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Table 1 Contextual factors hypothesized to affect MAPEDIR's effectiveness and indicators of their level

From: Maternal death inquiry and response in India - the impact of contextual factors on defining an optimal model to help meet critical maternal health policy objectives

   State
Contextual factor Indicators Rajasthan Madhya Pradesh West Bengal
Community     
Economic status % population BPL (rural/urban) [26] 14.3/28.1 29.8/39.3 24.2/11.2
Community cohesiveness % skilled birth attendance, by caste (SC/ST/other backward class/other) 27.0/23.9/37.3/42.8 25.7/13.9/32.6/49.5 46.2/24.5/64.5/44.5
Status of women % female age 15-49 literacy 39.0 50.0 64.0
Civil society networks and influence WSHGs: engagement in health activities; breadth of coverage* Limited health activities (mostly involved in livelihood generation and micro-financing) Assist with birth preparedness and arrange transport for normal or complicated labour; some districts Promote MH and provide loans for medical emergencies; 300, 000+ WSHGs throughout WB
Public health systems     
Responsiveness and accountability 1. % CHCs with obstetrician posted 1. 32.2 (105/326) 1. 5.7 (13/229) 1. 43.2 (41/95)
  2. % women contacted in last 3 months by community health or nutrition worker 2. 11.7 2. 16.9 2. 23.3
Capacity % blocks with a PH nurse* 0.0 (0/237 blocks) 0.0 (0/313 blocks) > 80% (> 348/436 blocks)
Governance     
Decentralization Decentralization index score [31] 0.35 0.59 0.75
Responsiveness and accountability % health expenditure from public resources/out-of-pocket 30.0/70.0 16.6/83.4 21.6/78.4
  1. BPL = below poverty line; CHC = community health centre; MH = maternal health; PH = public health; SC = scheduled castes; SHC = sub health centre; ST = scheduled tribes; WSHG = women's self-help group.
  2. *UNICEF state health officers' personal communications.
  3. 26GOI Press Information Bureau: poverty estimates are based on household expenditure for essential items data collected by the National Sample Survey Organization of the Ministry of Statistics and Programme Implementation and state-specific poverty lines (rupees per capita per month): Rajasthan: 375/560; Madhya Pradesh: 328/570; West Bengal: 383/449.
  4. 31The initial decentralization measure is being revised, however, with expectation of little effect on the states' rankings (personal communication with Anoop Sadanandan).