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.
A Monitoring and Evaluation Unit was established within UP TSU, to support the Government of Uttar Pradesh to enhance the use of data for decision-making in terms of data availability, accessibility, quality and use for improved health outcomes. This brief captures the innovative approaches and interventions adopted by UP TSU in strengthening government data eco-system in Uttar Pradesh.
This issue provides an update on UP-TSU’s efforts in integrating the Gender e-module in SBA training, a feedback workshop with Government of Uttar Pradesh health officials by medical college RRTC faculty members and support Monitoring and Evaluation division of National Health Mission on capacity building workshop for State/Division/District officials to improve data-driven decision-making.
In 2014, the Government of Uttar Pradesh, with the support of the UP TSU launched the Nurse Mentoring program in 25 high priority districts of the state. Based on the initial success, the program was scaled up across 820 blocks and 79 District Hospitals. This Photo Story captures the Nurse Mentoring Program at Aligarh District, highlighting the efforts on transition of the program to the government.