India, New Delhi; 2004.
17.
go back to reference Bhagat RB. Rural-urban classification and municipal governance in India. Singapore J Tropical Geo. 2005; 26(1): 61–73.CrossRef Bhagat RB. Rural-urban classification and municipal governance in India. Singapore J Tropical Geo. 2005; 26(1): 61–73.CrossRef
18.
go back to reference Planning commission of India. Report of the expert group on estimation of proportion and number of poor. New Delhi: Press Information Bureau; 2007. Planning commission of India. Report of the expert group on estimation of proportion and number of poor. New Delhi: Press Information Bureau; 2007.
19.
go back to reference International Institute for Population Sciences (IIPS) & MACRO International. Health and living conditions in Eight Indian Cities. National Family Health Survey (NFHS-3), 2005–06: Mumbai, India: IIPS; 2007. International Institute for Population Sciences (IIPS) & MACRO International. Health and living conditions in Eight Indian Cities. National Family Health Survey (NFHS-3), 2005–06: Mumbai, India: IIPS; 2007.
20.
go back to reference Mulgaonkar VB, Parikh IG, Taskar VR, Dharap ND, Pradhan, VP. Perception of Bombay slum women regarding refusal to participate in a gynecological health program; 1994. Mulgaonkar VB, Parikh IG, Taskar VR, Dharap ND, Pradhan, VP. Perception of Bombay slum women regarding refusal to participate in a gynecological health program; 1994.
21.
go back to reference Brockerhoff M, Biddlecom AE. Migration, sexual behaviour and the risk of HIV in Kenya. Intern Migration Rev. 1999; 33(4): 833–856.CrossRef Brockerhoff M, Biddlecom AE. Migration, sexual behaviour and the risk of HIV in Kenya. Intern Migration Rev. 1999; 33(4): 833–856.CrossRef
22.
go back to reference Islam M, Montgomery M, Taneja S. Urban health and care-seeking behavior: a case study of slums in India and the Philippines. Bethesda: The Partners for Health Reformplus Project, ABT Associates Inc; 2006. Islam M, Montgomery M, Taneja S. Urban health and care-seeking behavior: a case study of slums in India and the Philippines. Bethesda: The Partners for Health Reformplus Project, ABT Associates Inc; 2006.
23.
go back to reference APHRC. Averting preventable maternal mortality: delays and barriers to the utilization of emergency obstetric care in Nairobi’s informal settlements. Unpublished report of the World Bank-funded Maternal Health Survey; 2006. APHRC. Averting preventable maternal mortality: delays and barriers to the utilization of emergency obstetric care in Nairobi’s informal settlements. Unpublished report of the World Bank-funded Maternal Health Survey; 2006.
24.
go back to reference Rutstein S, Johnson K, Montana L. Targeting Health Services to the Urban Poor: is Slum Geography Enough? Paper presented at the XXV International Population Conference, International Union for the Scientific Study of Population, Tours, France; 2005. Rutstein S, Johnson K, Montana L. Targeting Health Services to the Urban Poor: is Slum Geography Enough? Paper presented at the XXV International Population Conference, International Union for the Scientific Study of Population, Tours, France; 2005.
25.
go back to reference Khan Z, Mehnaz S, Khalique N, Ansari MA, Soddiqui AR. Poor perinatal care practices in urban slums: possible role of social mobilization networks. Ind J Commu Medic. 2008; 34(2): 102–107. Khan Z, Mehnaz S, Khalique N, Ansari MA, Soddiqui AR. Poor perinatal care practices in urban slums: possible role of social mobilization networks. Ind J Commu Medic. 2008; 34(2): 102–107.
26.
go back to reference Gupta M, Thakur J, Kumar R. Reproductive and child health inequalities in Chandigarh Union Territory of India. J Urban Health. 2008; 85: 291–299.PubMedCrossRef Gupta M, Thakur J, Kumar R. Reproductive and child health inequalities in Chandigarh Union Territory of India. J Urban Health. 2008; 85: 291–299.PubMedCrossRef
27.
go back to reference African Population and Health Research Centre (APHRC). Health and livelihood needs of residents of informal settlements in Nairobi City. Nairobi: African Population and Health Research Centre; 2002. African Population and Health Research Centre (APHRC). Health and livelihood needs of residents of informal settlements in Nairobi City. Nairobi: African Population and Health Research Centre; 2002.
28.
go back to reference UN-HABITAT. State of the world’s cities 2006/7. London: Earthscan publications Ltd. UN-HABITAT. State of the world’s cities 2006/7. London: Earthscan publications Ltd.
