Maternal Continuum of Care among Homeless Women: Does Community Health Workers and Non-Government Organisation Involvements Matter?

Despite a growing literature on homeless women’s health, maternal healthcare research remains limited. This study addresses the research gap by examining maternal Continuum of Care (CoC) among homeless women in India.

The study is based on primary cross-sectional survey data from Kolkata Municipal Corporation (KMC), India’s largest urban center with a high population of homeless women. Descriptive statistics, multivariable logistic regression, and interaction analyses were used.

Only 25% of homeless women utilized maternal CoC, with beggars and floating homeless women showing particularly low utilization. Counseling by public Community Health Workers (CHWs) and routine contact with non-government organisations without profit (NGO) emerged as positive factors in CoC utilization. A combined effect of public CHWs and NGO engagements significantly increased the likelihood of maternal CoC use. Variations in utilization were also observed based on migration status and antenatal health status.

The study highlights critical gaps in maternal CoC among homeless women in India, with CHWs and NGOs playing key roles in improving access. The findings underscore the need for targeted interventions, including expanded public CHWs and NGO efforts and tailored outreach programs. Urgent policy reforms are necessary to provide adequate shelter and healthcare to the urban poor, ensuring that all women, regardless of their living conditions, have access to maternal health services.