Trend, Differential and Determinants of Deprivation of Reproductive and Child Health in the Districts of West Bengal, India

摘要

Reproductive and Child Health (RCH) is assumed to play a pivotal role in effective human capital formation as well as in determination of future demographic dividend of an economy. West Bengal exhibits a large scale inter-district disparity of health vulnerability measured by RCH Deprivation Index using Senian Power Mean Formula and Principal Component Analysis. Keeping in mind the variability of the RCH parameters, unitary weights and multicollinearity among the different RCH parameters, we suggest a measure of weighted RCH Deprivation Index. It is observed that the regional inequality of RCH Deprivation Index is increasing over time although parameter specific inequality studies give different results. The present study explores the inequality of three-tier rural health care infrastructure across the districts of West Bengal over three points of time and finds that there exists a wide range of gap between actual and required three-tier health care system in all the districts. Moreover, the inequality of this gap is found to be widening over time in respect of sub-centres, whereas it remains the same in terms of CHCs (namely, Rural Hospitals) and has been falling in respect of PHCs. The inequality of the medical bed availability is also found increasing. Cluster Analysis gives us that some districts like Uttar Dinajpur, Malda, Murshidabad and Purulia have been remaining backward over time in respect of selected RCH deprivation parameters. In order to find out the factors explaining the variations of RCH deprivation index, the panel data regression is carried out and the results confirm that it is not the per capita income, rather female literacy and the gap of the primary health centres are responsible in causing district wise variations for the backwardness of reproductive and child health status of West Bengal.