This paper assesses evidence for the hypothesis that facility births reduce NNM using new data from the National Family Health Survey, 2015-2016. It finds that for babies born outside of Uttar Pradesh and Bihar, facility birth is robustly associated with neonatal survival. The controlled association between facility birth and neonatal survival is 7 per 1000 in the east region (West Bengal, Assam, Jharkhand, Odisha) and 13 per 1000 in the central region (Madhya Pradesh and Chhattisgarh). In Uttar Pradesh and Bihar, however, being born in a health facility appears to confer no neonatal survival advantage.
Documenting the lack of an association between facility birth and
neonatal death in Uttar Pradesh and Bihar is important because these states collectively contribute 43% of India’s NNM. These findings suggest the need for future research to investigate whether and how the quality of maternal and newborn care in health facilities differs across regions.