Percepção dos residentes de favelas brasileiras sobre o ambiente alimentar: um estudo qualitativo / Perception of the food environment by Brazilian slum residents: a qualitative study / Percepción de los residentes de favelas brasileñas sobre el entorno alimentario: un estudio cualitativo

Resumo A disponibilidade de venda de alimentos no território pode influenciar no consumo alimentar da população. Entretanto, é importante compreender como as pessoas percebem o seu ambiente alimentar para se entender como essa disponibilidade afeta seu consumo em contextos distintos. O objetivo foi avaliar a percepção dos moradores de favelas brasileiras sobre o ambiente alimentar em suas vizinhanças. Estudo qualitativo, em que foram realizados grupos focais online guiados por um roteiro para reunir discursos coletivos sobre o acesso aos alimentos em favelas brasileiras. O convite ocorreu por meio das redes sociais e do contato com líderes comunitários e organizações não governamentais que atuam em favelas, por meio da técnica de amostragem "bola de neve". Para a análise, foi utilizada a abordagem grounded theory (teoria fundamentada) e, como técnica, foi empregada a análise de redes temáticas. O acesso aos alimentos por moradores de favelas é permeado pela falta de recursos e elementos fundamentais para uma alimentação adequada e saudável, como: a falta de informação sobre alimentação; a renda insuficiente; e a baixa disponibilidade de estabelecimentos que comercializam alimentos saudáveis a preços acessíveis. São necessários programas e políticas públicas que incentivem a ampliação de equipamentos de segurança alimentar e nutricional, como hortas e feiras, e que aumentem a oferta de alimentos saudáveis com valores baixos nas favelas. Também são necessárias ações que abordem a complexidade das barreiras enfrentadas por moradores de favelas para ter acesso aos alimentos saudáveis.

Abstract Food availability in the territory can influence food consumption by the population. However, it is important to understand how people perceive their food environment to see how food availability affects consumption in different contexts. This study aimed to assess the perception of the food environment by Brazilian slum residents in their neighborhoods. This is a qualitative study, with online focus groups guided by a script in order to gather collective discourses about access to food in Brazilian slums. The invitation to participate in this study was made through social media, and community leaders and nongovernmental organizations with actions in slums were contacted using the snowball sampling technique. Grounded theory analysis was applied with the technique of thematic networks. Access to food for slum residents involves lack of resources and essential elements for an adequate and healthy diet, such as lack of information about food, low income, and low availability of stores that sell healthy food at affordable prices. Public programs and policies are required to encourage the expansion of food and nutritional security resources, such as vegetable gardens and markets, to increase the supply and sell healthy food at affordable prices in slums. Actions are also required to address the complexity of obstacles faced by slum residents in the access to healthy foods.

Resumen La disponibilidad de venta de alimentos en el territorio puede influir en el consumo alimentario de la población. Sin embargo, es importante comprender la manera en que las personas perciben su entorno alimentario para comprender cómo esta disponibilidad afecta su consumo en diferentes contextos. El objetivo fue evaluar la percepción de los residentes de favelas brasileñas sobre el entorno alimentario en sus vecindarios. Estudio cualitativo, en el que se formaron grupos focales en línea orientados por un guion con el objetivo de reunir discursos colectivos sobre el acceso a los alimentos en favelas brasileñas. La invitación se dio por medio de las redes sociales y mediante el contacto con líderes comunitarios y organizaciones no gubernamentales que trabajan en favelas, utilizando la técnica de muestreo "bola de nieve". Para el análisis, se utilizó el enfoque de la grounded theory (teoría fundamentada) y, como técnica, se empleó el análisis de redes temáticas. El acceso a los alimentos de los habitantes de las favelas está permeado por la falta de recursos y elementos fundamentales para una alimentación adecuada y sana, tales como: la falta de información sobre la alimentación, los bajos ingresos y la poca disponibilidad de establecimientos que vendan alimentos sanos a precios asequibles. Se necesitan programas y políticas públicas para fomentar la ampliación de equipos de seguridad alimentaria y nutricional, como huertas y mercadillos, que aumenten la oferta y vendan alimentos sanos a precios asequibles en las favelas. También se necesitan acciones para abordar la complejidad de las barreras que enfrentan los residentes de las favelas para acceder a alimentos sanos.

