What Drives the Gap in Antenatal Care Utilization in India: Aspirational vs. Non-Aspirational Districts?

AJAY DUTTA, PhD Research Scholar
T R Dilip, IIPS

This study investigates disparities in antenatal care (ANC) visit rates between Aspirational and non-Aspirational districts in India, leveraging logistic regression and Fairlie decomposition. The analysis covers 176,841 women, with separate logistic regressions for both district types revealing significant predictors of ANC visits. In Aspirational districts, higher education, media exposure, and wealth are key predictors. Women with higher education levels have significantly higher odds of ANC visits (OR = 1.25, and media exposure increases the likelihood of ANC visit (OR = 1.45). Wealthier households also exhibit a higher likelihood of ANC visits. Conversely, in non-aspirational districts, education and media exposure remain strong predictors, with higher education showing pronounced effects (OR = 1.80), and media exposure enhancing ANC likelihood (OR = 1.41). Fairlie decomposition results indicate a total explained difference of 9.49 percentage points in ANC visit rates between the district types. The decomposition shows that disparities in education (-0.00789), media exposure (-0.0243461), and wealth index (-0.0526537) significantly contribute to the gap. Additionally, differences in region and parity also play a role. Targeted policies to improve educational attainment, media exposure and wealth inequalities in Aspirational districts could help bridge this gap and enhance maternal healthcare access.

Keywords: Sexual and Reproductive Health and Rights, Population and Development, Population Policies, Decomposition analysis

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