Background: Since the implementation of National Rural Health Mission (NRHM) in 2005, Maternal Mortality Ratio has significantly declined in India through a noticeable improvement in maternal health care services. However, India did not succeed to achieve the target of millennium development goal to reduced maternal mortality ratio by 2015. Also, there is substantial inequality exist at the regional, geographic, economic, and social level, and various socioeconomic factors contribute to the significantly large share in inequality in utilisation of maternal health care in India. Methods: Using data from the National Family Health Survey (2005 and 2015), this study examined the degree of inequality exist in maternal health care namely full antenatal care (full ANC), skilled attendants at birth (SBA), and postnatal care (PNC) in rural India. Descriptive statistics, concentration index (CI), and Wagstaff decomposition method have been performed to understand the pattern of maternal health care utilisation, and to explain the extent of inequality in maternal health care utilisation. Results: The study revealed that a substantial gap across socioeconomic groups exist in utilisation of maternal health care has significantly reduced in rural India during 2005-16. The results found a noticeable improvement in maternal health care utilisation, especially in utilisation of skilled attendants at birth (SBA). During this decade, the concentration index for SBA showed a significant decline from 0.28 in 2005-06 to 0.09 in 2015-16, while that of full ANC declined from 0.47 to 0.32 over the same period, and reduction of inequality in full ANC was least. Further, the results of decomposition analysis suggested that secondary and higher education, mass media exposure, and scheduled tribe contributed a significant share to the inequality. Conclusion:The exposure to mass media is the most significant contributor to inequality, and hence, there is a need for broad dissemination of awareness regarding maternal health care schemes in rural parts of country. Based on findings of study, it is suggested that health scheme related to maternal and child health care under NRHM be continued and focused for lower socioeconomic groups and marginalized mothers to reduce maternal health services inequality, particularly in the component of full ANC.

Since the implementation of the National Health Mission (NHM) in India there has been a noticeable improvement in the utilization of maternal care, namely antenatal care (ANC), skilled birth attendants (SBA) and postnatal care (PNC) in the country. The increase in utilization of these services is expected to reduce inequality across geographies and population sub-groups, but little is known about the extent of inequality in maternal care use across socioeconomic groups over time. Using data from the last two rounds of National Family Health Surveys conducted in 2005–06 and 2015–16, this study examined the extent of inequality in utilization of full ANC, SBA and PNC in India and its states. Descriptive statistics were used, a concentration index was computed and decomposition analyses performed to understand the pattern and change of inequality in use of maternal care. The results suggest that the gap in maternal care utilization across socioeconomic groups has reduced over time. The concentration index for SBA showed a decline from 0.49 in 2005–06 to 0.08 by 2015–16, while that of PNC declined from 0.36 to 0.13 over the same period. The reduction in inequality in utilization of full PNC was the least. The results of the decomposition analysis revealed that urban residence, education and belonging to Scheduled Caste and Scheduled Tribes positively contributed to the inequality. Based on these findings, it is suggested that the Janani Suraksha Yojana and Janani Sishu Suraksha Karyakaram schemes be continued and strengthened for poor mothers to reduce maternal health inequality, particularly in full ANC and PNC.

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In India, sterilisation is the most frequent method of modern contraception, and is primarily used by women. The contemporaneous assessment of sterilisation literature focuses only on trends and patterns that are limited to socioeconomic considerations, ignoring the cohort and period issues. No study has employed Age Period Cohort (APC) analysis to highlight the effect of APC on a particular outcome to yet. We have used maximum entropy method modelling to analyse the individual influence of APC on female sterilisation in India using the four rounds of the National Family Health Survey (NFHS). While the older group had higher sterilisation rates than the younger cohort, the age effects were found to have a standard inverted U-shaped curve, with women sterilising in their mid-30s as the might have completed their desire family size. The analysis found high rural-urban differentials in utilising female sterilisation, highlighting the relevance of education and empowerment in contraceptive decision-making among the educated one. Female sterilisation has become less common among Muslims in India over time, and among uneducated women, and it has shifted to later ages with each succeeding period. This was determined to be concerning in terms of India's future fertility. Since 1947, the government has implemented numerous policies to provide women with a variety of contraceptive options; however, the dominance of female sterilisation throughout all periods demonstrates that the government's efforts to provide temporary methods were futile.

The World Health Organisation (WHO) has recognised infertility as a public health issue. Although biological factors are considered to be the primary cause, factors like social, health, and lifestyle factors can all have an adverse effect on a couple’s ability to reproduce. The study aimed to comprehend the infertility scenario in India and explore some of the potential causes. The study used standard demographic definitions and four rounds of the National Family Health Survey (NFHS) from 1992–1993 to 2015–16 to estimate the levels of primary and secondary infertility in India. Bivariate analysis, the t-test, and the Chi-square test were applied to capture significant changes in infertility over time. The multivariate logistic regression model was used to understand the extent of infertility among Indian couples from various socioeconomic groups, lifestyle levels, and reproductive behaviour in 2015–16. Primary infertility declined steadily from 1992 to 2015, whereas secondary infertility increased from 19.5% in 1992–93 to 28.6% in 2015–16. This trend is related to declining fertility rates, particularly in India’s southern states. Age at marriage, biological factors, and lifestyle factors were all strongly linked to infertility. People with higher education levels and late marriages were more likely to experience primary infertility. Alcohol consumption, smoking, obesity, and noncommunicable disease are all strongly linked to secondary infertility. Our study has policy implications, and we draw attention to alarming infertility in India, which has gone unnoticed due to large population. We suggests enhancing the current health and reproductive programmes, educating people about improving their lifestyle choices and sexual behaviour, and calling attention to a significant shift in fertility dynamics.