Abstract
Background: Informal urban settlements, known as slums, are the home for a large proportion of the world population. Healthcare in these environments is extremely complex, driven by poverty, environmental challenges, and poor access to formal health infrastructures. This study investigated healthcare challenges faced and choices made by slum dwellers in Mumbai, India. Methods: Structured interviews with 549 slum dwellers from 13 slum areas in Mumbai, India, were conducted in order to obtain a population profile of health-related socio-economic and lifestyle factors, disease history and healthcare access. Statistical tools such as multinomial logistic regression were used to examine the association between such factors and health choices. Results: Private providers (or a mixture of public and private) were seen to be preferred by the study population for most health conditions (62% - 90% health consultations), apart from pregnancy (43% health consultations). Community-based services were also preferred to more remote options. Stark differences in healthcare access were observed between well-known conditions, such as minor injuries, pulmonary conditions, and pregnancy and emerging challenges, such as hypertension and diabetes. A number of socio-economic and lifestyle factors were found to be associated with health-related decisions, including choice of provider and expenditure. Conclusions: Better planning and coordination of health services, across public and private providers, is required to address mortality and morbidity in slum communities in India. This study provides insights into the complex landscape of diseases and health providers that slum dwellers navigate when accessing healthcare. Findings suggest that integrated services and public-private partnerships could help address demand for affordable community-based care and progress towards the target of universal health coverage.
Highlights
By 2025, the world population is projected to reach 8.1 billion, with the majority of this growth taking place in developing countries[1]
This study examined the disease burden, health awareness and services, and healthcare choices reported by residents across 13 slums in Mumbai, India
To provide insights into the heterogeneous nature of healthcare choices, the study focused on parents of young children who are likely to have recently encountered a number of health challenges including maternal health, common health conditions, and early-onset non-communicable diseases (NCDs)
Summary
By 2025, the world population is projected to reach 8.1 billion, with the majority of this growth taking place in developing countries[1]. Known as slums, are the home for a large proportion of the world population Healthcare in these environments is extremely complex, driven by poverty, environmental challenges, and poor access to formal health infrastructures. Methods: Structured interviews with 549 slum dwellers from 13 slum areas in Mumbai, India, were conducted in order to obtain a population profile of health-related socio-economic and lifestyle factors, disease history and healthcare access. Statistical tools such as multinomial logistic regression were used to examine the association between such factors and health choices.
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