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Design: Using data from the cross-sectional National Family Health Survey, 1992-93 and 2005-06, we grouped wealth and migration status into four distinct groups: poor-migrant, poor-non migrant, non poor-migrant, non poor-non migrant. Both chi-square test and binary logistic regression method were performed to assess the influence of wealth and migration status on safe delivery care among women experienced most recent birth in the four years preceding the survey.
Results: Results suggest a decline in safe delivery care among poor-migrant and poor-non migrant women during 1992-2006. The poor-migrant women were documented to be the most disadvantageous position with regard to safe delivery care during last 15 years.
Conclusion: This study adds to the existing evidence on the inequality in urban health care services utilization which is not restricted to the urban poor alone, rather poor-migrant women stands at even worse position. Urgent efforts are needed to pay special attention on poor-migrant women under ongoing National Urban Health Mission. More importantly, continuous programme evaluation is proposed to examine the real progress among target groups within urban areas. Further, to understand the urban health status and consequences it is imperative to set aside the misconceptions that have prevented the health care service utilization of urban population from being fully appreciated.
Learning Objectives: 1. This study advances the existing knowledge about health status in urban areas and takes an initial step to explore the urban health inequality beyond poor-rich differences. 2. An absolute decline in safe delivery care utilization among poor-non migrant women over the period confirmed that the increase in rich/poor gap in health services utilization in urban area during last few years is largely contributed by poor-migrant women. 3.The average improvement in maternal health service utilization have increased in urban areas but it hides significant difference among underserved groups and to understand these consequences, it is important to set aside the misconceptions that have prevented the health care service utilization of urban population from being fully appreciated.