Clusters of districts with high under-five mortality rate.

<p>Clusters of districts with high under-five mortality rate.</p

Results of OLS model, Spatial Lag model, and Spatial Error model assessing correlates of under-five mortality in high focus states in India, 2010–11.

<p>Results of OLS model, Spatial Lag model, and Spatial Error model assessing correlates of under-five mortality in high focus states in India, 2010–11.</p

Descriptive Statistics and Moran's <i>I</i> value of Variables.

<p>N = 284 (Districts).</p>a<p>All Moran's I value is significant at p<0.01.</p

Description of Variables.

<p>AHS = Annual Health Survey; SA = Statistical Abstract; HD, IMD = Hydromet Division, India Meteorological Department; DES, MoA, GoI = The Directorate of Economics & Statistics (DES), Ministry of Agriculture, Govt. of India; GIS = Geographical Information System; DLHS = District Level Household and Facility Survey; DESD = The Directorate of Economics & Statistics Division; CHC = Community Health Center; PHC = Primary Health Center; SC/ST = Scheduled Castes/Scheduled Tribes.</p

Correlation Matrix of all Variables.

<p>Note: For full description of variable code, see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0037515#pone-0037515-t001" target="_blank">Table 1</a>.</p>#<p>Correlation is significant at the 0.01 level (2-tailed).</p>*<p>Correlation is significant at the 0.05 level (2-tailed).</p>$<p>Variables were dropped in the regression model to avoid multicollinearity and for the best fit.</p

Residual maps of OLS and Spatial Error Model for under-five mortality across 284 districts in high focus states of India, 2010–11.

<p><b>A.</b> Univariate LISA Cluster map (Moran's I = 0.416) plotting residuals of OLS regression model. <b>B.</b> Univariate LISA Cluster map (Moran's I = 0.200) plotting residuals of Spatial Error regression model.</p

Study area and under-five Mortality.

<p><b>A.</b> Location of study area in India <b>B.</b> Under-5 Mortality Rate (per 1000 live births) across 284 districts in high focus states of India, 2010–11.</p

Bivariate LISA (Cluster and Significance) maps depicting spatial clustering and spatial outliers of under-five mortality by coverage gap index across 284 districts in high focus states of India, 2010–11.

<p><b>A.</b> Bivariate LISA Cluster map of Under-5 Mortality Rate and Coverage Gap Index. <b>B.</b> Bivariate LISA Significance map of Under-5 Mortality Rate and Coverage Gap Index.</p

Prevalence (%) of adolescent women experiencing professional attendance at delivery by socioeconomic and other select characteristics, India, 1990–2006.

<p>NFHS = National Family Health Survey; SC = Scheduled Castes; ST = Scheduled Tribes.</p>a<p>Calculated as relative change = [(final period %/period 1%)−1].</p>b<p>Based on Cochran-Armitage time trend analyses (for linear trend) and χ2 analyses^† (for nonlinear trend) with Rao-Scott adjustments to assess significant trends over time.</p><p>Note: Figures in parentheses are 95% Confidence Intervals for the proportions.</p

Socioeconomic Disparities in Maternity Care among Indian Adolescents, 1990–2006

<div><p>Background</p><p>India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15–19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15–19) in India during 1990–2006.</p><p>Methods and Findings</p><p>Data from three rounds of the National Family Health Survey of India conducted during 1992–93, 1998–99, and 2005–06 were analyzed. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends were applied, respectively, to understand the trend in the proportion of adolescent mothers utilizing select maternity care services during 1990–2006. Using pooled multivariate logistic regression models, the probability of select maternal healthcare utilization among women by key socioeconomic characteristics was appraised. After adjusting for potential socio-demographic and economic characteristics, the likelihood of adolescents accessing full antenatal care increased by only 4% from 1990 to 2006. However, the probability of adolescent women availing themselves of professional attendance at delivery increased by 79% during the same period. The study also highlights the desolate disparities in maternity care services among adolescents across the most and the least favoured groups.</p><p>Conclusion</p><p>Maternal care interventions in India need focused programs for rural, uneducated, poor adolescent women so that they can avail themselves of measures to delay child bearing, and for better antenatal consultation and delivery care in case of pregnancy. This study strongly advocates the promotion of a comprehensive ‘adolescent scheme’ along the lines of ‘Continuum of Maternal, Newborn and Child health Care’ to address the unmet need of reproductive and maternal healthcare services among adolescent women in India.</p></div