Birth preparedness and determinants of birth place among migrants living in slums and slum-like pockets in Delhi, India.

OBJECTIVE: The objective of this paper is to report birth preparedness and place of birth and its determinants among recent- and settled- migrant households living in slums of Delhi. METHODS: In a cross-sectional survey, 458 migrant mothers with a child aged below one year of age were identified. Socio-demographic details, data on the place of childbirth, antenatal care (ANC) and birth preparedness in terms of planning for home birth or hospital birth, transport, saving money, knowledge of danger signs were collected through interviewer-administered pretested questionnaire. Logistic regression was carried out for the determinants of hospital birth. RESULTS: The present study migrants are characterised by younger ages, low educational attainment, low incomes and represented by socioeconomically disadvantaged communities. They mainly relied on government healthcare services for maternal care. ANC seeking was not satisfactory with 16% of women with no ANC; 46% receiving 1-3 visits; and only 23% of women reported health worker visited them at home. 59% of the births took place at hospitals. Having ANC visits (Adjusted Odds Ratio (AOR) for having 4 or more ANC visits = 5.252), planning for hospital birth (AOR = 6.114), plan for transport (AOR = 1.989), mass media exposure (listening to radio; AOR = 2.871) and knowledge of danger signs (AOR = 3.872) resulted in significant chances of hospital birth. CONCLUSION: Migrant women are at the risk of utilizing the services to a less extent. The health systems need to take measures to mitigate the disadvantage due to migration through specific strategies to make them inclusive and outreach to the poor migrants.

Treatment seeking behaviour in hypertension: factors associated with awareness and medication among socioeconomically disadvantaged migrants in Delhi, India.

The present study is apart of a cross-sectional prevalence study. Descriptive statistics were used to present the awareness, treatment and control of hypertension. Multiple logistic regression analyses were performed to examine the influence of socio-demographic and other variables on awareness and on current medication use. The results reveal that only 41% of the total hypertensive persons were aware of their hypertension status, and only 59% of them were on medication. Of those treated, only 5% had controlled hypertension. Multiple logistic regression analyses reveal that gender, age, pulse rate and education were significantly associated with awareness of hypertension whereas age is the only significant factor associated with medication use. The Hosmer and Lemeshow tests for goodness of fit reveal that these regression models are a good fit. The study concludes that undiagnosed hypertension is considerable. Awareness, treatment and control of hypertension are not adequate among socioeconomically disadvantaged migrants. Since hypertension has become a common problem, the health education and awareness campaigns along with facilities such as blood pressure screening and hypertension treatment through primary health care system are essential.

Association of alcohol consumption and blood pressure in some low socioeconomic groups from Andhra Pradesh, India.

The present paper examines the relationship of alcohol consumption with blood pressure (BP) levels and hypertension prevalence. Data on BP, alcohol consumption and anthropometry were obtained from a cross sectional sample of 1316 adult men and women of six low socioeconomic groups belonging to four different ethnic groups from Visakhapatnam district of Andhra Pradesh, India. Considerable proportions of respondents reported the consumption of alcohol. Some groups recorded higher levels of systolic and diastolic BP among alcohol drinkers than non-drinkers, and in others it was reverse. There was no uniform association between alcohol consumption and hypertension prevalence, though the combined data revealed a higher prevalence of hypertension among non-drinker men and drinker women. The present study population was a heterogeneous group in terms of alcohol consumption, and many of them were occasional drinkers. The study revealed no consistent association of alcohol consumption with blood pressure. The study opines that it is necessary to take measures to reduce the prevalence of alcohol consumption, as it was an underlying social problem and, though not directly associated with blood pressure; and alcohol consumption has been demonstrated as a major risk factor for cardiovascular diseases.