Affiliations: Urban Health Resource Centre, New Delhi, India | Urban Health Resource Centre, Indore, Madhya Pradesh,
India | International Center for Advancing Neonatal Health,
Department of International Health, Johns Hopkins Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
Note: [] Corresponding author: Dr. Siddharth Agarwal, Urban Health
Resource Centre, B-7/122A, Safdarjung Enclave, New Delhi, India-110029. Tel.:
+91 11 41010920/26199781; Fax: +91 11 41669281; E-mail: siddharth@uhrc.in,
sids62@yahoo.com
Abstract: One-third of India's urban population resides in slums and
squatters, in extreme poverty conditions. Newborn care is sub-optimal among
India's urban poor, yet scarcely documented. We assessed newborn care practices
in 11 urban slums of Indore in Central India. Practices such as clean cord
care, thermal care, timely initiation of breastfeeding and exclusive
breastfeeding upto neonatal period were enquired from 312 mothers of infants
aged 2–4 months. Correlates of these practices were identified using
multiple logistic regression. 72.1% births were home births (slum-home: 56.4%,
native-village home: 15.7%). Slum-based traditional birth attendants (sTBAs)
conducted 77.3% slum-home births. Skilled assistance during slum-home births
was low (7.4%). Clean cord care (22.2%) and thermal care (10.2%) practices were
also low. Trained or skilled assistance during slum-home births was positively
associated with clean cord care (OR 4.8 CI 1.7–13.6) and thermal care (OR
2.0 CI: 1.1–4.1). Timely initiation of breastfeeding was sub-optimal
(50.6%) even in facility births. Exclusive breastfeeding upto neonatal period
was higher for mothers counselled on exclusive breastfeeding by a health
volunteer during neonatal period (OR 2.3, CI 1.4–3.8). Following emerge
imperative for improving newborn care in urban slums- i) antenatal and
postnatal counselling by trained health volunteers, ii) enhancing competence of
sTBAs and linking them to affordable facilities and iii) sensitizing and
training public health facility staff.
Keywords: Slums, urban poor, newborn care, logistic regression
