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Supply-Side Barriers to Maternity-Care in India: A Facility-Based Analysis

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  • Santosh Kumar
  • Emily Dansereau

Abstract

Background: Health facilities in many low- and middle-income countries face several types of barriers in delivering quality health services. Availability of resources at the facility may significantly affect the volume and quality of services provided. This study investigates the effect of supply-side determinants of maternity-care provision in India. Methods: Health facility data from the District-Level Household Survey collected in 2007–2008 were analyzed to explore the effects of supply-side factors on the volume of delivery care provided at Indian health facilities. A negative binomial regression model was applied to the data due to the count and over-dispersion property of the outcome variable (number of deliveries performed at the facility). Results: Availability of a labor room (Incidence Rate Ratio [IRR]: 1.81; 95% Confidence Interval [CI]: 1.68–1.95) and facility opening hours (IRR: 1.43; CI: 1.35–1.51) were the most significant predictors of the volume of delivery care at the health facilities. Medical and paramedical staff were found to be positively associated with institutional deliveries. The volume of deliveries was also higher if adequate beds, essential obstetric drugs, medical equipment, electricity, and communication infrastructures were available at the facility. Findings were robust to the inclusion of facility's catchment area population and district-level education, health insurance coverage, religion, wealth, and fertility. Separate analyses were performed for facilities with and without a labor room and results were qualitatively similar across these two types of facilities. Conclusions: Our study highlights the importance of supply-side barriers to maternity-care India. To meet Millennium Development Goals 4 and 5, policymakers should make additional investments in improving the availability of medical drugs and equipment at primary health centers (PHCs) in India.

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  • Santosh Kumar & Emily Dansereau, 2014. "Supply-Side Barriers to Maternity-Care in India: A Facility-Based Analysis," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-9, August.
    • Handle: RePEc:plo:pone00:0103927
    DOI: 10.1371/journal.pone.0103927
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    1. Alinda George & Pritee Sharma, 2023. "Spatial disparities in health status and access to health-related interventions in Madhya Pradesh," Asia-Pacific Journal of Regional Science, Springer, vol. 7(3), pages 865-902, September.
    2. Xiaotian Zhang & Lvlin Zhou & Henry Asante Antwi, 2019. "The impact of China's latest population policy changes on maternity insurance—a case study in Jiangsu Province," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 617-633, January.
    3. Joshua Amo-Adjei & Kofi Aduo-Adjei & Christiana Opoku-Nyamah & Chimaroake Izugbara, 2018. "Analysis of socioeconomic differences in the quality of antenatal services in low and middle-income countries (LMICs)," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-12, February.
    4. Mampi Bose, 2019. "Determinants of Choice of Care Providers During Childbirth in Rural West Bengal, India," Indian Journal of Human Development, , vol. 13(1), pages 47-70, April.

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