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Cited by 11Global Maternal and Child HealthReproductive Health and ContraceptionMaternal and Perinatal Health Interventions

Factors associated with women’s healthcare decision-making during and after pregnancy in urban slums in Mumbai, India: a cross-sectional analysis

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Batura, Neha, Poupakis, Stavros, Das, Sushmita, Bapat, Ujwala, Alcock, Glyn, Skordis, Jolene, Haghparast-Bidgoli, Hassan, Pantvaidya, Shanti +1 more·2022·BMC Public Health
DOI 10.1186/s12889-022-13216-7PMC PMC9009007
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Abstract

Background: Understanding factors associated with women's healthcare decision-making during and after pregnancy is important. While there is considerable evidence related to general determinants of women’s decision-making abilities or agency, there is little evidence on factors associated with women's decision-making abilities or agency with regards to health care (henceforth, health agency), especially for antenatal and postnatal care. We assessed women’s health agency during and after pregnancy in slums in Mumbai, India, and examined factors associated with increased participation in healthcare decisions. Methods: Cross-sectional data were collected from 2,630 women who gave birth and lived in 48 slums in Mumbai. A health agency module was developed to assess participation in healthcare decision-making during and after pregnancy. Linear regression analysis was used to examine factors associated with increased health agency. Results: Around two-thirds of women made decisions about perinatal care by themselves or jointly with their husband, leaving about one-third outside the decision-making process. Participation increased with age, secondary and higher education, and paid employment, but decreased with age at marriage and household size. The strongest associations were with age and household size, each accounting for about a 0.2 standard deviation difference in health agency score for each one standard deviation change (although in different directions). Similar differences were observed for those in paid employment compared to those who were not, and for those with higher education compared to those with no schooling. Conclusion: Exclusion of women from maternal healthcare decision-making threatens the effectiveness of health interventions. Factors such as age, employment, education, and household size need to be considered when designing health interventions targeting new mothers living in challenging conditions, such as urban slums in low- and middle-income countries.

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Authors
Batura, N., Poupakis, S., Das, S., Bapat, U., Alcock, G., Skordis, J., Haghparast-Bidgoli, H., Pantvaidya, S., & Osrin, D.
Affiliations
  • University College London (GB)
  • Society for Nutrition Education and Health Action (IN)
Corresponding author
Batura, Neha
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2022-04-13
Volume
22
Issue
1
Pages
743-743
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-022-13216-7
PMC
PMC9009007
OpenAlex
W4224039422
Cited by
11
References
0
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 1
FWCI
2.47
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • Greater South Information System
Funders
  • Wellcome Trust (081052/Z/06/Z)
  • ICICI Foundation for Inclusive Growth – Centre for Child Health and Nutrition
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
healthcare decision-making, prenatal care, postpartum care, perinatal care, urban slums, Mumbai, maternal health, household size, age at marriage, paid employment, gender and health
MeSH terms
Cross-Sectional Studies, Decision Making, Delivery of Health Care, Female, Humans, Male, Poverty Areas, Pregnancy, Socioeconomic Factors

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