Inequity in distribution of health infrastructure, human resources including specialists and its correlation with maternal, neonatal and child health outcomes in India

Background

Healthcare services in India are provided mainly through the three-tier healthcare delivery system i.e., community health centers (CHCs) at the top, primary health centers (PHCs) at the middle, and sub-centers (SCs) at the bottom.1 SCs and PHCs has been vested with the responsibility of providing essential health services through medical officers and nursing personnel, while the CHC is meant to provide specialist services like surgical, obstetric, gynaecological and paediatric services through a team of specialist doctors (as per Indian Public Health Standards [IPHS]).

The shortage or unequal distribution of the health centers, general or specialist healthcare workers can have serious implications on the quality of healthcare delivery at all the levels of healthcare delivery system.  This in turn will seriously impact the maternal, neonatal and child health outcomes of the poorer sections of society, as they rely mostly on the government funded facilities for their health needs. It also has serious economic impact, making them trapped into a vicious poverty cycle due to high direct and indirect costs when seeking care or consequence due to unavailability of care. Hence, we propose to conduct a study to identify the inequity in the distribution of health infrastructure, human resources including the specialists and its correlation with maternal, neonatal and child health outcomes in India.