Women’s Reproductive Health in Slum Populations in India: Evidence From NFHS-3
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The urban population in India is one of the largest in the world. Its unprecedented growth has resulted in a large section of the population living in abject poverty in overcrowded slums. There have been limited efforts to capture the health of people in urban slums. In the present study, we have used data collected during the National Family Health Survey-3 to provide a national representation of women’s reproductive health in the slum population in India. We examined a sample of 4,827 women in the age group of 15–49 years to assess the association of the variable slum with selected reproductive health services. We have also tried to identify the sociodemographic factors that influence the utilization of these services among women in the slum communities. All analyses were stratified by slum/non-slum residence, and multivariate logistic regression was used to analyze the strength of association between key reproductive health services and relevant sociodemographic factors. We found that less than half of the women from the slum areas were currently using any contraceptive methods, and discontinuation rate was higher among these women. Sterilization was the most common method of contraception (25%). Use of contraceptives depended on the age, level of education, parity, and the knowledge of contraceptive methods (p < 0.05). There were significant differences in the two populations based on the timing and frequency of antenatal visits. The probability of ANC visits depended significantly on the level of education and economic status (p < 0.05). We found that among slum women, the proportion of deliveries conducted by skilled attendants was low, and the percentage of home deliveries was high. The use of skilled delivery care was found to be significantly associated with age, level of education, economic status, parity, and prior antenatal visits (p < 0.05). We found that women from slum areas depended on the government facilities for reproductive health services. Our findings suggest that significant differences in reproductive health outcomes exist among women from slum and non-slum communities in India. Efforts to progress towards the health MDGs and other national or international health targets may not be achieved without a focus on the urban slum population.
KeywordsSlum India National Family Health Survey-3 Contraception Antenatal care Skilled delivery care
- 1.John D, Chander SJ, Devadasan N: National Urban Health Mission. An analysis of strategies and mechanisms for improving services for urban poor. National Workshop on Urban Health and Poverty, New Delhi; 2008Google Scholar
- 4.Census of India 2001. Metadata and Brief Highlights on Slum Population. Available at: http://censusindia.gov.in/Data_Products/Data_Highlights/Data_Highlights_link/metadata_highlights.pdf. Accessed on September 11, 2009.
- 6.Mony PK, Verghese L, Bhattacharji S, George A, Thoppuram P, Mathai M. Demography, Environmental Status and Maternal Health Care in Slums of Vellore Town, Southern India. Indian J Community Med. 2006; 31: 230–233.Google Scholar
- 7.Agrawal S, Bharti BM. Reproductive health in urban slums. J Obstet Gynecol India. 2006; 56: 255–257.Google Scholar
- 9.Kapadia KN, Kanitkar T. Primary healthcare in urban slums. Econ Polit Wkly. 2002; December: 5086–5089.Google Scholar
- 11.International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS. 2007.Google Scholar
- 12.National Family Health Survey, India. Available at http://www.nfhsindia.org/index.html. Accessed on July 11, 2009.
- 13.Madhiwalla N. Healthcare in urban slums in India. Natl Med J India. 2008; 20(3): 113–114.Google Scholar
- 14.Rutstein SO. The DHS Wealth Index: Approaches for Rural and Urban Areas. DHS Working Papers, 2008 No. 60. Available at http://pdf.usaid.gov/pdf_docs/PNADN521.pdf. Accessed on July 17, 2009.
- 15.Stephenson R, Hennink M. Barriers to Family Planning Service Use among the Urban Poor in Pakistan. Opportunities and Choices Working Paper No. 2, February 2004. Available at http://www.socstats.soton.ac.uk/choices/PakistanbarriersWP2.PDF. Accessed on September 15, 2009.
- 18.Puri A, Garg S, Mehra M. Assessment of unmet need for contraception in an urban slum of Delhi. Indian J Community Med. 2004; 29(3): 139–140.Google Scholar
- 20.Shekhar C, Ram F. National report on evaluation of functioning of urban health posts/urban family centres in india. International institute of population sciences (IIPS), Mumbai; 2005.Google Scholar