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Inequity in unmet health care needs of women and children in India: A barrier to sustainable development goals in health

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  • Raj Kumar
  • Indrani Roy Chowdhury

Abstract

Despite progress in maternal and child health, significant gap and high inequity persist in unmet health needs, creating a barrier to universal health coverage. Previous studies have analysed inequity of health outcomes and healthcare availability, but limited research is available on delayed or not‐seeking treatment. Research conducted on unmet treatment lacks emphasis on vulnerable groups; women and children. The objective is to fill this research gap by estimating the contribution of socio‐economic factors to inequality in the unmet health needs of women and children. This study uses the concentration index, concentration curve and horizontal inequity index to estimate inequality. A decomposition analysis is conducted to estimate the contribution of each socio‐economic factor to inequality. The need‐adjusted index shows the inequity due to non‐need factors. The unmet health needs are significantly higher among socioeconomically disadvantaged groups. In addition to wealth, factors such as caste (4.43% and 7.23%), education (7.27% and 13.05%), media exposure (3.88% and 6.39%) and distance problem (5.35% and 14.61%) contribute to the inequity for both women and children. A negative horizontal inequity index confirms that non‐need factors are major contributors to inequity. Findings add new theoretical insights on healthcare accessibility and inform policymakers on factors creating disadvantages in treatment‐seeking. Action plans for universal health coverage need to incorporate social and institutional factors in policy and budgetary allocations. Further, health‐card system, health‐record‐keeping practices and community‐health officer/clinic can improve treatment seeking.

Suggested Citation

  • Raj Kumar & Indrani Roy Chowdhury, 2024. "Inequity in unmet health care needs of women and children in India: A barrier to sustainable development goals in health," Sustainable Development, John Wiley & Sons, Ltd., vol. 32(6), pages 6595-6613, December.
  • Handle: RePEc:wly:sustdv:v:32:y:2024:i:6:p:6595-6613
    DOI: 10.1002/sd.3042
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    1. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    2. Brijesh C. PUROHIT, 2019. "Inequity in health care sector in India: A case study of district level in four Indian states," Theoretical and Applied Economics, Asociatia Generala a Economistilor din Romania / Editura Economica, vol. 0(1(618), S), pages 129-150, Spring.
    3. Marco J. Haenssgen, 2024. "Aligning global health policy and research with sustainable development: A strategic market approach," Sustainable Development, John Wiley & Sons, Ltd., vol. 32(3), pages 1876-1893, June.
    4. Gradín, Carlos & Wu, Binbin, 2020. "Income and consumption inequality in China: A comparative approach with India," China Economic Review, Elsevier, vol. 62(C).
    5. Samara da Silva Neiva & Ramaswamy Arun Prasath & Wellyngton Silva de Amorim & Mauricio de Andrade Lima & Samuel Borges Barbosa & João Marcelo Pereira Ribeiro & Flávio Ceci & Jonas Schneider & André Bo, 2021. "Sustainable urban development: Can the balanced scorecard contribute to the strategic management of sustainable cities?," Sustainable Development, John Wiley & Sons, Ltd., vol. 29(6), pages 1155-1172, November.
    6. Vaitheeswaran Kulothungan & Thilagavathi Ramamoorthy & Rohith Mohan & Prashant Mathur, 2024. "Assessing progress of India in reduction of premature mortality due to four noncommunicable diseases towards achieving the WHO 25×25 goal and the sustainable development goals," Sustainable Development, John Wiley & Sons, Ltd., vol. 32(3), pages 2020-2030, June.
    7. Anne Ardila Brenøe & Ramona Molitor, 2018. "Birth order and health of newborns," Journal of Population Economics, Springer;European Society for Population Economics, vol. 31(2), pages 363-395, April.
    8. John E. Ataguba, 2022. "A short note revisiting the concentration index: Does the normalization of the concentration index matter?," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1506-1512, July.
    9. Nausheen SODHI & Upinder SAWHNEY, 2023. "Governance in Indian States: An Inter and Intra State Analysis," Journal of Economic Policy Researches, Istanbul University, Faculty of Economics, vol. 10(1), pages 61-86, January.
    10. repec:agr:journl:v:1(618):y:2019:i:1(618):p:129-150 is not listed on IDEAS
    11. Isabell Kempf & Paramita Dutta, 2021. "Transformative social policies as an essential buffer during socio‐economic crises," Sustainable Development, John Wiley & Sons, Ltd., vol. 29(3), pages 517-527, May.
    12. Jingxian Wu & Yongmei Yang & Ting Sun & Sucen He, 2024. "Correction: Inequalities in unmet health care needs under universal health insurance coverage in China," Health Economics Review, Springer, vol. 14(1), pages 1-1, December.
    13. Azharuddin Akhtar & Indrani Roy Chowdhury, 2023. "The socioeconomic inequity in healthcare utilization among individuals with cardiovascular diseases in India," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1000-1018, May.
    14. Jingxian Wu & Yongmei Yang & Ting Sun & Sucen He, 2024. "Inequalities in unmet health care needs under universal health insurance coverage in China," Health Economics Review, Springer, vol. 14(1), pages 1-17, December.
    15. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    16. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
    17. Pascaline Dupas & Radhika Jain, 2024. "Women Left Behind: Gender Disparities in Utilization of Government Health Insurance in India," American Economic Review, American Economic Association, vol. 114(10), pages 3345-3385, October.
    18. Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
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