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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.
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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.
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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.
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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.
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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
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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.
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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.
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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
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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.
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Background: Early detection and identification of the risk factors is crucial in minimizing morbidity and mortality arising due to breast cancer. Research has proven that, physiotherapist as a part of multidisciplinary team, plays an important role in treating these patients after surgery. However, evidence suggesting the role of physiotherapist in the domain of health promotion and prevention is limited. Thus an effort is made in this study to explore the level of awareness about the risk factors and prevention and to predict the percent risk of having breast cancer in future five years.Methods: A cross sectional study was conducted in the urban slums of Turbhe. 200 females aged 35 years and above were selected. A self structured questionnaire was formed using Gail’s model. The questionnaire was validated and a house to house survey was conducted.Results: 67.5% females thought that alcohol/tobacco consumption carried the highest risk of breast cancer. 61.5% females were aware of lack of breast feeding as the risk factor for breast cancer. 74% females did not know about breast self – examination while 78.5% had not heard about mammography as screening methods for breast cancer prevention. 14.5% females carried a high risk of getting breast cancer in the future five years.Conclusions: Awareness of study participants about breast cancer was very poor. There is a need for awareness programs to educate women about risk factors and promotion of early detection of breast cancer.
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Background: Uttar Pradesh is the most populated state of the country having population of 199.581 million and total fertility rate of 3.3 (annual health survey [AHS] 2012�13) with high fertile trajectory. Currently, female sterilization accounts for about 18.4% and male sterilization for 0.3% of all sterilizations in Uttar Pradesh (AHS 2012�13). A strategy to promote men's involvement in effective birth control is needed to reduce the population growth. Since no scalpel vasectomy (NSV) is an easy method but still not being utilized; hence, the purpose of this research is to ascertain various factors of nonutilization of NSV. Objectives: The objective of the study is (i) to determine the barriers among married males for adopting NSV as a method of family planning, (ii) to determine the awareness about NSV, (iii) to suggest measures to increase uptake of NSV by the people. Methods: A cross-sectional study was carried out. A two-staged multistage random sampling technique was used. Lucknow is divided into eight Nagar Nigam zones. In the first stage, two urban slums from each geographical zone were selected randomly. In the second stage, from each selected slum a sample of 24 eligible households was selected at random to achieve the desired sample size. Results: It was observed that among the study participants maximum 89.2% perceived Sociocultural barriers, while 0.6% of the participants perceived service delivery barriers. However, 14% of the participants also perceived procedure-related barriers as the most important cause for not accepting NSV. Conclusion: Measures should be taken to remove these barriers, and increase uptake of NSV.
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Background: Knowledge regarding danger signs has been found helpful to reduce delays in seeking, reaching and obtaining care during obstetric emergencies. Aims & Objectives: To assess the awareness regarding obstetric and newborn danger signs among pregnant and recently delivered mothers residing in urban slums of Raipur city. Material & Methods: Observational study was conducted among 160 pregnant and 70 recently delivered women residing in urban slums. The assessment of awareness regarding danger signs was done by adding the marks obtained in various phases. Appropriate statistical tests were applied for any association between knowledge score and socio-demographic variables. Results: Subjects knowing at least one key danger sign during pregnancy, labour, postpartum and newborn period was 54.3%, 51.9%, 7.4%, and 11.3 % respectively. Those with age more than 20 years (p value 0.000), joint family (p value 0.000), educated more than 5 years (p value 0.009), and having married and getting first time pregnant after 20 years (p values 0.001 and 0.022 respectively) were found to have significantly more knowledge about danger signs. Conclusions: Knowledge regarding danger signs should be given at the time of every ANC visit and also at follow up visit after delivery.
