Sushmita Das|Ujwala Bapat|Neena Shah More|Latika Chordhekar|Wasundhara Joshi|David Osrin
Prospective study of determinants and costs of home births in Mumbai slums
Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|Society for Nutrition Education and Health Action|London International Development Centre|University College London
around 86 births mumbai india occur healthcare institutions aggregate figure hides substantial variation little known urban home births aimed explore factors influencing choice home delivery care practices costs identify characteristics women households environment might increase likelihood home birthas part city initiative newborn health used key informant surveillance system identify births prospectively 48 slum communities six wards mumbai covering population 280000 births outcomes documented prospectively local women mothers interviewed detail six weeks delivery examined prevalence home births associations potential determinants using regression modelswe described 1708 16 home deliveries among 10754 births two years 20052007 proportion varied 6 24 depending area commonly cited reasons home birth custom lack time reach healthcare facility labour seventy percent home deliveries assisted traditional birth attendant dai 6 skilled health personnel median cost home delivery us 21 institutional delivery public sector us 32 private sector us 118 adjusted multivariable regression model odds home delivery increased illiteracy parity socioeconomic poverty poorer housing lack water supply population transience hazardous locationwe estimate 32000 annual home births residents mumbais slums unevenly distributed cluster markers vulnerability since cost appear dominant disincentive institutional delivery efforts needed improve client experience public sector institutions might also productive concentrate intensive outreach vulnerable areas communitybased health workers could play greater part helping women plan deliveries making sure get help time