Mobility and access to maternal health services in peri-urban Buenos Aires.

ANDREA GUTIÉRREZ

Mobility and health. Bridging the gap

IFRTD- Swiss Tropical Institute

Lugar: London; Año: 2012;

In spite of policies to enable free and universal access to health services and a decade economic growth Argentina has not been successful achieving its commitment to reduce its maternal mortality rate by 20%. Contrary to tends elsewhere, in 2009 the rate was of 5.5 maternal deaths for every 10,000 live births, the highest since 1986 (Argentine – MINSAL 2010). This recent rise in maternal mortality is associated with a lack of access to health services, late initiation of antenatal checks among poor women, the growing rate of teenage pregnancy and irregular abortions (UNICEF 2010). Argentinean public policy establishes a model of maternal healthcare which includes a minimum of five ante-natal checkups (ANC) and a hospital birth. Access to maternal healthcare, then, depends on the services which involve Primary Healthcare Centres (PHCs) and hospitals. They receive medical care from the public health system and do not own their own means of transport. Their mobility is primarily on foot or by bicycle. They also use carts pulled by horses. Cars or trucks owned by neighbours are scarce, old and in bad condition. They travel outside the neighbourhood only occasionally, for healthcare or to attend to bureaucratic procedures. Going shopping, taking children to school or visiting family members were even less frequent causes for travel. Buenos Aires is one of the 20 largest metropolis in the world and it grows rapidly, in population and size, by extending its periphery. Peri-urban areas of the city are characterised by striking contrasts, where a high-income population living in closed communities coexists with the very poor. The most disadvantaged live towards the outer peri-urban zones, where there is a lack of infrastructure and services, and people have to contend with related environmental problems such as flooding and pollution. In Argentina the literature on mobility and health relating to maternal and infant mortality is scant overall, and there is a particular lack of research relating to vulnerable groups such as pregnant teenagers. However, teenage mothers and their babies are particularly vulnerable and infant mortality is 85% greater in argentinean teenagers than in mothers between 20 and 34 years of age. Additionally maternal and infant mortality is 8% greater in the periphery of Buenos Aires than in its centre (Argentine – GBA 2006). This lack of information constrains the formulation and application of effective policy (Gutiérrez 2008) therefore this study was designed to explore issues relating to maternal care shaping the vulnerability poor peri-urban teenage mothers and their infants. In this way evidence would be gathered to inform an effective response to fully include teenage mothers in maternal services and reduce health risks to them and their infants by improving their access to existing public services.