A Community Based Cross-Sectional Study to Assess the Socio-Economic and Health Status of Rag Pickers in Varanasi slums, North India

Background- Rag picking is one of the inferior economic activities in the urban informal sector, largely undertaken by children belonging to weaker sections of society for their survival and for supplementing their family income. Rag picking is one of the most dangerous activities in India. Rag pickers are working in a filthy environment surrounded by dust, dogs, and pigs. They suffer from many diseases, such as respiratory problems, anemia, fever, and other problems which include cuts, rashes, and injuries. Waste pickers are the general term adopted by the 1 st World Conference of Waste Pickers in 2008. Objective- [a] To assess the socio-economic condition of ragpickers in Varanasi, [b] To know the health condition and treatment behavior of ragpickers in Varanasi. Materials and Methods- A community-based descriptive cross-sectional study in which ragpickers reside in the slum area of Varanasi. All men and women present at the time of the interview who were involved in rag picking from the last 6 months were included. Seriously ill men and women were excluded. Since we had no prior knowledge about the proportion of cases (P) so a pilot study was conducted in which prevalence of health problem found in rag pickers in the last 6 months (P) = 0.90. Total estimated sample size is 100. In this study, Simple Random sampling was used. By using this sampling 100 individuals were selected randomly, fulfilling the inclusion criteria. Results-82 (82.0%) rag pickers were not educated in which 75 (91.5%) rag pickers suffered from health problems. Maximum 74 (74.0 %) rag pickers were migrants. Maximum 74 (74.0%) rag pickers were married in which 36 (48.0 %) rag pickers were married between 14- 18 ages. 80 (80.0%) rag pickers had not used any precautionary measure during rag picking in which 73 (91.2%) rag pickers faced health problems. Maximum 39(39.0%) were affected by dust during rag picking. Only 17(17%) ragpickers preferred government hospitals for treatment. 75 (75.0 %) rag pickers were addicted to intoxication in which 66 (88.0%) rag pickers faced health problems. 91 (91%) ragpickers affected by any health problems in the last 6 months in which a maximum of 63.7% of rag pickers suffered from fever, 60.4% of rag pickers complained about injuries, 56.2 % of rag pickers suffered from weakness problems, 52.7% of rag pickers affected by cough problems. There is a highly significance between educational status and any kind of intoxication. Discussion- The literacy level among the rag pickers was 18% which is much lower than the average literacy rate of Varanasi 75.60% (2011census). A study on slum dwellers in Dhaka showed the literacy rate higher than the finding of this study (18 vs 25 %). 28.0% of rag pickers adopted this work because they had no education. There is a high significance between educational status and any kind of intoxication. Chances of intoxication are high when no education among rag pickers. It is highly significant between educational status and health problems of rag pickers in the last 6 months. Uneducated rag pickers were not aware of the health effects.

URBANIZATION AND THE ROLE OF SC, ST URBAN SLUM DWELLERS IN INDIA

Strati?cation on the basis of caste is found all over India. Caste system as a form of strati?cation has a stronghold in urban slum areas also. City-ward migration for Scheduled Caste and Scheduled Tribe populations is synonymous with social development, as the city life offers socio-economic opportunities, better standards of living, educational and health facilities as compared to rural areas. The proportion of Scheduled Castes was higher in the slum areas (28.10%) compared to the population of Scheduled tribe in the country (21.19%). The state of Maharashtra has the largest number of Scheduled Castes and Scheduled Tribes living in urban slums. Andhra Pradesh had highest share of Scheduled Caste and Scheduled Tribe slum population in urban SC/ST population compared with other states

