Maternal Health Care Utilization in Tribal and Non-tribal Districts of Maharashtra: A Comparative Analysis
DOI:
https://doi.org/10.31305/rrjss.2026.v06.n01.027Keywords:
Maternal Health Care, Tribal and non-tribal DistrictAbstract
Maternal health care utilization is one of the key factors contributing to maternal morbidity and mortality. There is a reduction in maternal mortality and increased maternal health care utilization overall; however, there are obvious gaps between vulnerable and non-vulnerable communities. Therefore, the current study examines maternal health care utilization among the tribals by comparing with non-tribal mothers. A cross-sectional household survey was conducted with 240 young married women from two districts, Nandurbar and Satara of Maharashtra, India. The study revealed a higher maternal health care disparities between the tribal and non-tribal district of Maharashtra. This disparity particularly higher for ANC related indicators, counselling received, and for post-natal care. Therefore, the study suggests tailored intervention based on geographical and socio-economic vulnerability to fill the gaps in maternal health care utilization to achieve the SDG goal.
References
Adhav, A., & Gawde, N. (2015). Women’s Autonomy and Utilization of Antenatal and Delivery Services in a Tribal Block in Maharashtra, India. Journal of Family Welfare, 61(2), 50–63. https://www.researchgate.net/publication/315810720_women's_autonomy_and_utilization_of_antenatal_and_delivery_services_in_a_tribal_block_in_maharashtra_india
Barman, B., Saha, J., Chouhan, P. (2020). Impact of education on the utilization of maternal health care services: An investigation from National Family Health Survey (2015–16) in India. Children and Youth Services Review 108. 104642. https://doi.org/10.1016/j.childyouth.2019.104642.
Barman, B., Roy, A., Zaveri, A., Saha, J., Chouhan, P. (2020). Determining factors of institutional delivery in India: A study from National Family Health Survey-4 (2015–16). Clinical Epidemiology and Global Health, 8, 1335–1340. https://doi.org/10.1016/j.cegh.2020.05.007.
Calıskan, Z., Kılıc, D., Ozturk, S & Atılgan, E (2015). Equity in maternal health care service utilization: a systematic review for developing countries. Int J Public Health, 60(7), 815-25. DOI: 10.1007/s00038-015-0711-x.
Chaudhuri, A. 2012. Socio-economic inequity in health care utilization & expenditures in richer States in India. Indian journal of medical research, 136(3), 368–369. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510882/.
Chi, H., Jung, S., Subramanian, S. V., & Kim, R. (2024). Socioeconomic and geographic inequalities in antenatal and postnatal care components in India, 2016–2021. Scientific Reports, 14(1), 1-11. https://doi.org/10.1038/s41598-024-59981-w.
Fontenot, J., Brigance, C., Lucas, R., & Stoneburner, A. (2024). Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States. BMC Pregnancy Childbirth, 24, 350. https://doi.org/10.1186/s12884-024-06535-7.
Kaur, S. (2025). Strategies to increase effective usage of MCH services in tribal areas of India – perspectives of health care personnel. Journal of Family Medicine and Primary Care, 14(5), 1802. https://doi.org/10.4103/jfmpc.jfmpc_1460_24.
Kulkarni, R.N., Surve, S.V., Verma, S., Salvi, N., Suryawanshi, D., Chavan, M., Patil, S., Begum, S., Patil, A.D. & Chauhan, S. (2025). Perspectives of women and community workers regarding maternal and newborn care among tribal areas of Maharashtra, India: a qualitative study. International Journal of Community Medicine and Public Health, 12(7), 3159-3165. DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20252111.
Meh C, Sharma A, Ram U, Fadel S, Correa N, Snelgrove JW, Shah P, Begum R, Shah M, Hana T, Fu SH, Raveendran L, Mishra B, Jha P. (2022). Trends in maternal mortality in India over two decades in nationally representative surveys. BJOG, 129, 550–561. DOI: 10.1111/1471-0528.16888.
Mustafa A, & Shekhar, C. (2021). Contrast in utilization of maternal and child health services between Himalayan region and rest of India: Evidence from National Family Health Survey (2015-16). BMC Pregnancy Childbirth. 21(1):606. doi:10.1186/s12884-021-04081-0.
