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01.12.2017 | Research | Ausgabe 1/2017 Open Access

International Journal for Equity in Health 1/2017

Regional inequity in complete antenatal services and public emergency obstetric care is associated with greater burden of maternal deaths: analysis from consecutive district level facility survey of Karnataka, India

International Journal for Equity in Health > Ausgabe 1/2017
M. Himanshu, Carina Källestål
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12939-017-0573-3) contains supplementary material, which is available to authorized users.



This equity focused evaluation analyses change in inter-district inequity of maternal health services (MHS) in Karnataka state between 2006–07 & 2012–13, alongside association of MHS inequity with distribution of maternal deaths.


Repeated cross-sectional analysis of inequity and decomposition was done on nine district level MHS indicators using Theil’s T index. Data was obtained from population linked district level facility surveys and health information systems.


Inequity in births attended by skill birth attendants decreased the most (83.16%) among six other MHS indicators. Community provision of comprehensive emergency obstetric care strategy remained stagnant. Districts with higher complete antenatal care share and C-sections in public settings had lesser share of state’s maternal deaths (R2 = 0.29, p = 0.004). 5 districts suffered perpetual inequity of MHS with relatively greater burden of maternal deaths.


First 6 years of national rural health mission increased coverage of MHS and decreased regional inequity albeit non-uniformly. Distribution of system driven interventions of complete ANC and C-sections appear to determine decrease of maternal mortality in Karnataka.
Additional file 1: Supplementary data: List of perpetually disadvantaged districts in maternal health service coverage and districts with no FRUs providing CEMOC services. (DOCX 13 kb)
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