Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Odisha, one of the socioeconomically disadvantaged states of India, registers high maternal deaths. The state features wide regional and sociodemographic diversity with the Koraput-Balangir-Kalahandi (KBK) districts, dominated by disadvantaged tribal population. This study aims to assess the level and pattern of maternal healthcare services utilization among different subgroups of women in Odisha with a special focus on the regional, economic, and educational inequality using the latest District Level Household and Facility Survey (DLHS-III, 2007-08). Descriptive statistics and bivariate and multivariate analysis were used to understand the pattern of utilization of maternal healthcare services among women by different background characteristics. Concentration curve and decomposition analysis were used to understand the inequalities in utilization of maternal healthcare services and contribution of different socioeconomic factors. Results reveal wide regional variation in the utilization of maternal healthcare services. The utilization of maternal healthcare services is more concentrated among affluent households. Economic inequality in safe delivery is high. Decomposition analysis shows education as the leading contributor in explaining maternal healthcare services utilization. Enhancing literacy among women and improving of health infrastructure and its quality in rural and disadvantaged regions may be prioritized to improve the maternal health in Odisha.