Department of Geography, Delhi School of Economics, University of Delhi, New Delhi, India.
Department of Geography, Kalindi College, University of Delhi, New Delhi, India.
PLoS One. 2024 Jun 10;19(6):e0301587. doi: 10.1371/journal.pone.0301587. eCollection 2024.
Health is an inseparable part of life and central to all life supporting systems. The reproductive and child health shares a major portion of public health cases that is crucial for socio-economic development. Studies on reproductive and child health have traditionally been focused on demographic aspects using socio-economic parameters. Given the emphasis of Sustainable Development Goal (SDG)-3 on health and well-being, it is imperative to understand the geo-spatial dimension with the visible transition of key health indicators of fertility, maternal and infant/child health in the high burdened districts within these high focus Empowered Action Group (EAG) states of Rajasthan, Madhya Pradesh, Uttar Pradesh and Bihar that make up nearly 40% of India's population with relatively laggard health status.
This paper aims to understand the status and trend of key reproductive and child health indicators and vital statistics based on the recent representative demographic surveys. We intend to undertake a district level spatio-temporal analysis by developing District Composite Health Profile (DCHP) using Composite Index Method on selected 13 equally weighted key reproductive and child health indicators. The study has been carried out using data from National Family Health Survey-4 (2015-16) and National Family Health Survey-5 (2019-21) survey rounds. We employed geo-spatial techniques i.e. Moran's-I, and univariate LISA to comprehend the geographical clustering of high and low health burden districts and their heterogeneities at the district level.
RESULTS/CONCLUSIONS: The study highlights emerging inter-districts, and inter-state disparities over survey periods. With consistent improvement in the selected EAG states over time, the overall reproductive and child health status through DCHP along with each indicator was relatively better in the states of Rajasthan and worse in Bihar. Districts along the Terai belt in Uttar Pradesh and Bihar consistently performed sluggish during survey rounds. The geo-spatial clustering follows the political boundary of states, albeit with intra-state variations. Monitoring of key health indicators using composite index method provides a useful leverage for identifying priority districts/regions for universal health access that should also consider geographical space as an important policy dimension.
健康是生命不可分割的一部分，也是所有生命支持系统的核心。生殖健康和儿童健康占据了大部分公共卫生案例，对社会经济发展至关重要。传统上，生殖健康和儿童健康研究主要集中在使用社会经济参数的人口统计学方面。鉴于可持续发展目标 3 对健康和福祉的重视，了解高负担地区的关键健康指标——生育率、母婴和儿童/青少年健康的地理空间维度至关重要，这些地区在拉贾斯坦邦、中央邦、北方邦和比哈尔邦等重点授权行动组（EAG）邦内，这些邦占印度人口的近 40%，健康状况相对滞后。
本文旨在根据最近具有代表性的人口普查数据，了解主要生殖健康和儿童健康指标的现状和趋势。我们计划通过使用综合指数法对 13 个同等加权的关键生殖健康和儿童健康指标进行开发，对选定的 13 个同等加权的关键生殖健康和儿童健康指标进行地区层面的时空分析。这项研究是利用国家家庭健康调查 4 （2015-16 年）和国家家庭健康调查 5 （2019-21 年）的调查数据进行的。我们采用了地理空间技术，即 Moran's-I 和单变量 LISA，以了解高和低健康负担地区的地理聚类及其在地区层面的异质性。
结果/结论：该研究强调了调查期间不断出现的地区间和州际差距。随着时间的推移，EAG 州的选择有所改善，通过 DCHP 以及每个指标的整体生殖健康和儿童健康状况在拉贾斯坦邦相对较好，在比哈尔邦则较差。在北方邦和比哈尔邦的特赖地区，各地区在调查期间的表现一直很缓慢。地理空间聚类遵循州的政治边界，尽管存在州内差异。使用综合指数方法监测关键健康指标为确定普及全民健康的优先地区/区域提供了有用的手段，这也应考虑到地理空间作为一个重要的政策维度。
