Health reform and infant mortality in West Bengal, India: an untold story

ABSTRACT

Though studies have focused on the expansion of coverage of health care utilization after India’s health care reform in 2004–2005 under the National Rural Health Mission, the effect of limited risk protection of the programme, measured by non-availability of services at institutions, has remained under-studied. Using bivariate probit models on birth history data of 6568 children in two districts in West Bengal, an eastern state of India, this paper finds that in post-reform era, health care utilization in the form of institutional delivery has a tendency to enhance the risk of infant mortality, primarily owing to lack of timely services received at the institutions.

KEYWORDS:

• Health care reform
• breadth and depth of policy
• infant mortality rate
• institutional delivery

Acknowledgements

The authors would like to thank Professor David Bishai of Johns Hopkins University, Baltimore, MD, USA, for his detailed comments and suggestions on the first draft of the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Female literacy is taken as a proxy of overall development in any region.

2. Others category constituted mainly Muslims.

3. Health sub-centres in India are the health care facilities available at the lowest level of the publicly financed health system. They offer only maternal and childcare facilities through ASHAs and Auxiliary Nurse Midwives.

4. During 2005–2013, only 355 General Duty Medical Officers and 21 specialists have been inducted in government health facilities in West Bengal, while in SNCU the corresponding figures are 31 and 5, covering only a tiny section of actual requirement of doctors. Sources from Department of Health & Family Welfare, GoWB, confirm that in Hooghly, availability of maternal beds is only 0.46 per 1000 women in the reproductive age group. No such information was available for Murshidabad.

Additional information

Funding

This work was supported by Department of Health and Family Welfare, Government of West Bengal, India.

Notes on contributors

Arijita Dutta

Professor Arijita Dutta is a full time faculty member in Department of Economics in University of Calcutta. Her current research interest is Health Economics, Quantitative Development Economics and Econometrics. She has has published quite a few policy documents on health care in West Bengal. She has taught in a number of European Universities and has been a visiting researcher at United Nation University Merit, Maastricht, the Netherlands in 2014.

Ratan Khasnabis

Professor Ratan Khasnabis is currently associated with Institute of Development Studies, Kolkata. Previously he has served University of Calcutta as a Professor in Department of Business Management and Department of Commerce. He has been a recipient of Eminent Teacher’s Awards from this University. Professor Khasnabis also worked as a Director of MHROM Program under Department of Business Management. He has contributed significantly to the research on Macroeconomics, Economy of West Bengal and Human Development. He has written many scholarly articles in top international and Indian journals and completed many research projects.

Sharmishtha Banerjee

Professor Sharmishtha Banerjee is a full time faculty at the Department of Business Management, University of Calcutta. A double Fulbright Fellow, Professor Banerjee is the first Indian scholar at the prestigious Global Link Program, a public private partnership founded in 2011 between the U.S. Secretary of State's Office of Global Women’s Issues, Rollins College and Tupperware Brands. She has done extensive research on areas related to human resource management, small business management and human development.