Patterns and determinants of maternity delivery care in Maharashtra: an urban-rural comparison with a special focus on the urban poor.

In India underutilization of maternal and child health services is a major determinant of maternal and infant mortality. It is noted that the effects of the underutilization of health care services in urban slum pockets is likely to add to the problems of maternal mortality and morbidity already created by scarce resources and unsanitary conditions. Hence this paper aims to examine the determinants of maternity delivery care utilization with a special focus on the urban poor. The data set used in this analysis is the Maharashtra National Family Health Survey (1992) which contains information about the place of delivery for 4106 women of childbearing age between the ages of 13 and 49. A standard of living index is used as a measure of the socioeconomic status of the household and as a predictor of place of delivery. Overall this study demonstrates that place of residence has a significant impact on the type of maternal health care utilized which in turn has potential consequences for the health and survival status of mother and child. The urban poor demonstrate an increased uptake of formal services for higher parity births suggesting that exposure to the urban environment and its health infrastructure may influence the type of maternal care sought.