29.
go back to reference Madise N, Diamond I. Determinants of infant mortality in Malawi: an analysis to control for death clustering within families. J Bio Soc Sci. 1995; 27(1): 95–106. Madise N, Diamond I. Determinants of infant mortality in Malawi: an analysis to control for death clustering within families. J Bio Soc Sci. 1995; 27(1): 95–106.
30.
go back to reference Stephenson R. The impact of rural-urban migration on child survival in India. Unpublished thesis submitted for M.Phil. Candidature to the Department of Social Statistics, University of Southampton, UK; 1998. Stephenson R. The impact of rural-urban migration on child survival in India. Unpublished thesis submitted for M.Phil. Candidature to the Department of Social Statistics, University of Southampton, UK; 1998.
31.
go back to reference Sen A. Population: delusion and reality. New York Review, September 22, 1994. Sen A. Population: delusion and reality. New York Review, September 22, 1994.
32.
go back to reference Chattopadhyay A, Roy TK. Are urban poor doing better than their rural counterpart in India? A study of fertility, family planning and health. Demography India. 2005; 34(2): 299–312. Chattopadhyay A, Roy TK. Are urban poor doing better than their rural counterpart in India? A study of fertility, family planning and health. Demography India. 2005; 34(2): 299–312.
33.
go back to reference Ladusingh L, Singh HC. Rich-poor gap in maternal care: the case of northeast India. Asian Pop Stud. 2007; 3(1): 79–94.CrossRef Ladusingh L, Singh HC. Rich-poor gap in maternal care: the case of northeast India. Asian Pop Stud. 2007; 3(1): 79–94.CrossRef
34.
go back to reference Mohanty SK, Pathak PK. Rich-poor gap in utilization of reproductive and child health services in India. J Bio Soc Sci. 2008; 41(03): 381–398. Mohanty SK, Pathak PK. Rich-poor gap in utilization of reproductive and child health services in India. J Bio Soc Sci. 2008; 41(03): 381–398.
35.
go back to reference International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-3), 2005–06: India. Mumbai: IIPS; 2007. International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-3), 2005–06: India. Mumbai: IIPS; 2007.
36.
go back to reference Montgomery MR, Grangnolati M, Burke KA, Paredes E. Measuring living standards with proxy variables. Demography. 2000; 37(2): 1556–1574.CrossRef Montgomery MR, Grangnolati M, Burke KA, Paredes E. Measuring living standards with proxy variables. Demography. 2000; 37(2): 1556–1574.CrossRef
37.
go back to reference Vyas S, Kumaranayake L. Constructing Socio-economic status indices: how to use principal component analysis. Health Policy Plann. 2006; 21(6): 459–468.CrossRef Vyas S, Kumaranayake L. Constructing Socio-economic status indices: how to use principal component analysis. Health Policy Plann. 2006; 21(6): 459–468.CrossRef
38.
go back to reference Filmer D, Pritchett H. Estimating wealth effects without expenditure data-or tears: an application to educational enrollments in states of India. Demography. 2001; 38(1): 115–132.PubMed Filmer D, Pritchett H. Estimating wealth effects without expenditure data-or tears: an application to educational enrollments in states of India. Demography. 2001; 38(1): 115–132.PubMed
39.
go back to reference International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-1), 1992–93: India. Mumbai: IIPS; 1993. International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-1), 1992–93: India. Mumbai: IIPS; 1993.
40.
go back to reference International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-2), 1998–99: India. Mumbai: IIPS; 2000. International Institute for Population Sciences (IIPS), MACRO International. National Family Health Survey (NFHS-2), 1998–99: India. Mumbai: IIPS; 2000.
41.
go back to reference Mohanty SK. Alternative wealth indices and health estimates in India. Genus. 2009; LXV(2): 113–137. Mohanty SK. Alternative wealth indices and health estimates in India. Genus. 2009; LXV(2): 113–137.
42.
go back to reference Erreygers G. Correcting the concentration index. Research Paper 2006–07. Department of Economics, Faculty of Applied Economics, University of Antwerp. 2006. Erreygers G. Correcting the concentration index. Research Paper 2006–07. Department of Economics, Faculty of Applied Economics, University of Antwerp. 2006.
43.
go back to reference StatacCorporation. Stata statistical software: Release 8.0. College Station: StataCorp; 2003. StatacCorporation. Stata statistical software: Release 8.0. College Station: StataCorp; 2003.
