Development Studies, International Institute for Population Science, Deonar, Mumbai, India.
PLoS One. 2013;8(3):e58573. doi: 10.1371/journal.pone.0058573. Epub 2013 Mar 29.
BACKGROUND/OBJECTIVE: Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India.
Using data from the third wave of the National Family Health Survey (NFHS, 2005-06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues.
The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501), institutional delivery (CI = -0.3214), children without fully immunization (CI = -0.18340), underweight children (CI = -0.19420), and infant deaths (CI = -0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India.
Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.
背景/目的：儿童和妇女在健康方面属于弱势群体，并且受到经济不平等通过多维度渠道的严重影响。与农村地区相比，城市地区被认为具有更好的社会经济和母婴健康指标。这种看法导致了卫生政策的实施，忽略了城市内部的卫生不平等现象。因此，本研究的目的是解释印度城市人口中母婴健康指标的经济不平等的途径。
本研究使用来自第三次国家家庭健康调查（NFHS，2005-06 年）的数据，计算了社会经济因素对关键母婴健康指标（如产前检查（ANC）、机构分娩、完全免疫儿童比例、体重不足儿童比例和婴儿死亡率（IMR））不平等的相对贡献。除了常规的 CI 估计外，本研究还应用了 Wagstaff 等人提出的广泛使用的基于回归的不平等分解模型。
CI 估计显示，妇女 ANC 少于 3 次（CI=-0.3501）、机构分娩（CI=-0.3214）、未完全免疫的儿童（CI=-0.18340）、体重不足的儿童（CI=-0.19420）和婴儿死亡（CI=-0.15596）方面存在相当大的经济不平等。分解模型的结果表明，妇女及其伴侣的文盲、经济状况差和大众媒体接触是导致母婴健康指标经济不平等的关键因素。所有分解模型中的残差都很小；这意味着上述因素解释了印度城市人口母婴健康不平等的最大因素。
研究结果表明，妇女及其伴侣的文盲、经济状况差和大众媒体接触是经济因素对印度城市母婴健康结果不平等产生影响的关键途径。
