Study setting
Mangaluru is a coastal city of Dakshina Kannada district, Karnataka state in southern India. With Human and Urban Development Indices (HDI and UDI) of 0.83 and 0.69, Mangaluru is one of southern India’s fastest growing non-metro economies . It has a population of about a 0.5million and an average literacy rate of 93.7%. Off late, Mangaluru witnessed labour immigration due to an enormous spurt in construction activities and rapid industrialisation, which resulted in the growth of urban slums. According to Mangaluru city corporation office data, there are 21 urban slums in Mangaluru city. Of these 21, eight are notified (recognised by the local body), and 13 are non-notified slums (not recognised by the local body). Most of them are in private lands with a total population of about 11,000.
One district hospital and ten urban primary health centres are the public health infrastructure in the city . The private health sector is the major source of healthcare and delivery in urban areas of the district and Karnataka state . According to National Family Health Survey-4, (NFHS-4, 2015-16), institution delivery rate in the district is 97.1%. However, a considerable proportion of women in the district experienced complications during their last pregnancy (53.7%), childbirth (45.6%), and the postnatal period (11.1%) .