Prakash PATEL, Kanan DESAİ, Bhautik MODİ, RK BANSAL

Çoğu Bölgede Anne ve Yenidoğan Sağlığında Eşitsizlikler Açısından Şehirlerin Kenar Mahalleleri Yeni ve Önemli Alanlardır

AMAÇ: Bu çalışmanın amacı şehirlerin kenar mahalleleri ile kentsel alanlar arasında anne ve yenidoğan hizmetlerine ulaşımdaki eşitsizlikleri tahmin etmek ve karşılaştırmaktır. YÖNTEM: Bu çalışma Hindistan'da Tapi kentsel bölgesinin köylerinde ve Surat Belediye Şirketinin kenar mahalle alanlarında kesitsel araştırma dizaynı kullanılarak yürütüldü. Standart 30 küme örnekleme tekniği ile 216 kentli ve 377 kenar mahalleli son bir yılda doğum yapmış anne çalışmaya dahil edildi. Veri analizi Epi Info 2007 kullanılarak yapıldı. İki grup arasındaki anne ve yenidoğan sağlık hizmeti kullanımının standart göstergelerindeki farklılıklar çalışmanın temel ölçütü olarak kullanıldı. BULGULAR: Doğum öncesi en az üç muayene, doğum öncesi takip kartı, tetanoz aşısı ve demir-folik asit alımı gibi antenatal bakım değişkenleri; doğum sırasında gebe annelere refakat gibi intranatal bakım değişkenleri; doğum sonrası muayene ve aile planlaması tavsiyeleri gibi postnatal bakım değişkenleri ve yenidoğan muayenesi, erken emmenin başlatılması ve bebek nüfus kaydı gibi yenidoğan bakım değişkenlerinin çoğu için kapsam ve yararlanma kentsel bölgede kenar mahalle bölgesine göre daha yüksekti. Ancak, sağlık kurumunda doğum hızı, aile planlaması yöntemi kullanımı ve emzirme öncesi besleme kenar mahallede daha yüksektir. SONUÇ: Bu çalışma anne ve yenidoğan hizmetlerinin kullanımının kenar mahallelerde kentsel bölgeye gore daha kötü olduğuna ve bu açığın giderilmesi için politika geliştirilmesi gerektiğine dikkat çeker.

Urban Slums Are New and Important Areas for Inequalities in Maternal and Newborn Health in Many Areas

AIM: The objective of present study was to estimate and compare inequalities in access to maternal and newborn care services utilization between urban slums and rural areas. METHODS: The study was carried out in the villages of the rural district of Tapi and slum areas of Surat Municipal Corporation in India utilizing a cross-sectional study design. A standard 30 cluster sampling technique was utilized to select total 216 rural and 377 urban slum mothers delivered in last one year. Data analysis was done by Epi Info 2007. Differences in the standardized indicators of maternal and newborn health services utilization between rural areas and urban slums was the main outcome measure of the study. RESULTS: Coverage and utilization for most of the antenatal care variables like minimum three antenatal visits, antenatal card availability, Tetanus Toxoid immunization and Iron Folic Acid consumption; intranatal care variables like accompanying of pregnant mothers for deliveries to institute by peripheral workers ; postnatal care variables like postnatal check-ups (RR=1.77; CI=1.54-2.03), and family planning (FP) advices (RR=1.65; CI=1.47-1.86); and newborn care indicators like newborn check-ups (RR=1.86; CI=1.61-2.14), early breastfeeding initiation and birth registration were higher in rural areas compared to urban slums; but institutional delivery rate (RR=0.76; CI=0.68-0.84), use of FP methods (RR=0.58; CI=0.42-0.78) and prelacteal feed were better in urban slums. CONCLUSIONS: The study highlights that maternal and newborn care services utilization are poorer in urban slums compared to rural areas in Gujarat requiring attention to strategize policies toward reducing these gaps.

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