Maternal healthcare utilisation, women empowerment, and delivery care: geographical variations in India

Abstract

This study utilises the National Family Health Survey- 5 (NHFS-5) data to compare performance in three key indicators called pillars of maternal health, namely–Maternal Healthcare Utilisation (MHU), Women Empowerment (WE), and Delivery Care (DC) across six zones of India: East, West, North, South, Central, and Northeast. It employs the Statistical Performance Index (SPI) by the World Bank to calculate zonal scores for the pillars. Univariate and multivariate statistical analyses reveal significant zonal disparities in all the three pillars (MHU: p < .001, WE: p < .002, and DC: p < .010). Northeast zone has the lowest MHU score ( M = 56.52) and the second-lowest DC score ( M = 46.60), despite having the second highest WE score ( M = 66.37), only behind the South zone which leads in all pillars (MHU; M = 80.38, WE; M = 69.21, and DC; M = 57.60). WE accounts for only a small part of the variability in MHU ( R 2 = .166), indicating that WE alone is insufficient to improve MHU outcomes. This study emphasises the need for further exploration of factors such as difficult terrains and low hospital density, especially in the Northeast zone.