Objective : The
objectives of the study are as follows: To estimatethe maternal
morbidity in Bhubaneswar slums, to identify the treatment seeking behavior in
maternal complications and to determine perceptions and attitudes affecting the
choice of health care provider- public or private
Background : Even
as the Indian economy remains one of thebright spots in the world
showing an upward growth trajectory, around 49000 slums continue to blight the
urban landscape forcing lakhs of people to live in pathetic conditions
(according to a report released by NSSO). An analysis of population growth
trending between 1991 and 2001 shows that while India grew at an average annual
growth rate of 2%, urban India grew at 3%, mega cities at 4% and slum
populations rose by 5%. This rapid and unplanned urbanization has a visible
impact on the quality of life of the slum dwellers of the city.
Methodology : A
cross sectional survey across Bhubaneswar slumswas conducted using
quantitative research methods. Even married 150 women in the reproductive age
group of 15-49 who had delivered in past 2 years preceding the survey were
chosen as the primary respondents. The slums were selected by purposive
sampling while random sampling was used to select the respondents.
Findings : : It was found that, private providers were
preferred choicefor outpatient treatment of the study population. The
primary reasons for underutilization of public sector were long waiting times
(42.5%), distance of the facility (37.5%), uncourteous staff
(14.2%) and high rate of absenteeism (4.6%). On the contrary, the public
sector is preferred for inpatient treatment because of lower cost (60%). Though
92% of women received antenatal care, but of poor quality. Despite
various efforts to increase institutional deliveries, 49% of the women
delivered at home with around 75% of these being assisted by untrained dais.
This should really raise an alarm because unskilled birth attendants do not
maintain the required asepsis thereby, risking the lives of women and their
newborn children. The state of postnatal care is miserable with only 5% of the
respondents admitting to have visited by health personnel within 48 hours of delivery.
Recommendations : The study ascertains
the fact that the public healthsystem needs to be re-oriented to have a
more needs based approach. Strict measures must be taken to improve the
accessibility, affordability, acceptability and accountability of the public
sector. Further efforts must be made to involve all the major stakeholders in
policy framing, planning and implementation.
The objectives of the study are as follows: To estimate the maternal morbidity in Bhubaneswar slums, to identify the treatment seeking behavior in maternal complications