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Background: Poor outcomes of cataract surgery are a major problem in developing countries, including India which affects the demand and uptake of cataract surgical services. The present study was aimed to assess the visual outcomes after cataract surgery and identify factors associated with it, among persons aged 50 year and above in urban slums of Raipur.Methods: A community-based, cross-sectional study was conducted in15 randomly selected clusters (urban slums) of Raipur from June 2012 to March 2013. Interviews, Visual Acuity measurements and ocular examinations were performed on all persons aged 50 year and above through house to house visits. Details about surgical intervention i.e. date, setting, type of cataract surgery were obtained from cataract operated persons, for each eye that had cataract surgery. Collected data were analyzed by using both descriptive and inferential statistics. The chi- square test was used to determine the associations of different cataract related parameters with visual outcomes in cataract operated eyes.Results: Of the 870 participants, 203 persons (329 eyes) had undergone cataract surgery. Among all operated eyes, visual outcome was good (VA ?6/18) in 84.5%, borderline (VA <6/18 and ?6/60) in 12.5%, and poor (VA <6/60) in 3% of eyes with available correction. Visual outcome of cataract surgery was significantly associated with age at time of surgery, literacy, type of surgery, place of surgery and time since surgery.Conclusions: The visual outcomes of cataract surgery were excellent in study area; it can be further improved by appropriate refractive correction, provision of glasses and adequate follow up after cataract surgery.
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INTRODUÇÃO E OBJETIVO: A leptospirose é uma zoonose, causada pela bactéria Leptospira, de ampla distribuição e elevado impacto à saúde humana. As epidemias de leptospirose no Brasil acontecem a cada ano em áreas urbanas durante o período de chuvas sazonais. Porém não existem estudos que avaliem se as formas assintomáticas e/ou subclínicas seguem este padrão estacional relacionado a precipitação. O objetivo deste trabalho é determinar a incidência de infecção assintomática e de leptospirose grave durante diferentes períodos de precipitação em Salvador. METODOLOGIA: Realizamos cinco inquéritos sorológicos estacionais em uma coorte com 3176 habitantes na comunidade de Pau da Lima, Salvador Bahia, para identificar infecções assintomáticas por Leptospira spp (2013-2015)...
INTRODUCTION AND AIM: Introduction and aim: Leptospirosis is a zoonosis caused by Leptospira bacteria, and has a wide distribution with a high impact to human health. Outbreaks of leptospirosis in Brazil occur each year in urban areas during the rainy season. However, there are no studies to assess whether the asymptomatic and/or subclinical follow this seasonal pattern related to precipitation. The aim of this study is to determine the incidence of asymptomatic infection and severe leptospirosis. during different periods of rainfall in Salvador. METHODOLOGY: We conducted five seasonal serosurveys in a cohort of 3176 inhabitants in the community of Pau da Lima, Salvador-Bahia to identify asymptomatic infections by Leptospira (2013-2015)...
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Humans , Leptospira/growth & development , Leptospira/immunology , Leptospira/pathogenicity , Leptospirosis/diagnosis , Leptospirosis/pathology , Leptospirosis/prevention & controlABSTRACT
Background: Health inequity is becoming an emerging issue all over the world. Improving maternal health is one of the UN Millennium Development goals. Pregnant women inhabiting urban slums are a “high risk” group with limited access to health facility. Objective: To study the socio economic profile of the mothers and to study the differentials in utilization of maternal health care by the beneficiaries. Study Design: Descriptive, observational cross-sectional field based study in two purposively selected urban slums of district Dehradun. Results: About 70.9% of mothers belonged to social class II and III and 66% of them belonged to nuclear families. Teenage pregnancy was seen in 8.5%. 93.8% of women received complete antenatal care, majority preferring government hospitals. 93.2% of the women received 100 IFA tablets or more but only 63.7% consumed them for 100 days. Majority of the deliveries were institutional and 79.9% were conducted by trained personnel. About 68.5 % received postnatal care. Conclusion: Although usage of ANC service was high, opportunity to deliver important health services was not fully utilized. Policy and programme to improve the quality and care of antenatal mothers, especially for the poor and under privileged are essential to improve maternal health care. Special interventions should be undertaken on priority basis so as to achieve millennium developmental goals in all population groups.
