Factors Influencing Uptake of Institutional Delivery Among Scheduled Tribe and Non-scheduled Tribe Women in India: Evidence from the National Family Health Survey, 2019-21

Abstract

Scheduled tribe (ST) women in India continue to face disparities in maternal healthcare services due to sociocultural norms and geographic isolation. This study compared the estimates of institutional delivery across ST-women and non-ST women for the most recent childbirth using nationally representative data from NFHS 2019-21. A weighted sample size of 174 964 women aged 15-49 years was included in this study. Bivariate and multivariate logistic regression were used to assess the associations between institutional delivery and individual, socio-economic, physical accessibility and mass media factors. Findings revealed a lower institutional delivery rate among ST women (83.6%) compared to non-ST women (90.8%) for the most recent childbirth preceding the survey. Younger maternal age was associated with higher institutional delivery across both the groups while delayed marriage was significantly beneficial for ST women. Four or more ANC visits significantly improved institutional delivery odds across both the groups. Type of residence (urban vs rural) was not a strong predictor once socioeconomic factors were adjusted. However, regional disparities persisted more among ST women. Education emerged as a strong enabler for both the groups, but wealth index consistently influenced institutional delivery only among non-ST women. Mass media exposure through television was positively associated with maternal health service utilization only among non-ST women. The study findings underscore the need for differentiated strategies—culturally sensitive, geographically focused, and socioeconomically targeted—to ensure equitable and inclusive utilization of maternal health services by both groups.