A comparative study of the accessibility of health and family welfare services among slum dwellers.

In India an analysis of data from a household survey of 900 households in slums in Calcutta Indore and Bharuch compared the extent of availability and utilization of health and family welfare services. Regardless of the city the nearest private hospital tended to be closer to respondents dwellings than the nearest government hospital especially in Calcutta. 70% of the households in Calcutta reported at least 1 member being sick within the last 3 months compared to 40% in Bharuch and 33% in Indore. The total number of episodes was highest in Calcutta and lowest in Bharuch (427 vs. 102). Residents in Calcutta and Indore were more likely to seek medical care at a private facility than at a government facility (73% vs. 25% and 68% vs. 27% respectively) while Bharuch residents were likely to seek care from both (51% and 43% respectively). People seeking treatment in Calcutta and Bharuch spent significantly more money on physician fees medicine and transport for each episode than did those in Indore (Rs. 74 Rs. 70 vs. Rs. 52; p 90%). Calcutta slum dwellers had a higher knowledge level of all FP methods including spacing methods than those in Indore and Bharuch. Couples in Bharuch and Calcutta had higher levels of contraceptive use than did those in Indore (59% and 56% vs. 47% respectively). The most common method used in all 3 cities was sterilization especially tubectomy. Modern temporary method use was considerably higher in Calcutta than it was in the other 2 cities (22% vs. 4% in Bharuch and 3% in Indore). In all 3 cities most slum dwellers (84-92%) received FP services from government facilities. An earlier community survey showed that slum residents preferred government facilities for treatment of acute and chronic health problems and maternal and child health services. They used private facilities for minor ailments.