Urban Slums are New and Important Areas for Inequalities in Maternal and Newborn Health in Many Areas.

Abstract

AIM: The objective of present study was to estimate and compare inequalities in access to maternal and newborn care services utilization between urban slums and rural areas. Methods: The study was carried out in the villages of the rural district of Tapi and slum areas of Surat Municipal Corporation in India utilizing a cross-sectional study design. A standard 30 cluster sampling technique was utilized to select total 216 rural and 377 urban slum mothers delivered in last one year. Data analysis was done by Epi Info 2007. Differences in the standardized indicators of maternal and newborn health services utilization between rural areas and urban slums was the main outcome measure of the study. Results: Coverage and utilization for most of the antenatal care variables like minimum three antenatal visits, antenatal card availability, Tetanus Toxoid immunization and Iron Folic Acid consumption; intranatal care variables like accompanying of pregnant mothers for deliveries to institute by peripheral workers (RR [Relative Risk]=10.01; CI [Confidence Interval]=5.4-18); postnatal care variables like postnatal check-ups (RR=1.77; CI=1.54-2.03), and family planning (FP) advices (RR=1.65; CI=1.47-1.86); and newborn care indicators like newborn check-ups (RR=1.86; CI=1.61-2.14), early breastfeeding initiation and birth registration were higher in rural areas compared to urban slums; but institutional delivery rate (RR=0.76; CI=0.68-0.84), use of FP methods (RR=0.58; CI=0.42-0.78) and prelacteal feed were better in urban slums. Conclusions: The study highlights that maternal and newborn care services utilization are poorer in urban slums compared to rural areas in Gujarat requiring attention to strategize policies toward reducing these gaps.