Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of incomebased inequality in the full immunization of children aged 12-23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (− 13.5%) and age of the child (− 2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums.

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Introduction: Emerging evidence suggests a difference in access to facilities for medical termination of pregnancy (MTP) and delivery among women in different regions of the country. However, we lack assessments at a large scale across all geographies. Our study aims to describe the percent contribution of private and public sectors in institutional deliveries and MTP in India. Methods: A secondary data analysis using the Health Management Information System statistics was performed. We obtained selective data regarding the total number of MTP and deliveries conducted at public and private institutions. The standard reports of the period between April 2018 and March 2019 were analyzed. The states (n = 29) and union territories (n = 7) were dichotomized into regions, namely north, south, east, west, north-east, and central. Results: A large part of women underwent deliveries and abortions in the private sector in the southern and western states of India like Kerala, Tamil Nadu, Andhra Pradesh, Goa, and Maharashtra. Women in most of the northern states opted for public facilities for deliveries as well as abortions, except Punjab and Haryana. On the contrary, states like Bihar, Nagaland, and Union territories like Delhi and Dadra and Nager Haveli had a high percentage of abortions in the private sector and deliveries in public health facilities. Conclusion: This differential access highlights the need to assess the underlying factors for immediate actions by the policy-makers. Ensuring safe and good quality delivery and abortion services is the means to assure the sexual and reproductive health rights of women by the government.

Background: In previous decade, the rate of caesarean section has increased disproportionately in India. Breastfeeding in an hour post birth i.e. Colostrum feeding has benefits associated to both mother as well as child. Cesarean delivery is one of the most remarkable risk factor for postpartum infection. The infection can be there in the uterus or vagina and can be accompanied by fever, sepsis etc. Both these aspects in the periphery of C-section need to be thrown a light because these are proximately affecting maternal health. This paper aims to examine the colostrum feeding practices of mothers giving birth via C-section and the difference that exists between C-section and normal delivery on post-natal complications or intrication faced by women. Method: The study used data from the Demographic and Health Survey (DHS) acquired in India, i.e., the fourth round of National Family and Health Survey (2015-16). Bivariate and multivariate has been carried out to know the difference in prevalence of colostrum feeding among mothers who have delivered by C-section and those who delivered normally. Propensity score matching (PSM) has been used in the study; it helped us to find an effective strategy for controlling the confounding influence of post-natal complications faced among caesarean and normal delivery mothers. Results: It is found, among the unmatched treatment group i.e., mothers delivered under caesarean section, the prevalence of post-natal complications is around 24%, and the same for control group i.e. those who delivered normally is 18%. After matching, the value of ATT is around 24% in treatment group and 17.4 in control group. Conclusion: Study concluded that women who delivered via C-section actually had lower prevalence of feeding colostrum to the new born in comparison to those who delivered normally. Results of PSM analysis also showed that post-natal complications faced by women who delivered normally were higher than those who delivered via C-section.

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