An Exploratory Study of Knowledge, Health Seeking Behaviour and Access of Healthcare Infrastructure among Women during Pregnancy in the JJ Community at Zakhira Slum, New Delhi

Background: Around 30 million women experience pregnancy and approximately 26 million have a live birth each year in India, almost 45,000 deaths per annum occurs due to complications during pregnancy period which can be managed and prevented. India is contributing 16 per cent of the global maternal deaths. In the year 2106, India’s maternal mortality ratio is 130 per 100 000 live births. However, pregnancy period is critical period of women’s life, especially who belong to lower socio economic background, who are not aware about complications such as severe bleeding, pre-eclampsia and eclampsia, sepsis, obstructed labor, unsafe abortion, anaemia etc., and also lack of awareness regarding nutrition, hygiene and passive behaviour towards health. Other factors are also leading cause of maternal deaths such as early age of marriages, repeated child birth and traditional preferences for home deliveries among poor population. Aim of the study: To investigate the knowledge, health seeking behaviour and access of health care facilities regarding antenatal care among mothers who had last birth within 5 years. Methods: Descriptive epidemiology was done using cross-sectional analysis; non-random sample were taken from the JJ community of Zakhira in New Delhi, from February, 2019 to April, 2019. A total sample of 284 female were selected, who had last birth within 5 years. The study was done by interviewing women who had last birth within 5 years among slum dwellers with the help of predesigned and pretested semi-structured questionnaire along with the informed consent form. House to house survey was done to collect the information and the questionnaire was also available in the local language. Results: In this study, majority i.e., 60.21% of the women were in the age group between 20 to 25 years old. 67.25%of the women’s education level was only primary education that reflects upon the scarce of educational resource. 62.32% of the women were married before the stipulated age of 18 years. 45.42% of the respondents were registered more than 6 months of pregnancy. Meanwhile, 16.90% of the respondents were having no knowledge about registration of pregnancy. 68.77% of the women were having knowledge about the signs of pregnancy complications such as vaginal bleeding and foetal movement and 31.23% of women have knowledge regarding other complications such as convulsions, prolonged labor, breathing difficulties, and abdominal pain. 68.30 % of the women have knowledge about maternal health schemes such as JSY and JSSK. Meanwhile, 31.68%of the women were having knowledge regarding PMMVY, PMSMY. So, there is required to bring the benefit to the target beneficiaries, more tools to use to create higher awareness among poor population. 70.77% of the women said that maternal health schemes are not helpful at all because of procedural hassles. Only 5.98% of women were consumed iron and folic acid tablet for more than 4 months. Meanwhile 43.30% respondents were consumed iron and folic acid tablet for less than 2 months only. 83.45% of the women were purchased iron and foilc acid and 29.92% of the respondents were got iron and folic acid from hospital. The sources are clears that women are preferred to visit private nursing home. So, they need to buy iron and folic acid. Large numbers of women i.e., 63.73% were to be found that they were visiting a private nursing home instead of a government hospital. It further supports the finding poor women hard to find the hospital. Very few i.e., 19.71% of the women were followed doctor’s prescribed schedule. Meanwhile, 66.54% of the women have visited the hospital as the requirement arose. It indicates the women passive behaviour towards health during pregnancy. 83.33% of the women received once an ANC check-up during the entire period of pregnancy. It indicates that urban poor pregnant women are yet to get comprehensive antenatal care this indicates that antenatal services to be extended beyond sporadic visits. Conclusion: In this study, considerable gaps were found in the knowledge, health seeking behaviour and access of health care infrastructure regarding the antenatal care among the slum living women. Hence, there is a need to be increased community IEC activities about ANC services which are available free of cost in India. It will help to understand the importance of pregnancy care among the slum dwellers.