Maternal health-care service use among rural-urban migrants in Mumbai, India

Stephenson, Rob; Matthews, Zoë

doi:10.18356/25dd145d-en

Cited by 23 publications

(14 citation statements)

References 19 publications

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“…A study by Stephenson and Matthews [ 42 ] found that rural–urban migrant women in Mumbai reported levels of prenatal care similar to urban non-migrants but substantially lower delivery care, suggesting that migrants assimilated the urban preference for institutional prenatal care while preserving the traditional practice of home birth. One explanation was that while social networks provided women with information to access prenatal care, they were also a resource for home-based delivery care [ 42 ]. In a study of two migrant groups in a Delhi slum, institutional maternity care became habitual when modern health services were available and considered effective.…”

Section: Discussionmentioning

confidence: 99%

Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: a mixed methods study

Alcock

Das

et al. 2015

BMC Pregnancy Childbirth

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BackgroundDiscussions of maternity care in developing countries tend to emphasise service uptake and overlook choice of provider. Understanding how families choose among health providers is essential to addressing inequitable access to care. Our objectives were to quantify the determinants and choice of maternity care provider in Mumbai’s informal urban settlements, and to explore the reasons underlying their choices.MethodsThe study was conducted in informal urban communities in eastern Mumbai. We developed regression models using data from a census of married women aged 15–49 to test for associations between maternal characteristics and uptake of care and choice of provider. We then conducted seven focus group discussions and 16 in-depth interviews with purposively selected participants, and used grounded theory methods to examine the reasons for their choices.ResultsThree thousand eight hundred forty-eight women who had given birth in the preceding 2 years were interviewed in the census. The odds of institutional prenatal and delivery care increased with education, economic status, and duration of residence in Mumbai, and decreased with parity. Tertiary public hospitals were the commonest site of care, but there was a preference for private hospitals with increasing socio-economic status. Women were more likely to use tertiary public hospitals for delivery if they had fewer children and were Hindu. The odds of delivery in the private sector increased with maternal education, wealth, age, recent arrival in Mumbai, and Muslim faith. Four processes were identified in choosing a health care provider: exploring the options, defining a sphere of access, negotiating autonomy, and protective reasoning. Women seeking a positive health experience and outcome adopted strategies to select the best or most suitable, accessible provider.ConclusionsIn Mumbai’s informal settlements, institutional maternity care is the norm, except among recent migrants. Poor perceptions of primary public health facilities often cause residents to bypass them in favour of tertiary hospitals or private sector facilities. Families follow a complex selection process, mediated by their ability to mobilise economic and social resources, and a concern for positive experiences of health care and outcomes. Health managers must ensure quality services, a functioning regulatory mechanism, and monitoring of provider behaviour.

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Section: Discussionmentioning

confidence: 99%

Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: a mixed methods study

Alcock

Das

et al. 2015

BMC Pregnancy Childbirth

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“…Stephenson and Matthews showed that while both migrant and non-migrant women faced the barriers of availability, accessibility and affordability of services, and prevailing traditional attitudes towards childbirth to prevent them from utilizing maternal health-care, the migrant women faced the additional problem of being new to the city which, unless they had adequate social networks, limited their knowledge and access to maternal health-care. 18 Babu et al, in a study among migrants in Bhubaneshwar, showed that the availability of essential elements like doctors and medicines, and people"s judgment of quality of care were seen as a prerequisite to the credibility of health services, while issues of accessibility, affordability and loss of income from visits to the health facility were major obstacles. 19 A study on psychosocial health of migrant employees underscores the need to establish help lines and set-ups for extending care, help and support to migrant employees, focusing on their needs in terms of accommodation, settling-in, social interaction, medical care, counseling, information and advice.…”

Section: Discussionmentioning

confidence: 99%

Status of maternal and child health services amongst migrants in Ludhiana slums – how far from the MDG targets?

Sengupta

Benjamin

Babu

2017

Int J Community Med Public Health

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Background: It is essential to monitor the coverage of health interventions in subgroups of populations, especially the marginalized and those at higher risk, because national averages can hide important inequalities. This study was carried out to find out the utilization and coverage of MCH services among migrants in the slums of Ludhiana, Punjab.Methods: Cross-sectional sample study. 370 women, who had childbirth within two years prior to the survey, were randomly selected from the 3947 newer migrant households in 30 slum settlements in Ludhiana surveyed for provision of health care, and information obtained from them with regard to MCH services availed by them for their last pregnancy and childbirth. Their children 12-23 months old, 195 in number, were studied for child health services.Results: Antenatal care (ANC) was availed by 44.0% of the women, with 24.6% of them going for minimum 4 antenatal visits and 29.1% having an institutional delivery but only 35.9% by trained health personnel. Place of delivery was found to be a significant predictor of antenatal care. Women staying in Ludhiana availed the least ANC. Complete immunization coverage in the 12-23 month olds was 37.4%. Government health worker visited 7.8% of the homes.Conclusions: Despite the relative proximity and concentration of health centers in urban compared to rural areas, migrant slum-dwellers are still not able to access quality MCH care. The problem of non-availability of essential healthcare and uneven distribution of skilled health care providers is the central challenge in meeting our health goals.

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“…Bir ülkede iyi işleyen bir sağlık sistemi, o ülkenin sağlık statüsünün de iyi durumda olduğu gibi bir yanılsamaya neden olmaktadır (21). Ancak bütüncül sağlık modelinde sağlık statüsünün sadece sağlık hizmetleri ve sistemi ile açıklanmasının yetersizliği ortaya koyulmaktadır (22 Stephenson ve Matthews (45) 2004 Hindistan Doğum öncesi bakım hizmetleri kırdan kente göç edenler ile kentte yaşayan kadınlar arasında yüksek oranda kullanılmaktadır.…”

Section: Sağlık Statüsüunclassified

İç Göç, Sağlık Hizmetleri Kullanımı ve Sağlık Statüsüne İlişkin Kavramsal Bir İnceleme

Şantaş¹

2020

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Bu çalışmanın amacı iç göçün sağlık hizmetleri kullanımı ve sağlık statüsüne etkisinin kavramsal olarak incelenmesidir. Çalışmada dünyada ve Türkiye'de iç göç, sağlık hizmetleri kullanımı ve sağlık statüsü ilişkisini inceleyen ve erişimi sağlanabilen akademik yayınlara yer verilmiştir. Türkiye'de bu konuda yapılan çalışmaların daha çok kavramsal olduğu, ampirik çalışmaların mevcut durumu yansıtmadığı görülmektedir. İç göçün sağlık hizmetleri kullanımı ve sağlık statüsü üzerindeki etkisini güncel verilerle ve makro ölçekte ortaya koyan çalışmalara ihtiyaç duyulduğu söylenebilir.

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Maternal health-care service use among rural-urban migrants in Mumbai, India

Cited by 23 publications

References 19 publications

Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: a mixed methods study

Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: a mixed methods study

Status of maternal and child health services amongst migrants in Ludhiana slums – how far from the MDG targets?

İç Göç, Sağlık Hizmetleri Kullanımı ve Sağlık Statüsüne İlişkin Kavramsal Bir İnceleme

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