Socioeconomic inequalities still hinder access to prenatal care in India

In India, access to prenatal care has improved over the past few decades, but persistent gaps still prevent many women from receiving comprehensive monitoring. Between 1998 and 2021, the proportion of women undergoing at least eight prenatal visits increased, particularly in the most disadvantaged states. However, disparities between rural and urban areas, castes, and social groups remain significant, even if some have narrowed.

Women living in cities, who are more educated and from affluent backgrounds, are still more likely to receive adequate monitoring. Education plays a key role: women with secondary or higher education are more likely to use prenatal care. Women’s autonomy, their access to information through the media, and their wealth levels also strongly influence this usage. In contrast, poor, less educated women or those living in remote regions, such as Bihar or Assam, lag behind. Marginalized communities, such as scheduled castes and tribes, have seen their situation improve, although obstacles remain, particularly due to geographic isolation and limited access to healthcare infrastructure.

The differences between rural and urban areas have diminished, but women in rural areas continue to face difficulties. Geographic barriers, lack of transportation, and a shortage of qualified professionals limit their access to care. National programs, such as the National Rural Health Mission or financial incentives for pregnant women, have helped improve the situation, but structural inequalities persist.

Data analysis reveals that wealth and education are the main factors explaining these disparities. The wealthiest women are up to three times more likely to have eight prenatal visits than the poorest. Similarly, women whose partners are educated or who own a mobile phone have easier access to care. Pregnancy complications also drive women to seek more consultations, highlighting the importance of perceived need.

Despite progress, fewer than one in five women in India achieve the recommended number of visits. States like Kerala and Tamil Nadu, with stronger health systems, have rates well above the national average, while others, such as Uttar Pradesh or Rajasthan, struggle to keep up. These regional disparities reflect broader inequalities in infrastructure, awareness, and economic resources.

Public policies have led to advancements, but to achieve universal coverage, efforts must focus on improving women’s education, enhancing healthcare infrastructure in rural areas, and reducing financial barriers. Without these measures, inequalities are likely to persist, depriving part of the population of essential care for a safe pregnancy.

Website References

Scientific Reference

DOI: https://doi.org/10.1186/s12982-026-02164-x

Title: Socioeconomic heterogeneity and antenatal care utilisation in India

Journal: Discover Public Health

Publisher: Springer Science and Business Media LLC

Authors: Arvind Kumar Yadav; Susanta Nag; Amit Kumar Sahoo; Kirtti Ranjan Paltasingh