School of Economics, Shri Mata Vaishno Devi University, Katra, India.
Int J Health Care Qual Assur. 2020 Mar 1;ahead-of-print(ahead-of-print):0. doi: 10.1108/IJHCQA-08-2018-0212.
The present study delves into the health inequalities between the two most socially deprived groups namely Scheduled Tribes (STs) and Scheduled Castes (SCs) in rural India.
DESIGN/METHODOLOGY/APPROACH: This study used health-specific three rounds of National Sample Survey Office (NSSO) unit-level data for analyses. Probit model has been used to predict the differences in access to maternal healthcare services. Blinder-Oaxaca decomposition method is used to explore the inequality in health of rural population in India and assess the estimated relative contribution of socioeconomic and demographic factors to inequalities in maternal health.
The study establishes that STs women often perform poorly compared to SCs in terms of maternal health such as antenatal care, postnatal care and institutional delivery. Blinder-Oaxaca decomposition method shows that there exist health inequalities between STs and SCs women. Difference in household income contributes 21-34 percent and women's education 19-24 percent in the gap of utilization of maternal healthcare services between SCs and STs women. A substantial part of this difference is contributed by availability of water at home and geographical region. Finally, the study offers some policy suggestions in order to mitigate the health inequalities among socially marginalized groups of SCs and STs women in rural areas.
ORIGINALITY/VALUE: This study measures and explains inequalities in maternal health variables such as antenatal care, postnatal care and institutional delivery in rural India. Research on access to maternal healthcare facilities is needed to improve the health of deprived sections such as STs and SCs in India. The results of this study pinpoint the need for public health decision-makers in India to concentrate on the most deprived and vulnerable sections of the society. This study thus makes a detailed and tangible contribution to the current knowledge of health inequalities between the two most deprived social groups, i.e., SCs and STs.
本研究探讨了印度农村中两个最贫困的社会群体，即在册部落（ST）和在册种姓（SC）之间的健康不平等问题。
设计/方法/方法：本研究使用了健康特定的三轮国家抽样调查办公室（NSSO）单位级别的数据进行分析。使用概率模型来预测获得产妇医疗保健服务的差异。使用 Blinder-Oaxaca 分解方法来探索印度农村人口的健康不平等，并评估社会经济和人口因素对产妇健康不平等的估计相对贡献。
该研究表明，在产前护理、产后护理和机构分娩等产妇健康方面，ST 妇女的表现往往不如 SC 妇女。Blinder-Oaxaca 分解方法表明，ST 妇女和 SC 妇女之间存在健康不平等。家庭收入差异贡献了 21-34%，妇女教育贡献了 19-24%，这导致了 SC 妇女和 ST 妇女在利用产妇医疗保健服务方面的差距。这种差异的很大一部分是由家庭内可用水和地理位置造成的。最后，本研究提出了一些政策建议，以减轻农村地区 SC 和 ST 等社会边缘化群体的健康不平等。
原创性/价值：本研究衡量并解释了印度农村地区产妇健康变量（如产前护理、产后护理和机构分娩）的不平等现象。需要研究获得产妇医疗保健设施的机会，以改善印度贫困阶层（如 ST 和 SC）的健康状况。本研究的结果指出了印度公共卫生决策者需要关注社会中最贫困和最脆弱的阶层。因此，本研究为 SC 和 ST 这两个最贫困的社会群体之间的健康不平等问题提供了详细和切实的贡献。
