Multilevel Modeling of District, Community and Individual Correlates to Public Health Facility Utilization for MCH Care

Rachana Patel, International Institute for Population Sciences (IIPS)

This study aims to examine the inter-district and inter-village variation of utilization services for institutional births. Correlation matrix showed the maximum significant negative association between lowest wealth quintile and urban population. Village level external environmental covariates accessibility and availability to health center; and community health program variables (NRHM) captured significant variation in model. More number of deliveries at public-health-center was associated with the more institutional births. District variables like relative neighborhood poverty, neighborhood higher-education and percent urban have great influence on the utilization. Inter district variation was found to be 14% whereas 11% variation was observes for “between villages” variation for the utilization once controls for all the three level variables in the model. Study suggests that the mere availability of health facilities was necessary but not sufficient condition to promote use if the quality of service was inadequate and was inaccessible considering the inter-districts variation for the program implementation.