Camadas do sofrimento: impactos psicossociais das medidas de isolamento social em favelas da região metropolitana do Rio de Janeiro / Layers of suffering: psychosocial impacts from social isolation measures in slums of the Rio de Janeiro metropolitan region

Com a pandemia de COVID-19, medidas de isolamento social foram adotadas em escala global. Até 2019, pouco se sabia sobre os impactos desse tipo de estratégia na saúde mental das populações afetadas. Estudos realizados em outras epidemias apontam que indivíduos submetidos a períodos de quarentena tendem a apresentar sintomas de Transtorno de Estresse Pós-traumático (TEPT) e/ou Transtorno Depressivo Maior (TDM). No entanto, para além desta perspectiva psiquiátrica, autores vêm apontando para a necessidade de levar em consideração aspectos socioeconômicos e ambientais na investigação relacionados aos impactos da pandemia, sobretudo em populações que se encontram em situação de vulnerabilidade estrutural. No Brasil, favelas são territórios populacionalmente densos, permeados de pobreza e violência, que possuem muitas vezes habitações precárias, com pouca ventilação, falta de saneamento básico e água potável, fatores que, em si, são dificultantes para o atravessamento do período de isolamento. Nesse sentido, o presente trabalho tem como objetivo investigar os impactos psicossociais advindos de medidas de isolamento social em moradores de favelas da região metropolitana do Rio de Janeiro. Para tal, foram realizadas com 10 participantes moradores de favelas, maiores de 18 anos, entrevistas via Whatsapp de base qualitativa e roteiro semiestruturado. A partir dos resultados encontrados, foi possível inferir que o sofrimento, angústias e aflição dos participantes nesse momento não foram oriunda da pandemia ou de medidas de isolamento per se. Mas sim que a crise de COVID-19 se estabeleceu como um evento crítico que, em concomitância com outros atravessamentos e especificidades, tanto individuais como territoriais, compuseram o quadro de sofrimento dos participantes.

COVID-19 pandemis was responsible for the adpotion of social isolation measures on a global scale. Until 2019, little was known about the impacts of this type of strategy on the mental health of those which were subjected to those measueres. Studies conducted in other epidemics, indicates that individuals that undergone quarantine periods tend to exhibit symptoms of Post Traumatic Stress Disorder (PTSD) and/or Major Depressive Disorder (MDD). However, autores have been poiting to the need of going beyond this psychiatric perspective, and take into account socioeconomic and environmental aspects on investigations related to the impacts of the pandemic, especially of those in situation of structural vulnerability. In Brazil, slums are densely populated territories, permeated by poverty and violence, that often have precarious housing, with little ventilation, lack of basic sanitation and safe drinking-water, factors that are challenges during the period of social distancing. In this sense, this work aims to investigate psychosocial impacts from social isolation measures, on slum dwellers of the metropolitan region of Rio de Janeiro State. For this purpose were conducted via Whatsapp virtual, qualitative interviews with 10 participants who were over 18 years old, and lived on those regions. From the results it was possible to infer that the suffering, anguish and affliction of the participants at this moment did not originate from the pandemic or from isolation measures per se. Rather, the crisis of covid-19 was established as a Critical Event that, together with other smaller events, territorial and invidividual specificities, made up a web of suffering on the subjects of this research.

Vulnerability To Health in A Ward of Bengaluru: Insights from A Mobile-Based Survey

Context/Background: Rapid urbanization has resulted in a growing number of people living in under-served areas with inadequate and overburdened infrastructure and services, worsening of environmen-tal factors. Sustainable Development Goal 11: “sustainable cities and communities”, highlights, there is an urgent need to re-orient the community development strategies by adopting economically & techno-logically sustainable models. Aims/Objectives: An application-based household survey to assess the vulnerability and Health condi-tions among the urban poor of slums in Bengaluru. Methodology: The tool for Vulnerability Assessment by Government of India was modified to develop a user-friendly tool for Community Health Workers in an Android–based smartphone application (Namma Samudaya). Data was collected through house-to-house survey. Results: A total of 3165 households (HHs) were surveyed. Among these, 54.2% of the HHs belong to vulnerable category and 45.8% to highly vulnerable group. Conclusions: Domain-wise analysis showed, Residential -25.2% of HHs were located besides polluted water Social - “No social support” and “disability” was reported by 3% of households each; Health-Related - Catastrophic Health expenditure in the past 1 year was reported by 40.4% HHs. The baseline information of slums & their geographic mapping obtained during the survey can be used as foundation for effective planning of health care services.

