Regional Disparities in Maternal Healthcare Utilization between North Eastern and Mainland India: A Comprehensive Review
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Abstract
Maternal health is a key indicator of public health, healthcare equity, and socioeconomic development. Although India has made significant progress in improving maternal healthcare through the National Rural Health Mission (NRHM), National Health Mission (NHM), and flagship initiatives such as Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the LaQshya programme, substantial regional disparities continue to persist. This review critically examines maternal health inequalities between the North Eastern Region (NER) and mainland India by synthesizing evidence from empirical studies, government reports, and nationally representative datasets, particularly the National Family Health Survey (NFHS). It evaluates regional differences in antenatal care, institutional delivery, skilled birth attendance, postnatal care, and maternal health outcomes while identifying the socioeconomic, geographical, cultural, and health system factors underlying these disparities. The review reveals that women in many North Eastern districts experience comparatively lower utilization of maternal healthcare services due to difficult terrain, inadequate transportation, shortages of skilled health personnel, weak healthcare infrastructure, poverty, lower educational attainment, tribal concentration, and limited women's autonomy. Furthermore, marked inequalities exist not only between the NER and mainland India but also within districts across the North Eastern states, highlighting the need for decentralized planning. The review emphasizes strengthening health infrastructure, referral and transport systems, women's education and empowerment, culturally responsive healthcare delivery, and district-specific interventions to achieve equitable maternal healthcare and accelerate progress towards universal health coverage and the Sustainable Development Goals.
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