Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021

Abstract Utilization of maternal healthcare services such as four or more antenatal care visits (4+ ANC), delivery by a skilled birth attendant (Del-SBA), and postnatal care (PNC) is crucial for better pregnancy outcomes and reducing maternal and child mortality. Northeast India faces serious matern...

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Main Authors: Gajendra Gupta, Tejbir Singh Rana, Sadanand Karun, Ankita Roy
Format: Article
Language:English
Published: Springer 2025-06-01
Series:Discover Public Health
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Online Access:https://doi.org/10.1186/s12982-025-00660-0
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author Gajendra Gupta
Tejbir Singh Rana
Sadanand Karun
Ankita Roy
author_facet Gajendra Gupta
Tejbir Singh Rana
Sadanand Karun
Ankita Roy
author_sort Gajendra Gupta
collection DOAJ
description Abstract Utilization of maternal healthcare services such as four or more antenatal care visits (4+ ANC), delivery by a skilled birth attendant (Del-SBA), and postnatal care (PNC) is crucial for better pregnancy outcomes and reducing maternal and child mortality. Northeast India faces serious maternal health issues as Assam records the highest maternal mortality ratio in the country. Therefore, the present study aims to examine the spatial patterns and determinants of maternal healthcare utilization in Northeast India. The choropleth mapping, bivariate analysis, and logistic regression were applied to the National Family Health Survey-5 data to assess the spatial pattern and determinants of maternal healthcare services utilization. We found that the levels of 4+ ANC, Del-SBA, and PNC were 49.7%, 79.1%, and 69.7%, respectively, in Northeast India, which is lesser than the national level. The state and district-level patterns indicate significant disparities in the utilization of 4+ ANC, PNC, and Del-SBA. Among north-eastern states, Manipur had the highest level of 4+ ANC, and Sikkim had the highest level of PNC and Del-SBA. On the other hand, Nagaland performs worst in utilizing all three maternal health services. Women with exposure to mass media, higher educational level, Hindu religion, rich wealth quintile and urban residence were significantly more likely to utilize maternal healthcare services than their counterparts. Additionally, beneficiaries of government programmes such as the Janani Suraksha Yojana, health insurance, and mother and child protection cards were significantly more likely to utilize maternal healthcare services. In conclusion, to increase maternal healthcare utilization in northeastern states, special attention is required for women belonging to poor wealth status, scheduled castes and scheduled tribes, living in rural areas, and having no education. In addition, raising awareness and tailored policy intervention is needed in Nagaland and districts closer to international borders.
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spelling doaj-art-bf1161788f2e4883bbaf67ea7cdb37ba2025-08-20T03:24:30ZengSpringerDiscover Public Health3005-07742025-06-0122111410.1186/s12982-025-00660-0Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021Gajendra Gupta0Tejbir Singh Rana1Sadanand Karun2Ankita Roy3Department of Geography, Delhi School of Economics, University of DelhiShivaji College, University of DelhiInternational Institute for Population SciencesInternational Institute for Population SciencesAbstract Utilization of maternal healthcare services such as four or more antenatal care visits (4+ ANC), delivery by a skilled birth attendant (Del-SBA), and postnatal care (PNC) is crucial for better pregnancy outcomes and reducing maternal and child mortality. Northeast India faces serious maternal health issues as Assam records the highest maternal mortality ratio in the country. Therefore, the present study aims to examine the spatial patterns and determinants of maternal healthcare utilization in Northeast India. The choropleth mapping, bivariate analysis, and logistic regression were applied to the National Family Health Survey-5 data to assess the spatial pattern and determinants of maternal healthcare services utilization. We found that the levels of 4+ ANC, Del-SBA, and PNC were 49.7%, 79.1%, and 69.7%, respectively, in Northeast India, which is lesser than the national level. The state and district-level patterns indicate significant disparities in the utilization of 4+ ANC, PNC, and Del-SBA. Among north-eastern states, Manipur had the highest level of 4+ ANC, and Sikkim had the highest level of PNC and Del-SBA. On the other hand, Nagaland performs worst in utilizing all three maternal health services. Women with exposure to mass media, higher educational level, Hindu religion, rich wealth quintile and urban residence were significantly more likely to utilize maternal healthcare services than their counterparts. Additionally, beneficiaries of government programmes such as the Janani Suraksha Yojana, health insurance, and mother and child protection cards were significantly more likely to utilize maternal healthcare services. In conclusion, to increase maternal healthcare utilization in northeastern states, special attention is required for women belonging to poor wealth status, scheduled castes and scheduled tribes, living in rural areas, and having no education. In addition, raising awareness and tailored policy intervention is needed in Nagaland and districts closer to international borders.https://doi.org/10.1186/s12982-025-00660-0Maternal healthcare utilizationAntenatal careDelivery by skilled birth attendantPostnatal careNorth Eastern RegionNortheast India
spellingShingle Gajendra Gupta
Tejbir Singh Rana
Sadanand Karun
Ankita Roy
Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
Discover Public Health
Maternal healthcare utilization
Antenatal care
Delivery by skilled birth attendant
Postnatal care
North Eastern Region
Northeast India
title Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
title_full Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
title_fullStr Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
title_full_unstemmed Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
title_short Spatial pattern and correlates of maternal healthcare utilization in the North Eastern Region of India: evidence from the National Family Health Survey, 2019–2021
title_sort spatial pattern and correlates of maternal healthcare utilization in the north eastern region of india evidence from the national family health survey 2019 2021
topic Maternal healthcare utilization
Antenatal care
Delivery by skilled birth attendant
Postnatal care
North Eastern Region
Northeast India
url https://doi.org/10.1186/s12982-025-00660-0
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