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APHA Scientific Session and Event Listing

Gender differences in care-seeking for newborn infants in rural Uttar Pradesh, India

Jeffrey Willis, BA1, Vishwajeet Kumar, MBBS, MPH2, Saroj Mohanty, MS3, Pramod Singh, MSW3, Vivek Singh, MSW3, Abdullah Baqui, MBBS, DrPH1, Shally Awasthi, MD3, JV Singh3, Mathuram Santosham, MD, MPH1, and Gary Darmstadt, MD, MS1. (1) International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, 410-262-9597, jwillis@jhsph.edu, (2) King George Medical University & Johns Hopkins Bloomberg School of Public Health, Administrative Block, Lucknow, India, (3) King George Medical University, Administrative Block, Lucknow, India

Objective: To describe household care-seeking behavior for male and female neonates in rural Uttar Pradesh, India.

Background: Gender-based health disparities are prevalent in India, where households often neglect girls during the care-seeking process. Uttar Pradesh, one of India's poorer states, is an important place for documenting sources of gender based health disparities as its girl-to-boy ratio is one of the world's lowest.

Methods: The study was nested in a cluster-randomized trial of the impact of essential newborn care in Shivgarh, a rural block of Uttar Pradesh, India. Data from the comparison clusters (i.e., usual care) during the period of February and August 2005 were included in the study. A total of 255 households were prospectively enrolled.

Results: Perception of illness was significantly lower in incidence (O.R. 0.58, 95% C.I. 0.34-0.97) and later in recognition (p=0.06) among female compared to male neonates. While the amount of care delivered was similar across gender, the average healthcare expenditure during the neonatal period was nearly four-fold higher for males (Rps. 243.3 537.2) than females (Rps. 65.7 100.7) (p=0.07). Households with female newborn infants tended to utilize public providers, who were cheaper and delivered less satisfactory care than the private unqualified providers that were utilized most often for care of sick males.

Conclusion: During the neonatal period, care-seeking for girls is neglected relative to boys, indicating a need to address gender inequity in neonatal health programs in rural Uttar Pradesh.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Presenting author's disclosure statement:

Not Answered

Human Rights and Reproductive Rights: Experiences of Women

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA