ADOLESCENT MATERNAL HEALTH CARE-SEEKING BEHAVIOUR IN URBAN SLUMS, RAWALPINDI PAKISTAN

Abstract

Pakistan is among the countries with highest adolescent fertility rates with 44 of every 1000 live birth. The adverse pregnancy outcomes are more observed in Pakistani adolescent girls, unlike other fertility age group. Similarly, an urban-rural difference is significantly evident, as more adolescent pregnancies are observed in rural with poor availability of maternal health services. The intent of this study was to assess the adolescence girl‟s (age 15-19) maternal health seeking behaviours during the pregnancy and childbirth in selected lowincome, urban slum Pir-Wadhai, Rawalpindi, Pakistan, while analysing the four levels of Social Ecological Model (SEM). Two types of qualitative data were collected, (1) secondary data with qualitative Meta-Analysis and (2) primary data with in-depth interviews in sample area. Some interesting findings on adolescent‟s behaviour for seeking maternal health care were captured in triangulation of both qualitative data sets. The unique aspect of this research is to explore the adolescents‟ maternal behaviour in urban slums, where accessibility of maternal health services is higher as compared to rural areas. Integrated findings are classified into three categories (1) confirming findings, (2) differences of findings, and (3) unique contributors of study. Socio-ecological model level 1 explored the individual level contributors for adolescents maternal health care seeking behaviour, which included; ill knowledge related to pregnancy, need of emotional support, empathy and respect, low decision-making power, various types of fear related to delivery. Level 2 captured the social capital of family and friends, where the critical role of husband, and inlaws captured, who also influence the utilization of maternal health services for adolescents. The 3rd level reflected the contribution of community in utilization of maternal health care in adolescents and level 4 analysed the contribution of organizations providing maternal health services, where availability, accessibility (i.e. distance, cost) and quality of maternal health services are identified important factors influence the behaviour of adolescents.