44.
go back to reference Freedman LP, Graham WJ, Brazier E, et al. Practical lessons from global safe motherhood initiatives: time for a new focus on implementation. Lancet. 2007; 370: 1383–91.PubMedCrossRef Freedman LP, Graham WJ, Brazier E, et al. Practical lessons from global safe motherhood initiatives: time for a new focus on implementation. Lancet. 2007; 370: 1383–91.PubMedCrossRef
45.
go back to reference Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. Lancet. 2006; 368: 1189–200.PubMedCrossRef Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. Lancet. 2006; 368: 1189–200.PubMedCrossRef
46.
go back to reference Campbell OMR, Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006; 368: 1284–99.PubMedCrossRef Campbell OMR, Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006; 368: 1284–99.PubMedCrossRef
47.
go back to reference Ram F, Singh A. Is antenatal care effective in improving maternal health in rural Uttar Pradesh? Evidence from a district level household survey. J Bio Soc Sci. 2006; 38(4): 433–438. Ram F, Singh A. Is antenatal care effective in improving maternal health in rural Uttar Pradesh? Evidence from a district level household survey. J Bio Soc Sci. 2006; 38(4): 433–438.
48.
go back to reference Fotso JC, Ezeh A, Oronje R. Provision and use of maternal health services among urban poor women in Kenya: what do we know and what can we do? J Urban Health. 2008; 85(3): 428–42.PubMedCrossRef Fotso JC, Ezeh A, Oronje R. Provision and use of maternal health services among urban poor women in Kenya: what do we know and what can we do? J Urban Health. 2008; 85(3): 428–42.PubMedCrossRef
49.
go back to reference Kunst A, Houweling E. A global picture of poor–rich differences in the utilization of delivery care. Studies in Health Services Organizations and Policy. 2001; 17: 297–315. Kunst A, Houweling E. A global picture of poor–rich differences in the utilization of delivery care. Studies in Health Services Organizations and Policy. 2001; 17: 297–315.
50.
go back to reference Bankole A, Wesstoff CF. Mass media influences on contraceptive behavior and reproductive preferences. Paper Presented at the Annual Meeting of the Population Association of America, New Orleans, Lousiana; May 9–11, 1996. Bankole A, Wesstoff CF. Mass media influences on contraceptive behavior and reproductive preferences. Paper Presented at the Annual Meeting of the Population Association of America, New Orleans, Lousiana; May 9–11, 1996.
51.
go back to reference Ramesh BM, Gulati SC, Retherford RD. Contraceptive use in India, 1992–93. National Family Health Survey Subject Reports No. 2. Mumbai: International Institute for Population Sciences; and Honolulu: East–West Center, Program on Population; 1996. Ramesh BM, Gulati SC, Retherford RD. Contraceptive use in India, 1992–93. National Family Health Survey Subject Reports No. 2. Mumbai: International Institute for Population Sciences; and Honolulu: East–West Center, Program on Population; 1996.
52.
go back to reference Retherford RD, Mishra VK. Media exposure increases contraceptive use. National Family Health Survey Bulletin August (7). Mumbai: International Institute for Population Sciences and Honolulu: East–West Center Program on Population; 1997. Retherford RD, Mishra VK. Media exposure increases contraceptive use. National Family Health Survey Bulletin August (7). Mumbai: International Institute for Population Sciences and Honolulu: East–West Center Program on Population; 1997.
53.
go back to reference Rao KV, Mishra VK, Retherford RD. Effects of exposure to mass media on knowledge and use of oral rehydration therapy for childhood diarrhea in India. National Family Health Survey Subject Report No.10. Mumbai: International Institute for Population Sciences and Honolulu: East West Center Program on Population; 1998. Rao KV, Mishra VK, Retherford RD. Effects of exposure to mass media on knowledge and use of oral rehydration therapy for childhood diarrhea in India. National Family Health Survey Subject Report No.10. Mumbai: International Institute for Population Sciences and Honolulu: East West Center Program on Population; 1998.
54.
go back to reference Wong EL, Popkin BM, Guilkey DK, Akin AS. Accessibility, quality of care and prenatal care use in the Philippines. Soc Sci Med. 1987; 24(11): 927–944.PubMedCrossRef Wong EL, Popkin BM, Guilkey DK, Akin AS. Accessibility, quality of care and prenatal care use in the Philippines. Soc Sci Med. 1987; 24(11): 927–944.PubMedCrossRef
55.
go back to reference Bhatia JC, Cleland J. Determinants of maternal care in a region of South India. Health Trans Rev. 1995; 5(2): 127–142. Bhatia JC, Cleland J. Determinants of maternal care in a region of South India. Health Trans Rev. 1995; 5(2): 127–142.
Metadata
Title
Intra-urban Differentials in the Utilization of Reproductive Healthcare in India, 1992–2006
Authors
Abhishek Kumar
Sanjay K. Mohanty
Publication date
01-04-2011
Publisher
Springer US
Published in
Journal of Urban Health / Issue 2/2011
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-010-9532-7

Other articles of this Issue 2/2011

Journal of Urban Health 2/2011 Go to the issue