Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Motherhood is not always a positive and gratifying experience, for many women around the world it is accompanied with suffering, ill-health and even death (WHO). Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth; 20 per cent of these women are from India. Annually, it is estimated that 55,000 women die due to preventable pregnancy-related causes in India (UNICEF, India). This paper attempts to assess the spatial patterns of utilization of maternal health care services across the districts of northeastern states of India. And to acquire a statistical intra-assessment of relativity high and low performing areas with respect to geographically proximal areas. Data and Methods: We used National Family Health Survey-4 (2015-16) fact sheets data on maternal health indicators for 87 districts of northeastern states, India. Applied spatial analysis: Moran's I and LISA to assess the maternal health care services across the districts. Results: All the indicators depicted striking coverage variation across the northeastern states, India in this analysis. Among all the northeastern states, Nagaland is found to be poor in utilization of maternal health care services whereas Sikkim is found to be the better one.

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Background Levels of child undernutrition and its correlates exhibit considerable spatial variation at different levels of granularity. In India, such variations and their interrelation have not been studied at the sub-district level primarily due to the non-availability of good quality granular data. Given the sheer regional diversity in India, it is essential to develop a region-specific evidence base at the micro-level. Data and objectives The current study utilised, for the first time, a sub-district level survey data (Concurrent Child Monitoring Survey-II, 2014–15) to investigate the statistically significant clusters and spatial patterns of burden of undernutrition among children. The emergence of distinct patterns at the level of natural geographical regions of the state–coastal, southern and northern regions, lead to a region-specific analysis to measure the impact of various demographic, socio-economic and maternal factors on the prevalence of undernutrition specific to the three regions, using the National Family Health Survey-IV unit-level data. Methods The spatial dependence and clustering of child undernourishment across sub-districts in Odisha were studied using various spatial statistical techniques, including spatial econometric models. Binary logistic regression was applied in the region-specific analysis. Results Findings indicated statistically significant spatial clustering of undernutrition among children in specific geographic pockets with poor sanitation, low institutional and skilled deliveries, poor maternal health reinforcing the need for inter-sectoral coordination. Disparities across the three natural-regions, suggest that the parameters requiring priority for intervention may differ across levels of overall development. Conclusion The spatial clustering of different socio-demographic indicators in specific geographic pockets highlights the differential impact of these determinants on child undernutrition thereby reinforcing a strong need for targeted intervention in these areas. Present analysis and the evidence-based micro-level analysis can be utilised as a model for other Indian states and low-resource countries, making interventions more effective through multiple, synergistic and a multi-sectoral approach.