Inequalities in maternity care and newborn outcomes: one-year surveillance of births in vulnerable slum communities in Mumbai

More, Neena Shah; Bapat, Ujwala; Das, Sushmita; Barnett, Sarah A.; Costello, Anthony; Fernandez, Armida; Osrin, David

doi:10.1186/1475-9276-8-21

Cited by 31 publications

(28 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Poor and marginalised urban subgroups compare unfavourably with other urban dwellers with respect to mortality [17]–[20], and groups such as the poorest migrants from rural areas and slum dwellers may have maternal, newborn and child mortality rates as high as or even higher than the rural poor [4],[21]–[24].…”

Section: Is There An Urban Advantage In Maternal and Newborn Health mentioning

confidence: 99%

Examining the “Urban Advantage” in Maternal Health Care in Developing Countries

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Is There An Urban Advantage In Maternal and Newborn Health mentioning

confidence: 99%

Examining the “Urban Advantage” in Maternal Health Care in Developing Countries

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

“…There are socioeconomic, cultural and spatial barriers that explain why some women receive inadequate or no care in both countries. The poorest-poor, the less educated and women from socially deprived background usually have higher medical care needs but they receive inadequate or no care and often delay seeking health care (Victora et al, 2010;Allendorf, 2010;More et al, 2009;Ribeiro et al, 2009;Say and Raine, 2007;Sunil et al, 2006;Pallikadavath et al, 2004;Navaneetham and Dharmalingam, 2002). Physical distance to health facilities, lack of transportation and costs are major barriers to accessing antenatal care in India (Pathak et al, 2010).…”

Section: Introductionmentioning

confidence: 98%

Antenatal care use in Brazil and India: Scale, outreach and socioeconomic inequality

et al. 2012

View full text Add to dashboard Cite

This paper investigates the extent of socioeconomic inequalities in antenatal care use and related medical procedures in Brazil and India, which represent transition economies with contrasting geographical and sociocultural composition and health care provision. Concentration indices and regression analyses applied on recent Demographic Health Survey data reveal high and proportionate distribution of antenatal coverage in Brazil, whereas the Indian case present problems of both scale and equity. Inequalities in access to four or more antenatal visits are significantly pronounced in India, and in Brazil the differences are significant only for those who had six or more visits. Brazil's universal healthcare model which proved effective in promoting equitable distribution of antenatal care could be implemented in India. Future interventions should emphasis quality of care in monitoring essential antenatal services especially targeting the poor and deprived communities.

show abstract

“…The UN provisional operational definition of a slum (UN Expert Group Meeting, Nairobi 2002) includes five dimensions of vulnerability,4 and there is substantial heterogeneity both between and within communities 5 , 6. All of Mumbai’s slums share one characteristic—density—but “…slum pockets are highly differentiated by type, size and location, and occupy land held under a variety of ownership structures, including central government, state, municipal and private…” 7.…”

Section: Introductionmentioning

confidence: 99%

A Rapid Assessment Scorecard to Identify Informal Settlements at Higher Maternal and Child Health Risk in Mumbai

et al. 2011

Self Cite

View full text Add to dashboard Cite

The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes—less than three antenatal care visits, home delivery, and neonatal mortality—and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

show abstract

Inequalities in maternity care and newborn outcomes: one-year surveillance of births in vulnerable slum communities in Mumbai

Abstract: Background: Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups.

Cited by 31 publications

References 32 publications

Examining the “Urban Advantage” in Maternal Health Care in Developing Countries

Examining the “Urban Advantage” in Maternal Health Care in Developing Countries

Antenatal care use in Brazil and India: Scale, outreach and socioeconomic inequality

A Rapid Assessment Scorecard to Identify Informal Settlements at Higher Maternal and Child Health Risk in Mumbai

Contact Info

Product

Resources

About