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Fig 1.

The study area.

Source: Prepared by authors.

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Table 1.

Indicators, domains and their relationship with District Composite Health Profile (DCHP).

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Fig 2.

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Fig 3.

Maternal Mortality Ratio (MMR) in the selected EAG states (2001–2018).

Source: Sample Registration System Bulletins, Office of Registrar General of India (2020). *Analysis for the year 2016–18 excludes data of Jharkhand, Chhattisgarh, and Uttarakhand in their parent states.

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Fig 4.

Birth Rates in the selected EAG states (1997–2019).

Source: Sample Registration System Bulletins, Office of Registrar General of India (1999, 2006, 2014, 2021). *Analysis for the year 1997 includes data of Jharkhand, Chhattisgarh, and Uttarakhand for their parent states.

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Fig 5.

Death Rates in the selected EAG states (1997–2019).

Source: Sample Registration System Bulletins, Office of Registrar General of India (1999, 2006, 2014, 2021). *Analysis for the year 1997 includes data of Jharkhand, Chhattisgarh, and Uttarakhand for their parent states.

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Fig 6.

Infant Mortality Rates (IMR) in the selected EAG states (1997–2019).

Source: Sample Registration System Bulletins, Office of Registrar General of India (1999, 2006, 2014, 2021). *Analysis for the year 1997 includes data of Jharkhand, Chhattisgarh, and Uttarakhand for their parent states.

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Fig 7.

District Composite Health Profile, NFHS-4.

Source: Prepared by authors based on NFHS-4, International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), 2015-16, (2017).

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Fig 8.

District Composite Health Profile, NFHS-5.

Source: Prepared by authors based on NFHS-5, International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019-21 (2021).

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Table 2.

Descriptive statistics of DCHP and its indicators based on NFHS-4 and NFHS-5.

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Fig 9.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile, based on NFHS-4 (DCHP4) and District Composite Health Profile, based on NFHS-5 (DCHP5).

A. Univariate LISA Cluster map of DCHP4 across 197 districts in selected EAG States, 2015–16. B. Univariate LISA Cluster map of DCHP5 across 197 districts in selected EAG States, 2019–21. C. Univariate LISA Significance map of DCHP4 across 197 districts in selected EAG States, 2015–16. D. Univariate LISA Significance map of DCHP5 across 197 districts in selected EAG States, 2019–21.

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Fig 10.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile based on NFHS-4.

A. Univariate LISA Cluster map of Percent of currently married women (15–49) using any method of Family Planning across 197 districts in selected EAG States, 2015–16. B. Univariate LISA Significance map of Percent of currently married women (15–49) using any method of Family Planning across 197 districts in selected EAG States, 2015–16. C. Univariate LISA Cluster map of Percentage of women who had four or more ANC visits across 197 districts in selected EAG States, 2015–16. D. Univariate LISA Significance map of Percentage of women who had four or more ANC visits across 197 districts in selected EAG States, 2015–16. E. Univariate LISA Cluster map of Percentage of Births with three and more children across 197 districts in selected EAG States, 2015–16. F. Univariate LISA Significance map of Percentage of Births with three and more children across 197 districts in selected EAG States, 2015–16.

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Fig 11.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP 5), based on NFHS-5.

A. Univariate LISA Cluster map of Percent of currently married women (15–49) using any method of Family Planning across 197 districts in selected EAG States, 2019–21. B. Univariate LISA Significance map of Percent of currently married women (15–49) using any method of Family Planning across 197 districts in selected EAG States, 2019–21. C. Univariate LISA Cluster map of Percentage who had four or more ANC visits across 197 districts in selected EAG States, 2019–21. D. Univariate LISA Significance map of Percentage who had four or more ANC visits across 197 districts in selected EAG States, 2019–21. E. Univariate LISA Cluster map of Percentage of Births with three and more children across 197 districts in selected EAG States, 2019–21. F. Univariate LISA Significance map of Percentage of Births with three and more children across 197 districts in selected EAG States, 2019–21.

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Fig 12.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP4), based on NFHS-4.

A. Univariate LISA Cluster map of Percentage of children having any anaemia (<11.0 g/d) across 197 districts in selected EAG States, 2015–16. B. Univariate LISA Significance map of Percentage of children having any anaemia (<11.0 g/d) across 197 districts in selected EAG States, 2015–16. C. Univariate LISA Cluster map of Percentage of women having any anaemia (<12.0 g/dl) across 197 districts in selected EAG States, 2015–16. D. Univariate LISA Significance map of Percentage of women having any anaemia (<12.0 g/dl) across 197 districts in selected EAG States, 2015–16. E. Univariate LISA Cluster map of Percentage of children with full vaccination across 197 districts in selected EAG States, 2015–16. F. Univariate LISA Significance map of Percentage of children with full vaccination across 197 districts in selected EAG States, 2015–16.

