Dissecting socioeconomic inequalities in antenatal care utilization in India: a Blinder–Oaxaca decomposition approach

Purpose Antenatal care (ANC) is a crucial determinant of women’s and children’s health, especially in resource-constrained nations such as India. Despite its importance, access to ANC remains inequitable across various socio-economic groups. The study examines inequalities in antenatal care service (ANC4+) utilization among Indian women using data from three waves of the National Family Health Survey. Design/methodology/approach This study employs a quantitative research approach, utilizing the logistic regression method and the Blinder–Oaxaca decomposition (BOD) framework. Findings The findings reveal significant disparities in ANC utilization, with 73.0% of wealthier and educated women adhering to WHO guidelines, compared to only 28.0% of uneducated and 25.0% of the poorest women. The utilization of ANC was significantly affected by factors such as women’s autonomy, income and mass media exposure. Additionally, women with first-order births and those from Upper Hindu Caste exhibited a greater likelihood of ANC utilization as compared to their counterparts. Research limitations/implications The study emphasizes the necessity for sustained long-term investments and targeted interventions to bridge these gaps. Collaborative efforts between the government, healthcare providers and community-based organizations are key to implementing these policies and improving maternal and newborn health outcomes in India. Originality/value While previous studies have identified inequalities in accessing ANC, there remains a need for further investigation into the distribution of women receiving at least four ANC visits across various countries and socioeconomic groups. Therefore, this study suggests the need to understand the urgency and importance of ANC.