Maternal autonomy and birth registration in India: Who gets counted?

Area of Science:

• Public Health
• Sociology
• Demography

Background:

• Child birth registration is a fundamental right and crucial for accessing essential services.
• Maternal socio-economic status (SES) is recognized as a key determinant of child welfare outcomes.
• Understanding the nuanced impact of maternal SES on birth registration is vital for policy development in India.

Purpose of the Study:

• To investigate the influence of maternal socio-economic status, including autonomy and bargaining power, on child birth registration in India.
• To analyze the role of household, individual, district, and community characteristics in birth registration.
• To examine the variations in the impact of maternal autonomy across different districts.

Main Methods:

• Utilized data from the nationally representative India Human Development Survey-II (IHDS-II), 2011-12.
• Employed a multilevel mixed-effects model to account for the hierarchical data structure (child, district, community).
• Assessed the probability of birth registration by considering individual child, maternal, household, and contextual factors.

Main Results:

• Significant variations in birth registration probability exist between districts and individuals, sharing almost equal proportions.
• Maternal autonomy indicators, such as independent mobility and exposure to the outside world, positively correlate with higher birth registration probability.
• The impact of maternal autonomy on birth registration varies significantly across different districts in India.

Conclusions:

• Enhancing maternal socio-economic status and autonomy is critical for improving child birth registration rates in India.
• Policy interventions should consider district-specific contexts and the heterogeneity of maternal autonomy's effects.
• Factors like institutional birth, antenatal care, caste, religion, wealth, and parental education are also significant determinants of birth registration.