Safe drinking water and sanitary facilities utilization in households of Belagavi urban slums, Karnataka, India

Background: Safe water and adequate sanitation are basic to the health of every person, yet many people throughout the world do not have access to these needs. Access to these basic services is not only a fundamental right, but also a steppingstone to sustainable development of the country. Objective of this study was conducted to measure the proportion of slum households using improved drinking water and sanitation facilities.Methods: Study was conducted among 620 slum households in Belagavi from by interviewing one member from each household using WHO/UNICEF joint monitoring program core questions on drinking water and sanitation for household surveys.Results: All the slum households (100%) used improved drinking water source; piped water in yard or plot (68.22%) being the primary source. 94.35% of households used improved water source for cooking and/or hand washing purpose. 49.03% of households used improved sanitation facilities and 55.97% used unimproved sanitation facilities. Proportion of households with no latrine facilities and practicing open defecation were 13.06%. About 27.69% households had reported diarrheal events in children in the previous month. Type of latrine used by households was found significantly associated with the diarrheal events in children.Conclusions: Utilization of safe drinking water in Belagavi slums has increased when compared to global and national levels but households with piped water supply are still low. Access to improved sanitation facilities is still lacking in many households. Increasing access to basic sanitation at the household level and behavior change awareness programs could help in achieving universal sanitation coverage.

A study to assess the contraceptive use among married women of urban slums: a cross-sectional study

Background: Family planning services like use of modern contraceptives help the couples to delay pregnancy and avoid the unwanted pregnancies. So, understanding the choice of contraceptives for the underserved couples is a key for provision of family planning services. Objective was to assess the contraceptive use among married women of urban slums using semi-structured questionnaire.Methods: The present observational cross-sectional study was conducted over a period of one month i.e. November 2019 in urban slums of Trikuta Nagar, which is a field practice area of Department of Community Medicine, GMC Jammu. Information was gathered from married females of reproductive age group. 50% of the population was selected randomly by lottery method i.e. 90 females. But at the time of study, only 85 married females could be interviewed.Results: The results show that the maximum females belonged to the 15-25 years age group followed by 26-30 years age group. More than 50% were literate, 42.35% had education upto primary level. More than 50% females were self-employed as they were labourers and rests were home-makers. The duration of marriage of most of the respondent women was 0-5 years and 44.70% of women had three living children. 65.88% women had one year gap between the first two pregnancies.Conclusions: The information, education and communication activities about the advantages of using contraceptives and its side-effects while using these contraceptives need to be increased so as to promote the awareness among females of the urban slums.

Not covered enough: inadequate age appropriate immunisation in urban slums of Delhi: a community based cross sectional survey

Background: The urban average of childhood immunization coverage rates are partial against children living in slums and mask the disparity within the urban poor. The objective of study was to measure the age appropriate immunization as per India’s Universal Immunization Program (UIP) schedule, explore determinants of coverage and reasons for incomplete immunization in urban slums of New Delhi.Methods: A cross sectional survey was carried out in selected urban slums of West and South East districts of New Delhi. WHO’s coverage cluster survey sampling methodology was used. Three hundred mothers of under five children were selected. Age appropriate immunization status of the children was recorded on physical examination of the vaccination card.Results: Fifty eight percent (56% West; 60% South East district) of sample population was age appropriately immunized. The odds of age appropriate immunization were higher for institutional delivery (OR 10.5, 95% CI 4.27-23.6) and among third born children (OR: 1.8, 95% CI: 1.04-3.30). The odds were equal for people from Delhi or migrated from different state (OR: 1.015, 95% CI: 0.62-1.64). Most common reason for incomplete immunization were obstacles (72.8%) and lack of information (23.2%).Conclusions: There was a consistent drop in coverage among vaccines with more than one dose and by the subsequent dose of vaccine. The difference in coverage estimates among studies emphasise the need for identifying the key reasons of incomplete immunization and finding area specific solutions to improve coverage.

