Authors: BM Ramesh, Bidyadhar Dehury, Shajy Isac, Vikas Gothalwal, Ravi Prakash, Vasanthakumar Namasivayam, Shivalingappa Halli, James Blanchard, Ties Boerma
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.
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.
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.
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.
This brief identifies the opportunity gaps in the effective coverage cascade for prevention of anaemia among pregnant women in India. The effective coverage cascade is used to identify coverage gaps, quantify coverage at each step, determine where the largest gaps exist within the cascade and prioritize where actions are most urgent. The findings are based on NFHS 5 data.
The 14th issue of PAHAL offers insights on UP TSU’s work in the second quarter of 2022. This issue provides an update on the initiatives taken by UP TSU for enhancing the availability of Iron Folic Acid supplementation for pregnant women, accelerating PPH Emergency Care by Bundle Approach, the activation of district hospital level validation committee meetings and other key interventions.
The Government of Uttar Pradesh, with support from the UP TSU, rolled out an IT-enabled real-time ASHA Incentive application to bring transparency and efficacy to the incentive system in Uttar Pradesh. This brief talks about the incentive system and how the digitalization of the process has helped in tracking and monitoring ASHA incentive payment and performance.