The Critical First 1000 Days: Evaluating the Continuum of Care for Maternal and Child Health in India

Sampurna Kundu, Jawaharlal Nehru University
Punit Mishra, Population Council
Sanghmitra S. Acharya, Jawaharlal Nehru University
Aditi ., PopulationCouncil Consulting
Raman Mishra, International Institute for Population Sciences (IIPS)

The first 1000 days of life, from conception to two years of age, are crucial for a child's growth and development. This study investigates the impact of the continuum of care approach—integrating health, nutrition, and early childhood interventions—on child health outcomes in India. Using the fifth round of the National Family Health Survey-5, this paper employed a multivariate ordered logistic regression to evaluate the quality of care received during pregnancy, childbirth, and infancy, linking it to key nutrition indicators such as stunting, wasting, and anaemia among children under five. The study constructs a composite index of care based on services received, from antenatal care to immunization, and analyzes its relationship with background factors such as maternal education, birth order, and health insurance coverage. Results show that only 31% of children received high-quality continued care, with disparities based on socioeconomic status and access to health services. The findings highlight the need for universal coverage and consistent implementation of health and nutrition programs to reduce malnutrition and improve long-term health outcomes. This paper underscores the importance of strengthening community-based platforms and addressing gaps in service delivery, ensuring equitable access to the continuum of care for all mothers and children.

Keywords: Children, Adolescents, and Youth, Gender Dynamics

See extended abstract.