International Journal of Social Science & Economic Research
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Title:
Interstate Disparities in Women’s Reproductive Health Outcomes: A Cross-Sectional Analysis of Structural Determinants Across High-Focus States of India

Authors:
Dr. Umendra Singh

Journal: International Journal of Social Science and Economic Research (IJSSER)
ISSN: 2455-8834
Volume: 10
Issue: 12
Publication Date: December 2025
DOI: 10.46609/IJSSER.2025.v10i12.040

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Dr. Umendra Singh
Asst. Professor, University Department of Economics, Vinoba Bhave University, Hazaribag, Jharkhand, India

MLA 8
Singh, Dr. Umendra. "Interstate Disparities in Women’s Reproductive Health Outcomes: A Cross-Sectional Analysis of Structural Determinants Across High-Focus States of India." Int. j. of Social Science and Economic Research, vol. 10, no. 12, Dec. 2025, pp. 6779-6797, doi.org/10.46609/IJSSER.2025.v10i12.040. Accessed Dec. 2025.
APA 6
Singh, D. (2025, December). Interstate Disparities in Women’s Reproductive Health Outcomes: A Cross-Sectional Analysis of Structural Determinants Across High-Focus States of India. Int. j. of Social Science and Economic Research, 10(12), 6779-6797. Retrieved from https://doi.org/10.46609/IJSSER.2025.v10i12.040
Chicago
Singh, Dr. Umendra. "Interstate Disparities in Women’s Reproductive Health Outcomes: A Cross-Sectional Analysis of Structural Determinants Across High-Focus States of India." Int. j. of Social Science and Economic Research 10, no. 12 (December 2025), 6779-6797. Accessed December, 2025. https://doi.org/10.46609/IJSSER.2025.v10i12.040.

References

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ABSTRACT:
Maternal and reproductive health outcomes show substantial geographic variation across India’s five high-focus states. This study quantifies interstate variation in women’s reproductive health indicators using NFHS-4 and NFSH-5 data and observed disparities into compositional (population-level) and structural (health system-level) factors using regression-based methodology. Comparative cross-sectional analysis across five high-focus states (Bihar, Uttar Pradesh, Madhya Pradesh, Rajasthan, Jharkhand) have been done. Primary outcome measures institutional delivery rate, MMR, Anemia prevalence and antenatal care. Complex SurveyWeighted Descriptive Statistics, Estimated Annual Percentage Change (EAPC) and OaxacaBlinder regression-based decomposition methods have been used. Institutional Delivery Rates (NFHS-5, 2019-21) ranged from 72.1% (Bihar) to 94.9% (Rajasthan) with a 22.8 pp disparity among all five states. Rajasthan and Uttar Pradesh have shown rapid improvement with EAPC of +3.8% and +4.3% per year respectively. MMR (SRS 2020-22) ranged from 50 (Jharkhand) to 173 (Madhya Pradesh). Despite Rajasthan’s 94.9% institutional delivery, MMR remained 87; weak correlation (r = ?0.42) between institutional delivery and mortality indicated a coverage quality mismatch. Decomposition Analysis revealed that 55.3% of Bihar-Rajasthan institutional delivery gap reflected structural factors (health system quality 31.1%, program implementation 14.0%, financial barriers 10.1%) versus 44.7% compositional factors (female literacy 25.4%, women’s empowerment 10.5%, household wealth 6.6%). Economic barriers still persist despite universal insurance as Bihar mean OOP ?5,000 per delivery (71% above national average) versus Rajasthan ?3,000. Interstate reproductive health disparities mainly reflect health system implementation effectiveness (55.3%) rather than population characteristics (44.7%) alone. Integrated interventions are required to achieve targets of SDGs and to address the issues.

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