Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T07:25:26.341Z Has data issue: false hasContentIssue false
  • English
  • Français

REPRODUCTIVE AND CHILD HEALTH SERVICES AND DEMOGRAPHIC CHANGE IN THE DISTRICTS OF UTTAR PRADESH, 2002–13

Published online by Cambridge University Press:  03 October 2016

Mamta Rajbhar  and
Sanjay K. Mohanty
Mamta Rajbhar*
Affiliation:
International Institute for Population Sciences, Deonar, Mumbai, India
Sanjay K. Mohanty
Affiliation:
Department of Fertility Studies, International Institute for Population Sciences, Deonar, Mumbai, India
*
1Corresponding author. Email:kmmamta.manu@gmail.com
Get access Rights & Permissions [Opens in a new window]

Summary

This study examined the effect of reproductive and child health (RCH) services on fertility and child mortality in the districts of Uttar Pradesh. It specifically measured the effect of antenatal care, medical assistance at birth, child immunization and use of modern methods of contraception on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and Under-five Morality Rate (U5MR) before and after the National Rural Health Mission (NRHM) period. Data from the 2002–04 District Level Household Survey (DLHS-2), 2012–13 Annual Health Survey (AHS) and the 2001 and 2011 Censuses of India were used. The TFR and U5MR were estimated from the Census of India with district as the unit of analysis. Descriptive statistics, composite indices, random- and fixed-effects models and difference-in-difference models were used to understand the effect of RCH services on the reduction in TFR, IMR and the U5MR. The results suggest large inter-district variations in the coverage of RCH services in the state. During the post-NRHM period, improvement was highest in safe delivery followed by immunization coverage and antenatal care and least for contraceptive use in most districts. The relative ranking of districts has not changed much over time. In 2002–04, the RCH Index was highest in Lucknow (0.442) followed by Ballia and least in Kaushambi (0.115). By 2012–13, it was highest in Jhansi (0.741) and lowest in Shrawasti (0.241). The districts of Kaushambi, Unnao, Mahoba, Banda and Hardoi performed better in the RCH Index over time, while Ballia, Gautam Buddha Nagar, Kanpur Nagar, Pratapgarh and Sonbhadra remained poor. The RCH service coverage and demographic outcomes were poor in seven districts, particularly those in eastern and western Uttar Pradesh. The regression analyses suggest that the RCH Index exerts greater influence on the reduction in IMR and U5MR, while female literacy exerts greater influence on the reduction in TFR. The results of the hybrid model suggest that a 10% change in RCH Index would lead to a 3 point decline in IMR, and a 10% increase in female literacy would lead to a 0.2 point decline in TFR. The study suggests continuing investment in female education and RCH services with a greater focus on poor-performing districts to realize demographic and health targets.

