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印度在获取孕产妇健康福利方面的社会经济不平等的影响:基于 NFHS 数据的《孕产妇安全保障计划》证据。

Impact of socio-economic inequity in access to maternal health benefits in India: Evidence from Janani Suraksha Yojana using NFHS data.

机构信息

PhD Research Scholar, Population Research Centre, Institute for Social and Economic Change, Bengaluru, Karnataka, India.

PhD Research Scholar, Center for Economic Studies and Policy, Institute for Social and Economic Change, Bengaluru, Karnataka, India.

出版信息

PLoS One. 2021 Mar 11;16(3):e0247935. doi: 10.1371/journal.pone.0247935. eCollection 2021.

Abstract

BACKGROUND

Caste plays a significant role in Indian society and it influences women to health care access in the community. The implementation of the maternal health benefits scheme in India is biased due to caste identity. In this context, the paper investigates access to Janani Suraksha Yojana (JSY) among social groups to establish that caste still plays a pivotal role in Indian society. Also, this paper aims to quantify the discrimination against Scheduled Castes/Scheduled Tribes (SCs/STs) in accessing JSY.

METHODS

This paper uses a national-level data set of both NFHS-3 (2005-06) and NFHS-4 (2015-16). Both descriptive statistics and the Fairlie decomposition econometric model have been used to measure the explained and unexplained differences in access to JSY between SCs/STs and non-SCs/STs groups.

RESULTS

Overall, the total coverage of JSY in India is still, 36.4%. Further, it is found that 72% of access to JSY is explained by endowment variables. The remaining unexplained percentage (28%) indicates that there is caste discrimination (inequity associated social-discrimination) against SCs/STs in access to JSY. The highest difference (54%) between SCs/STs and non-SCs/STs in access to JSY comes from the wealth quintile, with the positive sign indicating that the gap between the two social groups is widening.

DISCUSSION AND CONCLUSION

It is necessary for the government to implement a better way to counter the caste-based discrimination in access to maternal health benefits scheme. In this regard, ASHA and Anganwadi workers must be trained to reduce the influence of dominant caste groups as well as they must be recruited from the same community to identify the right beneficiaries of JSY and in order to reduce inequity associated with social-discrimination.

摘要

背景

种姓在印度社会中扮演着重要的角色,它影响着社区中妇女获得医疗保健的机会。印度的孕产妇健康福利计划的实施因种姓身份而存在偏见。在这种背景下,本文研究了社会群体获得贾纳尼·苏拉卡沙亚约纳纳(简称 JSY)的情况,以确定种姓在印度社会中仍然起着关键作用。此外,本文旨在量化在获得 JSY 方面针对在册种姓/在册部落(简称 SC/ST)的歧视。

方法

本文使用了国家一级的数据集,包括 NFHS-3(2005-06 年)和 NFHS-4(2015-16 年)。本文使用了描述性统计和费尔利分解计量经济学模型,以衡量 SC/ST 群体和非 SC/ST 群体在获得 JSY 方面的可解释和不可解释差异。

结果

总体而言,印度 JSY 的总覆盖率仍为 36.4%。此外,研究发现,72%的 JSY 获得是由禀赋变量解释的。剩余的无法解释的百分比(28%)表明,在获得 JSY 方面,存在针对 SC/ST 的种姓歧视(与社会歧视相关的不公平)。SC/ST 群体和非 SC/ST 群体在获得 JSY 方面的最大差异(54%)来自于财富五分位数,这一正号表明两个社会群体之间的差距正在扩大。

讨论与结论

政府有必要实施更好的方法来消除在获得孕产妇健康福利计划方面的种姓歧视。在这方面,ASHA 和安加纳瓦迪工作人员必须接受培训,以减少主导种姓群体的影响,并且他们必须从同一社区招募,以确定 JSY 的正确受益人和减少与社会歧视相关的不公平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76a9/7951864/2ea40a433028/pone.0247935.g001.jpg

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