Measuring the inequality in the coverage of Reproductive, Maternal, New-born and Child Health Coverage Indicators in India Using National Family Health Survey, 2015-16

Sumirtha Gandhi, Tulasi Malini Maharatha, Umakant Dash & Suresh Babu M


BASE University Working Paper Series: 05/2021


Diligent monitoring of coverage of essential reproductive, maternal, new-born and child health related services (RMNCH) becomes imperative to smoothen the journey towards SDGs. In this study, we aim to measure the magnitude of inequalities in the coverage of RMNCH services. We also made an attempt to divulge the relationship between the various themes of governance and RMNCH indices. We used National Family Health Survey dataset (2015-16) and Public Affairs Index (PAI), 2016 for the analysis by employing two summative indices, namely Composite Coverage Index (CCI) and Co-Coverage (Co-Cov) indicator to measure the RMNCH coverage. Two analytical tools such as Slope Index of Inequality (SII), Relative Index of Inequality (RII) were adopted to measure inequality in the distribution of coverage of RMNCH. In addition, we have used Spearman’s rank correlation matrix to assess the association between governance indicator and coverage indices. We found that, both CCI and Co-Cov were inequitably distributed across different states. Our results show that, the RII values for the states like Punjab, Tamil Nadu and West Bengal hover around 1, indicating a movement towards equality. Whereas, the ratio of RII is highest in Haryana, where the utilisation by wealthiest section is 2.01 times more than the poorest sections. It is important to allude that the coverage of essential interventions like ANC4, DPT3, Family Planning, Measles and SBA show bottom level inequalities. The spearman’s rank correlation (coefficient ranging between 0.61 and 0.67) exhibited an emergence of strong and positive correlation between governance index and RMNCH services. We suggested that outreach programs related to ANC services at grassroot or village levels can be promoted and monitored by the centralised agency to ensure greater reach.