Type
Research Article
Information
Journal of Biosocial Science , Volume 49 , Issue 5 , September 2017 , pp. 685 - 709
Copyright
Copyright © Cambridge University Press, 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alagarajan, M. (2003) An analysis of fertility differentials by religion in Kerala state: a test of the interaction hypothesis. Population Policy and Research Review 22, 557–574.Google Scholar
Alagarajan, M. & Kulkarni, P. M. (1998) Fertility differentials by religion in Kerala – a period parity progression ratio analysis. Demography India 27(1), 213–228.Google Scholar
Alagarajan, M. & Kulkarni, P. M. (2008) Religious differentials in fertility in India: is there a convergence? Economic and Political Weekly 43(48), 44–53.Google Scholar
Angeles, G., Guilkey, D. K. & Mroz, T. A. (2004) The Effects of Education and Family Planning Programs on Fertility in Indonesia. Carolina Population Center.Google Scholar
Arokiasamy, P. & Goli, S. (2012) Fertility convergence in the Indian states: an assessment of changes in averages and inequalities in fertility. Genus LXVIII (1), 65–88.Google Scholar
Bairagi, R. & Datta, A. K. (2001) Demographic transition in Bangladesh: what happened in the twentieth century and what will happen next? Asia-Pacific Population Journal 16(4), 3–16.Google Scholar
Bhat, P. N. M. (1996) Contours of fertility decline in India. In Srinivasan, K. (ed.) Population Policy and Reproductive Health. Hindustan Publishing Corporation, New Delhi.Google Scholar
Bongaarts, J. (2003) Completing the Fertility Transition in the Developing World: The Role of Educational Differences and Fertility Preferences. Working Paper, Policy Research Division, Population Council, New York.CrossRefGoogle Scholar
Breiman, R. F., Streatfield, P. K., Phelan, M., Shifa, N., Rashid, M. & Yunus, M. (2004) Effect of infant immunization on childhood mortality in rural Bangladesh: analysis of health and demographic surveillance data. The Lancet 364, 2204–2211.Google Scholar
Dorius, S. F. (2008) Global demographic convergence? A reconsideration of changing inter-country inequality in fertility. Population and Development Review 34(3), 519–539.CrossRefGoogle Scholar
Dorius, S. F. (2010) Demystifying inter-country inequality: data, measures, and long-run trends in the inter-country and global distribution of human well-being. Dissertation in Sociology and Demography, the Pennsylvania State University. URL: https://etda.libraries.psu.edu/paper/11051/4963 (accessed 12th June 2015).Google Scholar
Franklin, R. S. (2002) Fertility convergence across Italy’s regions, 1952–1995. Paper presented at the 41st Annual Meeting, Western Regional Science Association, Monterey, CA.Google Scholar
IIPS (2002–04) District Level Household Survey-II. International Institute for Population Sciences, Ministry of Health and Family Welfare, Government of India, Mumbai.Google Scholar
James, K. S. & Nair, S. B. (2005) Accelerated decline in fertility in India since the 1980s: trends among Hindus and Muslims. Economic and Political Weekly 45(5), 375–384.Google Scholar
Koblinsky, M. A. (2003) Reducing Maternal Mortality. Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe. World Bank, Washington, DC.Google Scholar
Kristensen, I., Aaby, P. & Jensen, H. (2000) Routine vaccinations and child survival: follow-up study in Guinea-Bissau, West Africa. British Medical Journal 321, 1435–1450.Google Scholar
Lanzieri, G. (2010) Is There a Fertility Convergence Across Member States of the European Union? Working Paper 1, United Nations Statistical Commission and Economic Commission for Europe.Google Scholar
Lee, R. D. & Reher, D. S. (2011) Demographic transition and its consequences. In Birdsall, N., Kelley A. C. & Sinding, S. (eds) Population Matters: Demographic Change, Economic Growth, and Poverty in the Developing World. Supplement to Population and Development Review Vol. 37. Oxford University Press, New York, pp. 201–212.Google Scholar
Liu, L. & Becker, S. (2008) Three methods of estimating births averted nationally by contraception. Population Studies 62(2), 191–210.Google Scholar
Mason, K. O. (1997) Explaining Fertility Transitions. Demography 34(4), 443–454.Google Scholar
Mohanty, S. K., Fink, G., Chauhan, R. K. & Canning, D. (2016) Distal determinants of fertility decline: evidence from 640 Indian Districts. Demographic Research 34, 373–407.CrossRefGoogle Scholar
Mohanty, S. K. & Srivastava, A. (2012) Out-of-pocket expenditure on institutional delivery in India. Health Policy and Planning 28(3), 247–262.Google Scholar
Rajan, S. I., Nair, P. M., Sheela, K. L., Jagatdev, L. & Mishra, N. R. (2008) Infant and Child Mortality in India, District Level Estimates. Population Foundation of India.Google Scholar
Reher, D. S. (2004) The demographic transition revisited as a global process. Population Space and Place 10, 19–41.Google Scholar
Registrar General of India (2003) Sample Registration System Statistical Report 2002. Office of the Registrar General, Government of India, New Delhi.Google Scholar
Registrar General of India (2010–11) Annual Health Survey Bulletins. Office of the Registrar General and Census Commissioner, Government of India. URL: http://censusindia.gov.in/2011-common/AHSurvey.html (accessed 12th June 2015).Google Scholar
Registrar General of India (2012–13) Annual Health Survey Bulletins. Office of the Registrar General and Census Commissioner, Government of India. URL: http://censusindia.gov.in/2011-common/AHSurvey.html (accessed 12th June 2015).Google Scholar
Registrar General of India (2014) Sample Registration System Statistical Report 2013. Office of the Registrar General, Government of India, New Delhi.Google Scholar
Seltzer, J. R. (2002) The Origins and Evolution of Family Planning Programs in Developing Countries. RAND Corporation, Santa Monica, CA.Google Scholar
Shen, C. & Williamson, J. B. (1999) Maternal mortality, women’s status, and economic dependency in less developed countries: a cross national analysis. Social Science & Medicine 49, 197–214.Google Scholar
Stover, J. & Ross, J. (2010) How increased contraceptive use has reduced maternal mortality. Maternal Child Health Journal 14, 687–695.Google Scholar
Watkins, S. C. (1990) From Provinces into Nations: Demographic Integration in Western Europe, 1870–1960. Princeton University Press, Princeton.Google Scholar
WHO, UNICEF & UNFPA (2013) Trends in Maternal Mortality: 1990 to 2013. The World Bank and the United Nations Population Division.Google Scholar
Wilson, C. (2001) On the scale of global demographic convergence 1950–2000. Population Development Review 27, 155–171.Google Scholar
UNICEF (2014) Levels and Trends in Child Mortality. Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. URL: http://www.childmortality.org/files_v20/download/IGME%20report%202015%20child%20mortality%20final.pdf (accessed 12th June 2015).Google Scholar