Mzembe, T., Chikwapulo, V., Kamninga, T.M., Vellemu, R., Mohamed, S., Nthakomwa, L., Chifungo, C., Wazny, K., Musau, K., Abdullahi, L., Peterson, M., Madise, N., & Chipeta, M.G. (2023). Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews. BMC Public Health, 23, 1734. https://doi.org/10.1186/s12889-023-16558-y.
Novignon, J., Ofori, B., Tabiri, K.G. & Pulok, M.H. (2019). Socioeconomic inequalities in maternal health care utilization in Ghana. Int J Equity Health 18, 141. https://doi.org/10.1186/s12939-019-1043-x.
Paul, P. L. and Pandey Shanta. (2020) Factors influencing institutional delivery and the role of accredited social health activist (ASHA): a secondary analysis of India human development survey 2012. BMC Pregnancy and Childbirth, 20, 445. https://doi.org/10.1186/s12884-020-03127-z.
S, Rekha., Neethi Mohan, V., Vaidyanathan, G., Das, U. & Muraleedharan, V. R. (2024). Wealth and education-related inequalities in the utilisation of reproductive, maternal, newborn, and child health interventions within scheduled tribes in India: an analysis of Odisha and Jharkhand. BMC Public Health, 24, 1605. https://doi.org/10.1186/s12889-024-18857-4.
Shanto, H. H., Al-Zubayer, M. A., Ahammed, B., Sarder, M. A., Keramat, S. A., Hashmi, R., Haque, R., & Alam, K. (2023). Maternal Healthcare Services Utilisation and Its Associated Risk Factors: A Pooled Study of 37 Low- and Middle-Income Countries. International Journal of Public Health, 68, 1606288. https://doi.org/10.3389/ijph.2023.1606288.
Sontakke, P. and Jaswal S. (2024). Social Determinants of Maternal Health Care: Evidence from Hilly and Non-hilly Regions of Maharashtra. The Indian Journal of Social Work. Volume 86 (2), 201-222. DOI: 10.32444/IJSW.2024.85.2.201-222
Tanou, M and Kamiya, Y. (2019). Assessing the impact of geographical access to health facilities on maternal healthcare utilization: evidence from the Burkina Faso demographic and health survey 2010. BMC Public Health, 19, 838. https://doi.org/10.1186/s12889-019-7150-1.
Toppo, N.A.; Thakur, A.; Singh, A.G.; Soni, D. (2024). Unveiling challenges of maternal health in India’s tribal mothers: Insights from a case series of maternal deaths. Journal of Family Medicine & Primary Care. 13(11), 5362-5366. doi:10.4103/jfmpc.jfmpc_708_24.
Tounkara, M., Sangho, O., Beebe, M., Whiting-Collins, L.J., Goins, R.R., Marker, H.C., Winch, P.J., & Doumbia, S. (2022). Matern Child Health J, 26(3), 649-657. DOI: 10.1007/s10995-021-03364-4.
Tsawe, M., Moto, A., Netshivhera, T., Ralesego, L., Nyathi, C., Susuman A.S. (2015). Factors influencing the use of maternal healthcare services and childhood immunization in Swaziland. Int J Equity Health, 14(32). https://doi.org/10.1186/s12939-015-0162-2.
UNICEF Data (2024): Maternal Mortality. Monitoring the situation of children and women https://data.unicef.org/topic/maternal-health/maternal-mortality/ Accessed: 23/05/2024.
Vivekanandhan R., & Ravishankar, A.K. (2021). Socio-Economic Determinants of Maternal Health Care Payments among Women in India. Indian Journal of Public Health Research & Development, 12(1), 117-123. https://doi.org/10.37506/ijphrd.v12i1.13838.
World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank Group, & United Nations Department of Economic and Social Affairs, Population Division. (2023). Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. https://www.who.int/publications/i/item/9789240068759
WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization (2025). Trends in maternal mortality estimates 2000 to 2023. https://www.who.int/publications/i/item/9789240108462?utm_source=chatgpt.com , accessed 01/09/2026
Zhao, P., Han, X., You, L., Zhao, Y., Yang, L., & Liu., Y. (2020). Maternal health services utilization and maternal mortality in China: a longitudinal study from 2009 to 2016. BMC Pregnancy Childbirth, 20, 220. https://doi.org/10.1186/s12884-020-02900-4.