Study on gender preference and awareness regarding prenatal sex determination among married women of reproductive age group in urban slums of Raipur city

Background: Gender preference, especially male, is a matter of serious concern in our country. It happens due to misuse of recent advancement in medical technology for prenatal sex determination. Therefore, awareness of these issues needs to be evaluated. Objectives: The present study is conducted to assess the knowledge regarding issues of sex determination and also to identify the real picture of gender preference among married women (reproductive age group) residing in urban slums. Materials and Methods: A community-based cross-sectional study using simple random sampling for the selection of slum and 230 urban slum dwellers married women in reproductive age group was interviewed. Results: It was found that 79% of women were aware of prenatal sex determination. Among them, 92.30% of women knew about ultrasonography technique for determining sex of the child. About 92.80% of women knew about criminal aspects of prenatal sex determination, but only 76.40% knew about the punishment associated with sex determination. The present study shows that there is no particular gender preference among the married women. About 70.80% have either sex preference in their next pregnancy, but 17.80% of women have preference for male child and 11.30% of women prefer female child. The present study also shows more male child preference among women having all female children in their previous births. Conclusion: There is a need for stronger implementation of existing legal measures such as Pre-conception and Pre-natal Diagnostic Techniques Act and also creating awareness of them is felt. Information Education and Communication (IEC) pertaining to these issues must be promoted.

What ails the urban slums - morbidity profile of urban slum dwellers from three major cities of India

Background: India today has over 61 million people residing in urban slums. Slums, on one hand, lack the basic requirements of housing, sanitation, and water supply that are detrimental for good health and on the other hand subject its residents to extreme poverty, unemployment and stress. Exposure to these environmental factors is expected to cause a distinct sort of morbidity pattern, which this study seeks to explore.Methods: This cross-sectional study was a secondary data analysis of aggregated data of patients who availed health services at the mobile medical unit (MMU) of the Ujjivan program run by Piramal Swasthya in the last one year. The project has a fleet of MMUs that makes at least one predestined monthly visit to each service point in urban slums of Bangalore (42 sites), Pune (18 sites) and Mumbai (19 sites).Results: Musculoskeletal disorders (30.69%) and cardiovascular diseases (25.56%) together accounted for 56.25% of the total disease burden. The analysis of blood pressure readings of all the registrations showed that the mean systolic and diastolic pressures were 129.71 and 84.92 mmHg respectively. 51.58% of all individuals had hypertension and 23.51 % had diabetes.Conclusions: According to the study a major proportion of urban populous seeking healthcare at the MMU are women and elderly and do so for non-communicable diseases. Hypertension and diabetes are major health threats among them. MMU could be used as an effective mode of service delivery for women and the elderly especially, for chronic diseases

Menstrual restrictions among young females in urban slums of Cochin

Background: Menstruation is associated with taboos and socio-cultural restrictions. The social and cultural significance of menstruation interacts with the physiological process to produce culturally determined norms and practices. This study was conducted among young females aged 15-35 years from urban slums of Kochi, India. The objective was to assess prevalence, factors, and patterns of restrictions faced by young females during menstruation.Methods: A cross-sectional study was conducted among 130 young females in three urban slums of Kochi. A pre-formed pretested questionnaire was used. Data were analysed statistically by simple proportions.Results: Only 8.8% young females felt they had restrictions during menstruation but when asked in detail 88% had socio-religious restrictions. Source for restrictions was traditionally followed patterns 60.8%, patterns taught by elderly mainly mother or mother in law 11.2% and self-imposed restrictions 28%. Reasons for restriction are that 14.4% considered it was good and give rest to the body, 8% women think they are unclean and 57.6% women fear to disobey religious restrictions. 77.6% of Women felt these restrictions are necessary and 40.8% felt restrictions do not need change. Out of 22.4% who felt religious restrictions were unnecessary only 1.6% were affected by religious restrictions.Conclusions: Only a few (8.8%) felt they had restrictions and more than two-third had restrictions (88%) and felt these restrictions are necessary (77.6%). This paper explains restrictions practiced and the origin of such restrictions during menstruation. The key issues identified from the community will be an asset to combat restrictions.

