Geospatial analysis of utilization of maternal health care services in india

Millions of women in developing countries experience life-threatening health problems related to pregnancy or childbirth. Despite several policies and program provisioning the accessibility, availability, and affordability of maternal health care services, improvement in maternal health remains a challenge to the Indian health care system. This study is an attempt to measure maternal health care utilization with the help of geospatial techniques. Outcome variables include full antenatal care and institutional delivery. Exposure variables include the number of hospitals, number of bed in hospitals, number of doctors, number of medical shops, average nearest hospital facility, Schedule Caste and Schedule Tribe, and female literacy. Two regression models, namely ordinary least square (OLS) and Spatial Error Model (SEM), were employed. A correlation matrix was computed to assess the association between the outcome variable and predictors before applying the multivariate spatial OLS and spatial error models (SEM). Result found that female literacy is positively significant with full ANC in OLS (0.334 "0.000") and SEM (0.259 "0.000") models. Average Hospital distance is positively significant with institutional deliveries in both OLS (0.112 "0.009") and SEM (0.082 "0.044") models. High-high clusters are concentrated in the southern region. Uttar Pradesh, Rajasthan, and Bihar have clusters of low female literacy and low antenatal care. The primary concern is the clustering of low full Ante-natal care and Institutional delivery in certain pockets of the country like Uttar Pradesh, Bihar, and Madhya Pradesh. Promoting community-based education for improved maternal care could bring significant improvements in maternal health in the high priority districts.