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Fig 13.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP 5), based on NFHS-5.

A. Univariate LISA Cluster map of Percentage of children having any anaemia (<11.0 g/d) across 197 districts in selected EAG States, 2019–21. B. Univariate LISA Significance map of Percentage of children having any anaemia (<11.0 g/d) across 197 districts in selected EAG States, 2019–21. C. Univariate LISA Cluster map of Percentage of women having any anaemia (<12.0 g/dl) across 197 districts in selected EAG States, 2019–21. D. Univariate LISA Significance map of Percentage of women having any anaemia (<12.0 g/dl) across 197 districts in selected EAG States, 2019–21. E. Univariate LISA Cluster map of Percentage of children with full vaccination across 197 districts in selected EAG States, 2019–21. F. Univariate LISA Significance map of Percentage of children with full vaccination across 197 districts in selected EAG States, 2019–21.

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Fig 14.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP4), based on NFHS-4.

A. Univariate LISA Cluster map of Percentage of Births delivered in a health facility across 197 districts in selected EAG States, 2015–16. B. Univariate LISA Significance map of Percentage of Births delivered in a health facility across 197 districts in selected EAG States, 2015–16. C. Univariate LISA Cluster map of Percentage of Deliveries assisted by health personnel across 197 districts in selected EAG States, 2015–16. D. Univariate LISA Significance map of Percentage of Deliveries assisted by health personnel across 197 districts in selected EAG States, 2015–16. E. Univariate LISA Cluster map of Percent of currently married women (15–49) with total unmet need of Family Planning across 197 districts in selected EAG States, 2015–16. F. Univariate LISA Significance map of Percent of currently married women (15–49) with total unmet need of Family Planning across 197 districts in selected EAG States, 2015–16.

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Fig 15.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP5), based on NFHS-5.

A. Univariate LISA Cluster map of Percentage of Births delivered in a health facility across 197 districts in selected EAG States, 2019–21. B. Univariate LISA Significance map of Percentage of Births delivered in a health facility across 197 districts in selected EAG States, 2019–21. C. Univariate LISA Cluster map of Percentage of Deliveries assisted by health personnel across 197 districts in selected EAG States, 2019–21. D. Univariate LISA Significance map of Percentage of Deliveries assisted by health personnel across 197 districts in selected EAG States, 2019–21. E. Univariate LISA Cluster map of DCHP5 and Percent of currently married women (15–49) with total unmet need of Family Planning across 197 districts in selected EAG States, 2019–21. F. Univariate LISA Significance map of Percent of currently married women (15–49) with total unmet need of Family Planning across 197 districts in selected EAG States, 2019–21.

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Fig 16.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP4), based on NFHS-4.

A. Univariate LISA Cluster map of Percentage of Women with BMI <18.5 (total thin) across 197 districts in selected EAG States, 2015–16. B. Univariate LISA Significance map of Percentage of Women with BMI <18.5 (total thin) across 197 districts in selected EAG States, 2015–16. C. Univariate LISA Cluster map of Underweight across 197 districts in selected EAG States, 2015–16. D. Univariate LISA Significance map of Underweight across 197 districts in selected EAG States, 2015–16. E. Univariate LISA Cluster map of Stunting across 197 districts in selected EAG States, 2015–16. F. Univariate LISA Significance map of Stunting across 197 districts in selected EAG States, 2015–16. G. Univariate LISA Cluster map of Wasting across 197 districts in selected EAG States, 2015–16. H. Univariate LISA Significance map of Wasting across 197 districts in selected EAG States, 2015–16.

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Fig 17.

Univariate LISA (Cluster and significance) maps depicting spatial clustering and spatial outliers of District Composite Health Profile (DCHP5), based on NFHS-5.

A. Univariate LISA Cluster map of Women with BMI <18.5 (total thin) across 197 districts in selected EAG States, 2019–21. B. Univariate LISA Significance map of Women with BMI <18.5 (total thin) across 197 districts in selected EAG States, 2019–21. C. Univariate LISA Cluster map of Underweight across 197 districts in selected EAG States, 2019–21. D. Univariate LISA Significance map of Underweight across 197 districts in selected EAG States, 2019–21. E. Univariate LISA Cluster map of DCHP5 and Stunting across 197 districts in selected EAG States, 2019–21. F. Univariate LISA Significance map of Stunting across 197 districts in selected EAG States, 2019–21. G. Univariate LISA Cluster map of Wasting across 197 districts in selected EAG States, 2019–21. H. Univariate LISA Significance map of Wasting across 197 districts in selected EAG States, 2019–21.

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Table 3.

Moran-I statistics for the DCHP and indicators the selected EAG states of India, 2016–2021.

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