Influence of anti-tobacco advertisements on the attitude of slum dwellers about use of tobacco: a cross-sectional study from Mandya city

Background: As per the Cigarette and Other Tobacco Products Act (COTPA) rules, the anti-tobacco health spots and disclaimers are being provided by the Ministry of Health and Family Welfare, India. These advertisements are aimed at creating awareness about the ill effects of tobacco use. Mass media anti-tobacco advertising campaigns play an important role as part of a comprehensive tobacco control program and are associated with increase in smoking cessation and declines in adult tobacco use prevalence.Methods: This cross-sectional study was conducted to assess the influence of anti-tobacco advertisements among slum dwellers of Mandya city. A self-structured, close-ended questionnaire was used to interview 700 slum dwellers. The questionnaire consisted of sociodemographic data, tobacco usage status, questions related to awareness about anti-tobacco advertisements, and influence of anti-tobacco advertisements on attitude toward tobacco use. Frequency distributions and percentages were examined for each item and Chi-square test was used.Results: Out of 700 participants 54.5% were males and 45.5% were females. Nearly 87.7% of males and 70.2% of females had noticed the statutory warning which is shown during tobacco products’ usage on television/movies. Almost 66.4% of males and 68.0% of females had a positive change in attitude toward tobacco use due to influence of anti-tobacco advertisements.Conclusions: There is awareness against use of tobacco and this awareness should be used to motivate them to quit tobacco as well as to stop them from initiating tobacco use.

Knowledge, attitude and treatment seeking behaviour among postmenopausal women in an urban slum area of Bhubaneswar, Odisha

Background: In every women life this unique physiological phase that is menopause take place. In developing countries like in India most of women neglected their basic health care which poses the major public health challenges. The objectives of the study were to assess the knowledge, attitude towards menopause and its associated factors among postmenopausal women of urban slum; to explore the treatment seeking behaviour and the barriers for not seeking health care among these post-menopausal women.Methods: This cross sectional study was conducted using multistage cluster sampling and house to house visit in randomly selected slums under the UHTC area of KIMS, Bhubaneswar. A pretested and predesigned questionnaire was used among 220 postmenopausal women.Results: The results of the study show that 60.9% of women have a heard about menopause before attaining menopause but 33.1% women attitude towards menopause is negative. Only 10% of study population were aware of HRT that it treats menopausal symptoms. We found that the awareness of cancer cervix was 19.1% but the screening was done only by 2.7% of study population.Conclusions: There is considerably lack of knowledge and awareness about the effects and the treatment of menopausal symptoms especially in rural and slum women in India. So, such studies help in creating awareness since disseminating health education for postmenopausal women is of prime importance.

Documenting catastrophic spending on health by migrant slum population

Background: India ranks among the bottom five countries in public health spending. Out of pocket spending of households on healthcare is almost 70% of income and reimbursement in any form availed by households whose members are employed in the formal sector is negligible. Objectives: To determine the usual source of medical care opted for by the study population. To find out the illness pattern and its age/sex distribution in the study population. To find out the expenditure incurred on illness and its source of procurement by the study population. Methodology: 52.42% urban Aligarh resides in slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further forced into poverty and indebtedness on account of expenditure on illness. Conclusions: National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

An assessment of the awareness and practices regarding HIV/AIDS among married women of the reproductive age group in urban slums of Eastern Uttar Pradesh

