Assessment of reproductive health service utilization in urban slums: Evidence from Western Rajasthan

Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

Midwives’views and experiences of providing healthy eating advice to pregnant women:a qualitative content analysis of semi-structured interviews

Objective:To explore midwives’views on how they provide healthy eating education to pregnant women after attending a healthy eating education workshop/webinar.Methods:A qualitative descriptive approach was utilized.Semi-structured interviews were conducted to explore the views and experiences of midwives on providing healthy eating education for pregnant women.A purposive sample of six midwives was interviewed face-to-face,and one was conducted by telephone interview.Data were analyzed through qualitative conventional content analysis.Results:Midwives described their views and experiences of factors that impacted their role in providing healthy eating educa-tion.They identified three categories:perceived role of midwi ves,health literacy,and model of care.Conclusions:Knowledge and confidence of midwives improved after attending the workshop/webinar on healthy eating education.Findings suggested that midwives perceived their role as important in providing nutrition education.However,time and resources were highlighted as challenges when providing healthy eating education for pregnant women.The availability of health literacy and model of care were significant factors in enabling midwives to adequately provide this education.Midwives acknowledged a need for further education in areas of vegan diet,cultural food preferences for ethnic minority groups,and regular updates on national healthy eating guidelines.