Pattern of Healthcare Utilization of India's Urban Middle Class for Maternal Health: Comparative Analysis of two rounds of national level data

Utilization of maternal healthcare services is a critical determinant of IMR and MMR and hence is an important subject of discussion for academicians as well as policymakers and practitioners across the world. Most studies on... [ view full abstract ]

Utilization of maternal healthcare services is a critical determinant of IMR and MMR and hence is an important subject of discussion for academicians as well as policymakers and practitioners across the world. Most studies on utilization pattern of maternal health care in particular and health care in general focus on underprivileged sections like the poorer and remote section of society especially in the low and middle income countries as they have high IMR and MMR. Literature seldom discusses on the status among the Middle class, especially in urban areas. Since the population of the urban Middle class has characteristics that are distinct and different from the poor or the rich and its share in the population is increasing, they merit detailed attention. This paper describes the utilization pattern of maternal healthcare services of the urban middle class in India. In doing so it argues against the popular understanding that majority of the Middle class in India uses private sector. The analysis is based on two rounds of national survey data spread over 10 years, 2004 -2014. The pattern of utilization is captured through the lens of type of healthcare institutions used, unmet need for healthcare and expenditure incurred in utilizing the services. The paper reveals that while at the aggregate level the majority of India’s urban Middle class is using the private sector for maternal health care, when disaggregated by social group, education level, nature of employment and geographical location, certain section within this class continue to rely on public sector and in some the proportion of population using public sector is increasing. Although the paper is in the context of India’s urban Middle class, it also compares India’s urban middle class with other countries like China and Brazil who have a significant population of urban Middle class.