Inequality in RMNCH (Reproductive, Maternal and Child Health Care) Coverage in Rural and Urban Area Across All Indian States
Authors: kumari Anjali , kumar Manoj 
Published: October 2022

Abstract
Background
Rigorous assessment of disparities in the coverage of crucial reproductive, maternal, new-born, and child healthcare (RMNCH) services is becoming more and more important in order to ease the path towards the Sustainable Development Goals (SDGs). The goal of this study is to measure the extent of disparities in RMNCH service coverage. Children and women are vulnerable groups in regards to health, and they are significantly influenced by the effects of economic imbalances across multiple dimensions. The main goal of this strategy is to reduce the neo-natal mortality rate to 16 per 1000 up to 2025 and under 5 mortality rates to 23 per 1000 up to 2025. Urban areas are assumed to have greater socioeconomic indicators, as well as maternal and child health indicators, than remote places. Because of this view, health policies were introduced that are oblivious of intra-urban health disparities. Several intervention schemes, such as the 'Janani Suraksha Yojana' (JSY) and others, have raised consumption of antenatal care services at the national and provincial levels. Tackling the discrepancy in the coverage of mother and infant and child healthcare services across different socio-economic segments of the society and throughout state is a critical component of modern health policy of India.
Objective
Aim of the study is to measure the inequality in the maternal and child health care coverage though the RMNCH strategy across distinct locality of the society (i.e., rural and urban) for different states in India.
Method
We are using secondary data for this study and CCI index is calculated using the eight indicators that identify the maternal and child health coverage. We collected data from the National Family Health Survey (2015–16) and (2019–2021) for 23 states to assess the RMNCH coverage through cumulative indicators, especially the Composite Coverage Index (CCI) indicator, is developed. The absolute Index of Inequality (Q2-Q1) and Relative Index of Inequality (Q2/Q1) is also calculated to evaluate inequalities in the dispersion of RMNCH coverage. The descriptive statistics is calculated to analysis the characteristics of the data. Then paired t- test is calculated to see the mean difference between for two data set of the same variable that are separated by time that is composite coverage index for two quartile we defined for the two different year 2015-16 and for the year 2019-21. The time series plot according to locality is shown.
Result
The result show that the coverage of key indicators has improved over the years but still there is inequality in the coverage of RMNCH indicators across different quartile. The absolute difference in coverage has reduced for the year 2019-21 as compared to 2015-16. The mean coverage in rural area is 63.52 percent and urban area is 69.09 percent in 2015-16 and 69.69 percent in rural area and 71.60 percent in urban area in 2019-21 in India. For the urban area 79.38 coverage for Punjab is highest and for the rural area highest coverage state is Punjab with 80.825 in the year 2015-16.