Investigating Access to Health Services Using Spatial Dimension: Proximity to Services and Its Utilization for Institutional Births in Rural India

Rachana Patel, International Institute for Population Sciences (IIPS)

This study tried to associate by taking distance and road connectivity with institutional births through spatial dimension. DLHS 3(2007-08) data is utilized for the purpose. Results showed physical accessibility for institutional births was an important predictor, even when other individual characteristics were considered. Odds are more for women to institutional births where villages were connected by all-weather road to health facility (SC/PHC) and nearby (<10 km). Component of service utilization include spatial proximity, availability of doctors and ANM were significant co-variates whereas working women and birth order were negatively correlated. Spatial association showed the autocorrelation in the institutional births among the neighboring districts of Middle East and some of Western UP and the significance level to accept the substantial spatial correlation with the service utilization indicators (Moran’s I, LISA). Health service availability with doctors/ANM and average distance from villages indicator captures the spatial structure of institutional births (Bi-LISA).