Introduction
Birth preparedness and complication readiness (BPCR) is a programmatic
approach to enhance the use and effectiveness of key maternal and
newborn health services. Preparing women (and family) for birth and
being ready for complications reduces 3-phase delays (decision to seek,
reach and obtain care) in receiving services and hence, reduces
mortality. Multilevel stakeholders (women, families, communities,
providers, and policymakers) need to engage in BPCR as diverse factors
contribute to three delays . A meta-analysis reported that BPCR
interventions, with minimum 30% population coverage, significantly
reduce maternal (53%) and neonatal mortalities (24%) in low-resource
settings.
With 17% of the world’s population, India holds the key to global
progress on sustainable development goals (SDG 2030). Since 2005 (launch
of National Rural Health Mission, NRHM), India has made significant
progress in reducing maternal (from 254-122/100,000 live births) and
neonatal (from 38-23/1000 live births) mortalities. Various NRHM
strategic initiatives and flagship programs (increased access to
essential maternal health services, promoting institutional deliveries,
and subsidised demand-side financing) successfully improved maternal and
child health. Despite these improvements, India lags on SDG 2030 and
national health policy-2017 goals.
To further gain on improvements by addressing regional health
inequities, India launched National Urban Health Mission (NUHM) in 2013,
focusing on urban population (mainly urban poor) health care needs .
Under NUHM, Auxiliary Nurse Midwife (ANM), for every 10,000 population,
renders essential maternal and child health services supported by a
community health volunteer, ASHA (Accredited Social Health Activist). As
a key component of antenatal care (ANC), BPCR is recommended for all
pregnant women.
Due to the patriarchal societal norms in many developing countries, men
are often the primary decision-makers and play a key role in the first
two delays (decision to seek care and reach care). Many studies and
meta-analyses reported that male involvement is linked to various
benefits, including improved women’s self-care, use of skilled care, and
maternal health outcomes in developing countries. Men’s involvement in
which they relate to reproductive health problems, programmes, rights,
and behaviour is a key intervention for improving maternal health
Several Indian studies assessed women’s involvement in BPCR. Although
involving men in maternal and child healthcare is not a new strategy,
data on Indian men’s involvement in BPCR is scarce.
Objective: To assess the level of husband’s involvement in and the key
factors associated with BPCR in urban slums of Mangaluru, India.