The rapidly expanding urbanization process and migration flow to the largest cities in low-and-middle- income countries (LMIC) has resulted in increasingly overcrowded shanty settlements where people encounter numerous challenges creating a serious public health burden. Despite the growing attention to improving the quality and access to maternal health services (MHS), the maternal mortality ratio still remains high in LMIC. The main objective of the present research is to examine the factors and constraints inherent to urban slums in megacities which contribute to delays in utilization of MHS. The used conceptual framework, explaining the reasons why women frequently find it difficult to utilize MHS when they are supposed to do so, was expanded by in-depth findings on the three megacities Jakarta, Lagos and Kinshasa, which are the largest cities in the countries notorious for high maternal mortality ratio and high urbanization indexes. In order to collect existing data regarding the current situation in maternal health relevant to the selected urban areas, this exploratory research used a narrative review and qualitative research methods. As a result of the literature review and 8 semi structured interviews, it was revealed that in addition to the socioeconomic factors and cultural beliefs, the lack of education, gender inequalities, women’s empowerment, reliance on traditional birth attendants as well as access to and quality of care have a major influence on adequate utilization of maternal health services by women living in urban slums in megacities Jakarta, Lagos and Kinshasa.
This research showed that the vast majority of factors contribute to the dramatic maternal health outcomes in LMICs. The gap in knowledge regarding the urban slums in megacities requires conducting more advanced research in terms of finding alternative solutions in order to address existing challenges in utilization maternal health services.
