Abstract
BackgroundIn 2013, the Government of India launched the National Urban Health Mission (NUHM) in order to better address the health needs of urban populations, including the nearly 100 million living in slums. Maternal and neonatal health indicators remain poor in India. The objective of this study is to highlight the experiences of women, their husbands, and mothers-in-law related to maternal health services and delivery experiences.MethodsIn total, we conducted 80 in-depth interviews, including 40 with recent mothers, 20 with their husbands, and 20 with their mothers-in-law. Purposeful sampling was conducted in order to obtain differences across delivery experiences (facility vs. home), followed by their family members.ResultsMajor factors that influence decision-making about where to seek care included household dynamics and joint-decision-making with families, financial barriers, and perceived quality of care. Women perceived that private facilities were higher quality compared to public facilities, but also more expensive. Disrespectful care, bribes in the facility, and payment challenges were common in this population.ConclusionsA number of programmatic and policy recommendations are highlighted from this study. Future endeavors should include a greater focus on health education and public programs, including educating women on how to access programs, who is eligible, and how to obtain public funds. Families need to be educated on their rights and expectations in facilities. Future programs should consider the role of husbands and mothers-in-law in reproductive decision-making and support during deliveries. Triangulating information from multiple sources is important for future research efforts.
Highlights
In 2013, the Government of India launched the National Urban Health Mission (NUHM) in order to better address the health needs of urban populations, including the nearly 100 million living in slums
Much of the maternal health efforts have focused in rural areas; in 2013, in response to growing urban health disparities, India launched the National Urban Health Mission (NUHM), which focuses on meeting the healthcare needs of the urban poor, slum populations
Women spent an average of 7,721 rupees on services, supplies and Decision-making about delivery location Throughout the course of pregnancy, women and their families made a number of decisions regarding where to seek health services for antenatal and delivery care
Summary
In 2013, the Government of India launched the National Urban Health Mission (NUHM) in order to better address the health needs of urban populations, including the nearly 100 million living in slums. In India, facility deliveries have impressively increased from about 20 % to over 70 % in a span of 10 years; this has not resulted in the maternal and neonatal health improvements expected by health policy analysts [2]. National programs in India, such as the Janani Suraksha Yojana (JSY), have been the major drivers of increases in facility deliveries, among the poorest populations. Much of the maternal health efforts have focused in rural areas; in 2013, in response to growing urban health disparities, India launched the National Urban Health Mission (NUHM), which focuses on meeting the healthcare needs of the urban poor, slum populations
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