Inclusive partnership and community mobilization approaches to improve maternal health care access among internal migrants in nine Indian cities

Bontha V Babu; Yadlapalli S Kusuma; Muthusamy Sivakami; Dharmesh K Lal; Jagjeevan B Geddam; Anoop Khanna; Monika Agarwal; Godi Sudhakar; Paramita Sengupta; Anna S Kerketta; Yogita Sharma

doi:10.1016/j.jmh.2022.100130

Inclusive partnership and community mobilization approaches to improve maternal health care access among internal migrants in nine Indian cities

J Migr Health. 2022 Sep 5:6:100130. doi: 10.1016/j.jmh.2022.100130. eCollection 2022.

Authors

Affiliations

¹ Division of Socio-Behavioural and Health Systems Research, Indian Council of Medical Research, Ansari Nagar, New Delhi 110 029, India.
² Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
³ Centre for Health and Social Sciences, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
⁴ International Institute of Health Management Research, New Delhi, India.
⁵ National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.
⁶ Indian Institute of Health Management Research, Jaipur, India.
⁷ Department of Community Medicine and Public Health, KG Medical University, Lucknow, India.
⁸ Department of Human Genetics, Andhra University, Visakhapatnam, India.
⁹ Department of Community Medicine, Christian Medical College, Ludhiana, India.
¹⁰ Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India.

Abstract

Background: Disparities in healthcare access to internal migrants exist, and the gaps may widen further if appropriate steps are not taken. Innovative approaches are needed to better align the healthcare services with the migrants' needs.

Aim: The aim was to develop and test a supportive strategy of healthcare, which would achieve the desired level of access and delivery of maternal healthcare services to internal migrants living in nine Indian cities.

Methods: This intervention with the quasi-experimental design was conducted with pre- vs post-intervention comparisons within the interventional groups and with the control group. The intervention was implemented with an inclusive partnership approach. Advocacy and community mobilization were the main intervention components.

Findings: An increased proportion of women sought antenatal care during the intervention. More women initiated seeking antenatal care in the first trimester. Due to intervention, health workers' prenatal (41.7% in the post- against 14.7% in the pre-interventional phase) and postnatal home visits increased (11.6% to 34.7%) considerably.

Conclusions: Interventions with inclusive partnership would improve healthcare access to vulnerable communities such as migrants. Hence, efforts to strengthen the government healthcare system through novel strategies are crucial to provide better healthcare to migrants.

Keywords: ANM, auxiliary-nurse-midwives; ASHA, accredited social and health activist; Community mobilization; Community-based intervention; IEC, information, education and communication; Internal migration; Maternal health; NGO, non-government organizations; NHM, national health mission; OPD, out-patient department; Partnership; Quasi-experimental; SPSS, statistical package for social sciences.