Background: HIV/AIDS is such a dreaded disease which can be prevented if the people are aware of the ways to do so. Urban slums share a specific position in the demographic profile of district because of the inequalities of health care system where the rural health care system is far to reach and the more flourished private health care system is unaffordable for most of the inhabitants. HIV/AIDS is not only a health-related problem but it also has socioeconomic, behavioral and cultural aspects. Methods: Descriptive cross-sectional among currently married women in reproductive age group (15-49 years) residing in any of the selected urban slums of district Gorakhpur. Cluster sampling was used and clusters were chosen by probability proportional to size (PPS) method of cluster sampling from a list of urban slums obtained from District Urban Development Authority (DUDA), Gorakhpur. The final sample size was 600. Results: 82% of women had ever heard about HIV/AIDS and 72% of women got the knowledge about HIV through television followed by 56% of woman who got knowledge by relatives and friends. 68% of woman believes that the mode of transmission of HIV is unsafe sex followed by 58% of women who believed that infected blood transfusion is the mode of transmission of HIV. Conclusions: Awareness is crucial in the prevention and control of HIV/AIDS. Women should have more access to the knowledge resources and facilities for testing and prevention of HIV/AIDS.

Menstrual hygiene: knowledge and practices during menstruation among adolescent girls in urban slums of Jorhat district, Assam, India

Background: Menstruation is still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the facts of menstruation and hygienic practices, which sometimes results in adverse health outcomes. The present study was carried out to assess the knowledge and practices regarding menstrual hygiene, to find out the disorders during menstruation and to determine the factors associated with existing practices of menstrual hygiene among adolescent girlsMethods: A community-based cross-sectional study was conducted in two randomly selected urban slums of Jorhat district from March to August 2017 among 110 adolescent girls using predesigned pretested proforma. Data were analyzed using SPSS; association was determined using chi-square test with Yates correction or Fisher’s exact test, as appropriate.Results: 47.27% girls were aware about menstruation prior to menarche. Mother was the first informant in 65.38% of them. 69.09% were ignorant about the source of menstrual bleeding. Sanitary pads were used by 59.09% of girls. Majority (97.27%) practiced some form of restriction during menstruation. Dysmenorrhoea was the most common complaint (53.63%). Type of absorbent used was significantly associated with literacy status of girls and their mothers, socio-economic status, religion and prior knowledge about menstruation. Educational status of girls and their mothers were also significantly associated with satisfactory cleaning of external genitalia during menstruation.Conclusions: Ignorance and unsafe practices regarding menstruation, menstruation related problems and traditional beliefs and restrictions are quite common among adolescent girls in urban slums. Literacy status and awareness are the most important factors affecting the menstrual behaviours

Access to sanitation and risk of developing urinary tract infections among women from low socio-economic settings

Background: Poor sanitation facilities are root cause of many health problems of people residing in slums. The present study estimates the prevalence of urinary tract infections (UTI) and identifies factors associated with an increased risk of UTI among women.Methods: A cross-sectional study was conducted among 616 women aged between 18 to 60 years residing in 33 slums across four cities in Maharashtra, India. Data related to individual characteristics of women, housing condition, access to sanitation facilities, behaviors adopted by the women that could lead to UTI and an episode of symptomatic UTI in the previous one month were recorded through structured questionnaire. Logistic regression analysis was performed to find out risk factors for UTI among women.Results: The prevalence of UTI was found to be 19.6%. The prevalence was higher among young women aged upto 30 years (23.2%). In absence of individual toilet, women had adopted certain behaviors such as urine holding (21.3%), modify dinner to avoid toilet use at night (26.6%) and avoid intake of liquids (10.7%) to reduce frequency of visits to toilet. All these behaviors were significantly associated with UTI. Multiple logistic regression indicated that UTI was strongly and independently associated with age (OR=1.64, 95%CI: 1.08, 2.47), no access to bathroom (OR=2.21, 95%CI: 1.08, 4.49) and avoid intake of liquids (OR=2.70, 95%CI: 1.53, 4.75) (p<0.05).Conclusions:Behavior modifications by women to adjust with restricted use of place of urination may affect their health and increase the likelihood of developing UTI. Younger women are more at risk of developing UTI.

