DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20194151

Tracking of antenatal services and outcomes using community health information system in a slum population of North India

D. S. Faujdar, Neha Dahiya, Har Ashish Jindal

Abstract


Background: Despite of improvement of public health service, the reach of these services has remained low in urban slums due to various socio cultural and environmental factors.

Methods: An information and communication technology (ICT) based community health information system was installed in a urban primary health centre catering to urban slum populations in North India. The system was used to track all the antenatal cases registered over a period of one and half years for antenatal services, risk factors and antenatal outcome. The system allowed for tracking of antenatal cases for antenatal care (ANC) visits, investigations, high risk factors, delivery and perinatal care. Real-time monitoring of antenatal cases was made possible through dynamic dashboard with indicators.

Results: Among 614 women tracked for ANC and outcome, majority were below 30 years of age (78.3%), belonged to lower caste (85.7%) and many were illiterate (42.8%). Out of all antenatal cases 68% got registered in 1st trimester and only 47% completed 4 ANC visit. Majority delivered in government hospitals (95.4%) with 22.8% delivered through caesarean section. Illiteracy was found to have significant association with higher gravida (>2) (p<0.001). The high risk factors were present in 29.5% of antenatal cases and it was found to be significantly associated with increasing age (p=0.02) and preterm deliveries (p<0.001). Twin pregnancy was also found to be significantly associated with increasing age (p<0.001).

Conclusions: An ICT based community health information system can be an effective tool for real-time monitoring of health services, identifying the gaps and tracking of antennal cases especially in difficult to reach slum population.


Keywords


Antenatal, Slum population, High risk, Health information system

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References


United Nations. World Urbanization Prospects: The 2001 Revision. New York: The United Nations; 2002.

Department of Medical Health and Family Welfare, Government of Uttaranchal. Five Year Urban Health Proposal (Under RCH II) for Dehradun. Dehradun: Government of Uttaranchal; 2003.

Taneja S, Agarwal S. Situational analysis for guiding USAID/India and EHP/India: Technical assistance efforts in Indore, Madhya Pradesh, India. Washington, DC: Environmental Health Project; 2004.

Health and Family Welfare Department, Government of West Bengal. Five Year Urban Health Proposal (Under RCH II) for Bally, West Bengal, Kolkata: Government of West Bengal; 2004.

Khan Z, Mehnaz S, Siddiqui AR, Ansari A, Khalil S, Sachdeva S. All slums are not equal: maternal health conditions among two urban slum dwellers. Indian J Community Med. 2012;37(1):50-6.

Mehnaz S, Abedi AJ, Fazli SF, Khan Z, Ansari MA. Quality of care: predictor for utilization of ANC services in slums of Aligarh. Int J Med Sci Public Health. 2016;5(9):1869-73.

Bala K, Sahni B, Dewan D, Kumar T, Sangral R. Epidemiological determinants of pregnancy outcome in urban slums of Jammu city-a prospective study. Int J Med Sci Public Health. 2018;7(1):23-8.

Sanneving L, Trygg N , Saxena D, Mavalankar D, Thomsen S. Inequity in India: the case of maternal and reproductive health. Glob Health Action. 2013;6:19145.

Singhal A. Utilization of maternal health services in slums of Rajasthan. Int J New Tech Res. 2015;1(8):76-81.

Cantarutti A, Franchi M, Compagnoni MM, Merlino L, Corrao G. Mother’s education and the risk of several neonatal outcomes: an evidence from an Italian population-based study. BMC Preg Childbirth. 2017;17(1):221.

Kumar A, Mohanty SK. Intra-urban differentials in the utilization of reproductive healthcare in India, 1992-2006. J Urban Health. 2011;88:31128.

Badge VL, Pandey M, Solanki MJ, Shinde RR. A cross-sectional study of migrant women with reference to their antenatal care services utilization and delivery practices in an urban slum of Mumbai. J Family Med Prim Care. 2016;5:759-64.

Pahwa1 P, Sood A. Existing practices and barriers to access of MCH services-a case study of residential urban slums of district Mohali, Punjab, India. Glob J Med Public Health. 2013;2(4):1-8.

Devasenapathy N, Jerath SG, Allen E, Sharma S, Shankar AH, Zodpey S. Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project. BMC Preg Childbirth. 2015;15:212.

Sinha S. Outcome of antenatal care in an urban slum of Delhi. Indian J Community Med. 2006;31(3):189-91.

Jaideep KC, Prashant D, Girija A. Prevalence of high risk among pregnant women attending antenatal clinic in rural field practice area of Jawaharlal Nehru Medical College, Belgavi, Karnataka, India. Int J Community Med Public Health. 2017;4:1257-9.

Vijay BK, Amandeep K, Sumit C, Manisha M. Prevalance and correlates of high risk pregnancy in rural Haryana: A community based study. IJBAMS. 2013;3(2):212-7.

Majella MG, Sarveswaran G, Krishnamoorthy Y, Sivaranjini K, Arikrishnan K, Kumar SG. A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India. J Educ Health Promot. 2019;8:12.

Trivedi P, Saxena D, Puwar T, Savaliya S, Ganguly P. A cohort study on risk factors for preterm births in rural Gujarat. Indian J Public Health. 2018;62:111-6.

Bateman BT, Simpson LL. Higher rate of stillbirth at the extremes of reproductive age: A large nationwide sample of deliveries in the United States. Am J Obstetr Gynecol. 2006;194:840-5.

Begum F, Buckshe K, Pande JN. Risk factors associated with preterm labour. Bangladesh. Med Res Counc Bull. 2003;29:59-66.

Bavaliya M, Shah B, Munshi S. Study of risk factors for preterm neonates. Int J Sci Res. 2014;3:9-10.

Rezavand N, Veisi F, Malek-Khosravi SH, Zangeneh M, Kohzadi M. Assessment of Frequency of Twin Pregnancy and Neonatal Outcome in Deliveries of Mo'tazedi Hospital, Kermanshah in 2004-2007. J Obstetr Gynaecol India. 2014;64(1):19-22.

Saurabh S, Sarkar S, Pandey DK. Female literacy rate is a better predictor of birth rate and infant mortality rate in India. J Fam Med Prim Care. 2013;2(4):349-53.