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Sociocultural and institutional factors influencing antenatal care utilization amongst Mumbai's slum population: a critical literature synthesis

Sarnaik, Shashi (2018) Sociocultural and institutional factors influencing antenatal care utilization amongst Mumbai's slum population: a critical literature synthesis. Master's Thesis, University of Pittsburgh. (Unpublished)

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Introduction: Low-income women living in Mumbai’s slums exhibit poor antenatal care utilization and, as a result, experience a disproportionate burden of maternal mortality and morbidity. Identifying the diverse range of underlying factors associated with this population’s antenatal care seeking behavior is a vital step in developing effective antenatal care policies and programs.
Background: In spite of India’s provision of free and subsidized antenatal care programming, women living in Mumbai’s slums overwhelmingly exhibit unsafe antenatal care seeking behavior. The existing public antenatal care policies and programs are insufficient to address their antenatal care utilization rates.
Method: A critical literature synthesis utilizing two databases and one search engine identified peer-reviewed papers examining the factors associated with antenatal care utilization and non-utilization amongst low-income women living in Mumbai slum communities. The search utilized 10 Boolean terms and restricted inclusion to articles published since 2013.
Results: The search identified 12 relevant articles and included both quantitative and qualitative studies of care seeking for pregnancy, childbirth, abortion, and family planning. Studies identified a number of factors influencing women’s decisions to seek antenatal care services, including sociodemographic factors, gender and social relations, knowledge, preferences, and beliefs, and the availability, accessibility, acceptability, and quality of care provision.
Discussion: An examination of the recent literature revealed significant gaps in the literature, including measurements of between-group differences and women’s real access to components of antenatal care. Additionally, the various sociocultural and institutional factors appear to intersect and exacerbate women’s non-utilization of antenatal care services, with issues such as slum legality and weak public health governance complicating women’s access to quality antenatal care services.
Conclusion: Given the complex nature of Mumbai’s slum policies and public health care systems, slum-dwelling women’s urgent need for quality antenatal care demands an effective and comprehensive public health strategy. Recommendations include adopting a more context-appropriate conceptualization of antenatal care, improving the demand for and supply of skilled antenatal care services through NGO-led community mobilization and the redistribution of key antenatal care services to more effective and acceptable providers, and addressing gaps in the existing antenatal health research.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Sarnaik, Shashisas385@pitt.edusas385
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHawk,
Committee MemberNelson,
Committee MemberTerry,
Date: 20 September 2018
Date Type: Publication
Defense Date: 2 August 2018
Approval Date: 20 September 2018
Submission Date: 23 July 2018
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 79
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: antenatal care maternal health poverty areas Mumbai, India utilization
Date Deposited: 20 Sep 2018 19:59
Last Modified: 01 Sep 2019 05:15


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