Utilization of maternal health care services in India: household economy vs. political economy

Sonalde B. Desai, University of Maryland
Lijuan Wu, Pennsylvania State University

There is great regional variation on utilization of maternal health care services across India. While regional differences have long been established, why women in some states are more likely to utilize maternity care than in others still remains poorly understood. Research efforts to date have focused on controlling for such individual characteristics as education, age, parity, and household socioeconomic status in order to see if variations in these explain the regional variation. We take a different approach and argue that the observed regional differences in India reflect two major dimensions affecting maternity care utilization: (1) Marriage and kinship patterns which determine the extent to which households are willing to invest in women’s health; and (2) Characteristics of the state and civil society which determine the extent to which households are willing to trust medical systems. Using the data from our newly collected India Human Development Survey 2004-2005, we examine these relationships using hierarchical linear models.