title: Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India.
abstract: OBJECTIVE
  To identify the determinants of adequate antenatal care (ANC) utilisation and institutional deliveries among socio-economically disadvantaged migrants living in Delhi, India.
  
  
  METHODS
  In a cross-sectional survey, 809 rural-urban migrant mothers with a child aged below 2 years were interviewed with a pretested questionnaire. Data on receiving antenatal, delivery and post-natal services, migration history and other social, demographic and income were collected.
  
  
  RESULTS
  Recent migrants used the services significantly less than settled migrants. ANC was adequate only among 37% (35% of recent migrant women and 39% of settled migrants). Multinomial regression revealed that being a recent migrant, multiparous, illiterate and married to an unskilled worker were significant risk factors for receiving inadequate ANC. Around 53% of deliveries took place at home. ANC seeking has a strong influence on place of delivery: 70% of births to women who received inadequate ANC were at home. Women who are educated, had their first delivery after the age of 20 years and received adequate ANC were more likely to deliver their child in hospital. Post-natal care is grossly neglected among these groups.
  
  
  CONCLUSIONS
  Migrant women, particularly recent migrants, are at the risk of not receiving adequate maternal healthcare. Because migration is a continuing phenomenon, measures to mitigate disadvantage due to migration need to be taken in the healthcare system.
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Yadlapalli S
authors.initials: YS
authors.lastname: Kusuma
authors.forename: Rita
authors.initials: R
authors.lastname: Kumari
authors.forename: Sonia
authors.initials: S
authors.lastname: Kaushal
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008427:Maternal Health Services / Q000592:standards / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012423:Rural Health; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data*; D014504:Urban Health; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: antenatal care; internal migration; maternal health; primary healthcare