Utilization of maternal and child health services and its determinants among women of 15-49 years in India: Evidence from National Family Health Survey-5.

Abstract Background Although there has been a significant improvement over the last two decades, maternal health, covering pregnancy, childbirth, and the postpartum period, still faces challenges in India. In 2023, WHO reported 287,000 maternal deaths worldwide, with India's maternal mortality rate at 113/100,000 live births for 2016–18, improving from the previous period. The SDG global target of reducing the maternal mortality ratio to less than 70 per 100,000 live births by 2030, which India has committed itself to, necessitates immediate attention to address socioeconomic and demographic disparities in maternal care to inform national health missions like PMJSY and JSSK. Adequate utilization of maternal and child health (MCH) care services is critical to improve maternal health. This study aims to assess the extent of utilization of MCH services in India, viz ., antenatal care (ANC), skilled birth attendant (SBA), and postnatal care (PNC), and identify socioeconomic and demographic barriers in utilization of these services. Methods The present study used data from NFHS-5 (2019–2021) on 176483 mothers and 232920 children for analysis. Outcome variables representing utilization of ANC, SBA and PNC are derived from relevant variables using their standard definitions. We examined the association of demographic and socioeconomic factors with the three outcomes using univariate and multivariable logistic regression models. Further, states were divided into four groups based on their child health performance to investigate disparities in utilization of MCH between these groups. Results Overall, 26.7%, 74.6% and 88.67% mothers availed full ANC, PNC, and SBA services for their most recent births. As per the results of the logistic regressions, higher levels of education of mothers, higher wealth quintiles of the household, and urban residency are strongly associated with higher chances of availing the three services. A mother’s lack of exposure to mass media, higher number of births, and socially disadvantaged status act as barriers in utilization of MCH services. Conclusion Disparities in the utilization of MCH services are associated with socioeconomic and demographic factors, like education level of mother, social background, wealth status, and rurality of residence. Our findings reiterate the significance of female education and universal health coverage in bridging the socioeconomic gap in the utilization of MCH services.