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J Public Health (Oxf). 2013 Dec;35(4):598-606. doi: 10.1093/pubmed/fds108. Epub 2013 Jan 27.

Coverage gap in maternal and child health services in India: assessing trends and regional deprivation during 1992-2006.

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Department of Humanities & Social Sciences, Indian Institute of Technology (IIT) Roorkee, Roorkee 247667, Uttarakhand, India.



Increasing the coverage of key maternal, newborn and child health interventions is essential, if India has to attain Millennium Development Goals 4 and 5. This study assesses the coverage gap in maternal and child health services across states in India during 1992-2006 emphasizing the rural-urban disparities. Additionally, association between the coverage gap and under-5 mortality rate across states are illustrated.


The three waves of National Family Health Survey (NFHS) conducted during 1992-1993 (NFHS-1), 1998-1999 (NFHS-2) and 2005-2006 (NFHS-3) were used to construct a composite index of coverage gap in four areas of health-care interventions: family planning, maternal and newborn care, immunization and treatment of sick children.


The central, eastern and northeastern regions of India reported a higher coverage gap in maternal and child health care services during 1992-2006, while the rural-urban difference in the coverage gap has increased in Gujarat, Haryana, Rajasthan and Kerala over the period. The analysis also shows a significant positive relationship between the coverage gap index and under-five mortality rate across states.


Region or area-specific focus in order to increase the coverage of maternal and child health care services in India should be the priority of the policy-makers and programme executors.


India; NFHS; coverage gap; maternal and child health care; public health

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