title: Healthcare behavior and expenditure in an urban slum in relation to birth experience and newborn care.
abstract: BACKGROUND
  Newborn care practices and healthcare seeking are important determinants of neonatal morbidity and mortality in the resource-limited settings of the urban slums.
  
  
  OBJECTIVE
  To examine the current patterns of healthcare-seeking behavior and estimate out-of-pocket expenditure for delivery and common neonatal problems in the urban slums of Chandigarh.
  
  
  METHODS
  Community-based cross-sectional survey.
  
  
  METHODS
  Structured questionnaire was used to collect data from the clusters selected by the World Health Organisation (WHO) Expanded Program for Immunization's cluster survey method.
  
  
  METHODS
  Independent t-test, one-way ANOVA and Pearson's Chi-square tests were used to analyze the data. All tests were two-tailed and p < 0.05 was taken as significant.
  
  
  RESULTS
  31.7% of the mothers delivered at home with 4.18 ± 2.16 mean number of antenatal visits and 73.9% used prelacteals. Factors significantly predicting home deliveries were identified. About 44.7% of the neonates had problems after birth, with 40.3% requiring hospitalization. Choice of private healthcare providers governed the care seeking in the majority (61.4%). Out-of-pocket expenditure was significantly high for the private care providers in terms of the cost of delivery and the overall cost of neonatal illness though no gender-based differences were seen.
  
  
  CONCLUSIONS
  Private sector emerged as the major healthcare provider in the urban slums resulting in higher out-of-pocket expenditure. A comprehensive health strategy comprising of health education, improvement in antenatal practices, institutional deliveries, behavior change communication activities and quality perinatal care is required for these urban slums.
authors: Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Arushi G
authors: AG
authors: Saini
authors: Bhavneet
authors: B
authors: Bharti
authors: Suman
authors: S
authors: Gautam
mesh_terms: D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures; D006801:Humans; D007194:India; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018743:Perinatal Care / Q000191:economics / Q000379:methods*; D011204:Poverty Areas; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population