Title : Role of primary health care in antenatal care services utilization among recently delivered women in urban slums of lucknow, Uttar Pradesh

Background: Primary Health Care (PHC) is the foundation of maternal health services, ensuring equitable access to quality antenatal care (ANC). Despite the availability of community-based maternal health services under the public health system, disparities in ANC utilization continue to exist among urban slum populations. This study aimed to assess the determinants and utilization pattern of ANC services among recently delivered women (RDWs) residing in urban slums of Lucknow, Uttar Pradesh.

Methods: A community-based cross-sectional study was conducted among 422 recently delivered women selected through multistage random sampling from the urban slums of Lucknow district. Data were collected using a pre-tested semi-structured questionnaire. ANC utilization was assessed using key indicators, including first-trimester registration, number of ANC visits, tetanus-diphtheria (Td) immunization, iron-folic acid (IFA) consumption, recommended clinical examinations, laboratory investigations, and ultrasonography. Descriptive statistics, Chi-square test, and multivariable logistic regression were performed to identify factors associated with optimal ANC utilization.

Results: Among the participants, 96.9% were registered for ANC services, 77.0% registered during the first trimester, 82.0% completed four or more ANC visits, and 97.2% received Td immunization. bivariate logistic regression analysis of RDWs age, education, husband’s education, husband’s employment status, joint family type, socio-economic status, age at marriage, age at first pregnancy, gravida, parity, type of index pregnancy, nearest health care facility, distance from home, anyone accompanying for visits, and presence of Anganwadi center were found to be significant predictors of ANC service utilization.

Conclusion: Primary health care and community-based maternal health services have substantially improved ANC coverage among women living in urban slums. However, disparities persist due to socio-demographic and healthcare access factors. Strengthening community outreach through frontline health workers, enhancing awareness of government schemes, improving accessibility to PHC facilities, and promoting family involvement in maternal care can further optimize ANC utilization. These findings reinforce the critical role of primary health care in achieving equitable maternal health outcomes and advancing Universal Health Coverage.

Keywords: Primary Health Care, Community Services, Antenatal Care, Urban Slums, Maternal Health, Recently Delivered Women, Uttar Pradesh.

Dr Vijay Kumar Singh, Professor of Statistics in the Department of Community Medicine and Public Health, King George’s Medical University, UP, Lucknow, Uttar Pradesh, India. Before this, he was an Assistant Professor at Government Medical College, Haldwani, Nainital, Uttarakhand, India. He received the Ph D degree in 2003 from MJP Rohilkhand University, Bareilly, UP, India. He has published more than 50 research papers and supervised more than 50 MD/MS/MCh students.