Spatial Inequalities in Maternal and Child Health in India: Examining Inter-State Disparities

Abstract

Maternal and child health (MCH) remains a critical component of human development and public health policy in India. Despite considerable improvements in recent decades, substantial inter-state disparities persist, reflecting uneven socio-economic development and variations in health system performance. The present study constructs a Composite Maternal and Child Health Index (MCHI) using data from the National Family Health Survey-5 (2019–21), with the objective of examining spatial inequalities in maternal care, child health outcomes, and nutritional status across Indian states.

The index incorporates eight indicators covering antenatal care, institutional delivery, postnatal care, immunization, infant and child mortality, anemia among women, and child stunting. All indicators are standardized using z-score normalization, a widely accepted method for constructing composite indices (OECD, 2008), and subsequently aggregated using an equal-weighting approach. The results reveal a pronounced regional pattern characterized by a north–south divide. Southern states such as Kerala and Tamil Nadu demonstrate consistently superior performance, while northern and northeastern states, including Bihar, Uttar Pradesh, and Meghalaya, lag behind. Although improvements in healthcare utilization are evident, persistent challenges in nutrition and mortality highlight structural constraints.

The study underscores the need for region-specific policy interventions and demonstrates the utility of composite indices in capturing multidimensional health disparities. The findings have important implications for targeted public health planning and resource allocation.