Generating evidence in maternal and newborn health in Urban India: a rigorous process

Background Nearly half of the population in India is expected to reside in urban areas by 2030. However, little is known about appropriate delivery mechanisms or effective intervention strategies for urban areas. Analysis of... [ view full abstract ]

Background
Nearly half of the population in India is expected to reside in urban areas by 2030. However, little is known about appropriate delivery mechanisms or effective intervention strategies for urban areas. Analysis of the NFHS III data confirms the worse-off health status of the urban poor . While the recently launched National Urban Health Mission (NUHM) seeks to improve access to primary health care in urban areas, with a focus on the urban poor, it is equally important that the processes and platforms that help design sensitive, responsive, and relevant urban health interventions are in place. Saving Newborn Lives (SNL) project of Save the Children is working on generating evidence to help develop effective service delivery mechanisms for maternal and newborn health care in urban poor settings.

Methods
A meditated and rigorous process was carried out comprising of: emphasis on urban newborn in the India Newborn Action Plan INAP; A landscape analysis that identified key stakeholders working in urban health; Formulation of a Technical Advisory Group (TAG) for urban health; Undertaking a literature review and secondary data analysis; Conducting of HMIS study; Conducting a situation analysis (focusing both on demand and supply side) in two cities and developing city specific approaches detailing out required service delivery mechanisms for MNH in urban poor settings.

Discussion
The process elicits consensus building strategies and mechanisms proposed in the form of city specific approaches for improving maternal and newborn health in urban poor settings of India. It indicates that no single magic bullet mechanism exists for providing primary health care for the mothers and newborns in cities and that every mechanism should look into the aspects of availability and accessibility in order to bring about significant changes.