Evaluation of effectiveness of ‘my community’ project for improving maternal and newborn health of women in urban slums: a case study of Gautam Buddh Nagar (Noida)
Student name: Ms Sakshi Nigam
Guide: Dr Prashant Kumar Singh
Year of completion: 2018
Host Organisation: MAMTA- Health Institute for Mother and Child
Supervisor (Host Organisation): Dr Murari Chandra
Abstract: India has witnessed one of the largest urban growth in the past two decades. Accompanying this rapid pace of urbanization has been a faster growth in the migrant population residing in slums. Maternal and newborn health has emerged as one of the dominant concerns with the recent findings from NFHS-3&4 as maternal health indicators for both urban poor and rural areas have long been at same position. Although community mobilisation and participatory approaches have garnered global support in low-resource settings, less has been researched about its effectiveness in improving maternal and newborn health outcomes in urban poor settings where there exists complex interplay of both supply and demand side barriers. The present research is an outcome effectiveness evaluation of an urban poor maternal health intervention. The aim of the study was to examine awareness, uptake of ANC, institutional delivery and PNC among urban poor women and inform measures for program’s improvements. The study utilised a non-experimental design with a purposive sampling technique, 27 women from three clusters were interviewed.
The evaluation found an increased levels in ANC awareness and uptake, and nearly 70% deliveries took place in government health facilities. The poorest performing component was PNC as the negative experiences due to behaviour of health personnel, violence, corruption at health facilities and low awareness acted as a deterrent for women to go back to government facilities. Although women after coming in contact with health workers preferred government facilities for ANC and institutional deliveries, however, there is an increasing trust deficit which could jeoparadise program’s objective. It is recommended that intensive training be provided for health workers so that home visits for newborn and mother could be provided. There needs to be collective prioritisation of women’s health of which safe and positive motherhood experience is a part of. The intervention also should work towards increasing community cohesiveness so as to provide well-equipped mechanisms for pregnancy and childbirth.
Keywords: Maternal and newborn health, urban poor, urban slums, community mobilisation