Awareness, Knowledge and Practices of Contraceptive Methods among Married Males of Slums of Phulwarisharif block of Patna District, Bihar

Background: Even though India was the first country to launch family planning programme, population growth rate of India is still higher. Males are often the dominant decision makers of the family. Many studies regarding contraception has been done on females but the same is lacking on males. Aims & Objectives: The aim was to assess the level of awareness and practices about the contraceptive methods and factors associated with awareness and use among the married males in slums of Phulwarisharif block of Patna. Material & Methods: A cross-sectional study was conducted among 212 married males aged 18 to 60 years over a period of 3 months in slums of Phulwarisharif, Patna. Data were collected by interview of study subjects using predesigned and pretested questionnaire. Descriptive statistics and chi-square test were applied using SPSS software. Results: Among 212 married males 91.5 % have heard of at least one contraceptive method, while only 42.45% have ever used any contraceptive method. The major source of knowledge among 194 aware participants were friends and family members (78.9%). Age, duration of marriage, number of children and position in the family were associated with level of awareness. Conclusion: Despite of high awareness about contraceptives low utilization and limited knowledge was observed among the married male participants.

A cross-sectional study on prevalence of substance use and its determinants among the male youth aged 15-24 years of slums of city Amritsar

Background: Slums are not new phenomenon. They are characterized by insanitary condition, crime, drug abuse etc. The male youth living in the slums, are prone to various health impacting conditions including substance use like alcohol consumption, smoking, tobacco chewing, drugs etc.Methods: Cross-sectional study was conducted in the four selected urban slums of Amritsar city. From each slum 250 male youth aged 15-24 years were included in the study, so total 1000 respondents were interviewed and required information was filled in pre-designed semi-structured proforma. Data was compiled, analysed and valid conclusions were drawn.Results: The overall prevalence of substance use among the respondents was 25.9% and as the age increases the prevalence of substance use also increases. Among substance users, tobacco (86.8%) was the most common substance consumed both in smoking form (52.1%) and smokeless form (34.7%), followed by the alcohol (72.2%) and then drugs (12%). Majority (62.1%) of respondents had initiated the substance use between 15-19 years of age. Factors like illiteracy, migration, joint family, married status and increased mental stress were significantly associated with substance use, however no association was found with socio economic status of the respondents.Conclusions: Government should take robust steps to improve the awareness and education status of the youth living in the slums. As the younger ages are most vulnerable ones, health education, IEC and BCC activities regarding the harmful effects of substance use along with life skills should be incorporated into the school curriculum.

A study on relation of sociodemographic factors and living conditions on health of female youth in urban slums of Amritsar city

Background: Slums are most vulnerable and deprived areas within a city. The unhygienic and polluted environment, overcrowding, poor housing and absence of educational exposure affect youth in slums. Consequently, their health is affected adversely.Methods: This cross-sectional study was conducted in four slums, one each from four different directions (north, south, east and west) of Amritsar city. A total of 1000 respondents, 250 from each slum were interviewed by using pre-tested semi-structured questionnaire. Data was compiled and statistically analysed.Results: Out of total study population, 41.2% of the families had migrated from other states, Overcrowding was present in majority (92%) of the families, 20% of the respondents didn’t have latrine facility at their home, 44.4% respondents throw their garbage waste in the open space nearby their dwellings and 45% of population was not satisfied with the cleanliness of their slum, 54.6% of the respondents reported to have some kind of health problem during last three months. Educational status, socio-economic status and overcrowding were significant factors affecting their health.Conclusions: Important factor in causation of disease were found to be poor socio-economic status, lack of education and overcrowding. There is a strong need to intensify the IEC/BCC activities to raise the awareness about the health-related issues.