title: Pathways of economic inequalities in maternal and child health in urban India: a decomposition analysis.
abstract: OBJECTIVE
  Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India.
  
  
  METHODS
  Using data from the third wave of the National Family Health Survey (NFHS, 2005-06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues.
  
  
  RESULTS
  The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501), institutional delivery (CI = -0.3214), children without fully immunization (CI = -0.18340), underweight children (CI = -0.19420), and infant deaths (CI = -0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India.
  
  
  CONCLUSIONS
  Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.
authors.affiliation: Development Studies, International Institute for Population Science, Deonar, Mumbai, India. sirispeaks2u@gmail.com
authors.forename: Srinivas
authors.initials: S
authors.lastname: Goli
authors.forename: Riddhi
authors.initials: R
authors.lastname: Doshi
authors.forename: Arokiasamy
authors.initials: A
authors.lastname: Perianayagam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008429:Maternal Welfare; D008875:Middle Aged; D008962:Models, Theoretical; D012959:Socioeconomic Factors; D014505:Urban Population
references.citation: Am J Public Health. 2006 May;96(5):818-25
references.pmid: 16571702
references.citation: Indian J Community Med. 2012 Jan;37(1):50-6
references.pmid: 22529541
references.citation: Int J Public Health. 2010 Aug;55(4):347-51
references.pmid: 20063112
references.citation: Health Aff (Millwood). 2002 Mar-Apr;21(2):60-76
references.pmid: 11900187
references.citation: Soc Sci Med. 1994 Jul;39(2):233-45
references.pmid: 8066502
references.citation: Indian Pediatr. 2005 Mar;42(3):233-44
references.pmid: 15817971
references.citation: Bull World Health Organ. 2002;80(2):97-105
references.pmid: 11953787
references.citation: Bull World Health Organ. 1999;77(7):537-43
references.pmid: 10444876
references.citation: Int J Equity Health. 2006 Jul 11;5:9
references.pmid: 16831231
references.citation: Indian J Public Health. 2005 Jul-Sep;49(3):141-51
references.pmid: 16468278
references.citation: Health Policy. 2010 Dec;98(2-3):114-20
references.pmid: 20576309
references.citation: BMJ. 1997 Feb 22;314(7080):591-5
references.pmid: 9055723
references.citation: World Health Stat Q. 1991;44(2):62-9
references.pmid: 1926894
references.citation: Indian J Med Res. 2007 Oct;126(4):355-63
references.pmid: 18032810
references.citation: Soc Sci Med. 1991;33(5):545-57
references.pmid: 1962226
references.citation: J Urban Health. 2010 Mar;87(2):264-277
references.pmid: 20148311
references.citation: Bull World Health Organ. 2000;78(1):42-54
references.pmid: 10686732