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Background & objectives: Domestic violence is identified as a public heath problem. it is associated with adverse maternal health. This study examined the prevalence and determinants of domestic violence among women in urban slums of Mumbai, India. Methods: A community based cross-sectional household survey was carried out among eligible women for the study during September 2012 to January 2013. A total of 1137 currently married women aged 18-39 yr with unmet need for family planning and having at least one child were selected using cluster systematic random sampling from two urban slums. Information on socio-demographic, reproductive and domestic violence was collected through face-to-face interview using a pretested structured questionnaire after obtaining informed written consent. Bivariate and multivariate analyses were carried out to find the socio-demographic factors associated with ever experienced domestic violence among women. Results: The prevalence of women ever experiencing domestic violence in the community was 21.2 per cent. Women whose husband consumed alcohol [RR: 2.17, (95% CI: 1.58-2.98)] were significantly at an increased risk of ever experiencing domestic violence than their counterparts. Risk of domestic violence was twice [RR: 2.00, (95% CI: 1.35-2.96)] for women who justified wife beating than women who did not justify wife beating. Interpretation & conclusions: The findings showed that domestic violence was prevalent in urban slums. Factors like early marriage, working status, justified wife beating and husbands use of alcohol were significantly associated with domestic violence.
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Background: The feasibility of using mobile health clinics (MHCs) to deliver health services in urban poor areas has to be explored as the health needs of the residents are not sufficiently addressed by the existing primary health care delivery system in India. Objective: To estimate the cost of providing primary health care services and the out of pocket expenditure (OOPE) incurred, while utilizing these services provided through the MHC based Urban Health Program of a Medical College in North India for the year 2008-2009. Materials and Methods: A cross-sectional study to estimate OOPE was conducted among 330 subjects selected from patients attending the mobile health care facility. For estimation of provider cost, 5 steps process involving identification of cost centres, measurement of inputs, valuing of inputs, assigning of inputs to cost centers, and estimation of unit cost were carried out. Results: Total annual cost of providing services under Urban Health Program in the year 2008-2009 was Rs. 7,691,943 Unit cost of providing outpatient curative care, antenatal care, and immunization were Rs. 107.74/visit, Rs. 388/visit and Rs. 66.14 per immunization, respectively. The mean OOPE incurred was Rs. 29.50/visit, while utilizing outpatient curative services and Rs. 88.70/visit for antenatal services. Conclusion: The MHC can be considered as a viable option to provide services to urban poor.
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Aims: The aim of the study was to determine the pattern and factors influencing exclusivebreast feeding and weaning practices in a homogenous urban slum. Study Methods: The study was a descriptive cross-sectional among 143 mother-child pairsusing a combination of simple and systematic sampling methods. Interviewer administered questionnaire was used to obtain information on pattern of breastfeeding, weaning and weaning foods. Results: The ages of the mothers ranged from 13-41 years while the infants were aged 0-26 months. Breastfeeding was initiated by 83 mothers within 30 minutes of delivery and the main reason for delayed initiation of breastfeeding was the belief that colostrum was dirty 99(69.2%). only 32 (22.3%) of the mothers commenced weaning before the age of 4 months mainly on pap made from corn or millet.Out of the 143 respondents, only 46 (32.2%) practiced exclusivebreast feeding. There was a statistically significant relationship (P=0.006) between the age ofthe respondents’ and the practice of EBF as the mothers who were more than 30 years of agewere more likely to practice EBF compared to those younger than 30 years. However, the level of education andoccupation of the mothers had no significant bearing on the practice of EBF. Conclusion: The practice of exclusive breast feeding is low and is influenced by socialdeterminants that need to be addressed by policy makers. Risk factors for early weaning should be identified and appropriate interventions put in place.
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An integrated model based approach was used to improve health status of children in an urban slum. An urban slum was selected based on fixed criteria and health needs were assessed. The environmental conditions were improved. Health care needs were taken care of and self-help groups were started to make them financially independent. This model was evaluated in 204 families with 350 under-five children. Survey revealed that 88% of them used safe garbage disposal and 95% of them had household latrines. Only 24% of under-five children had water borne morbidity in past one year and there were no vector borne diseases. 71% of the eligible couples followed some contraception. Mean duration of exclusive breast feeding was 7 months and average total duration of breast feeding was 15 months. Integrated model based approach based on principles of primary health care works in urban slum with effective community participation.
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Objectives: To study the Antenatal and Intra-Natal Care Practices in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (71%) of the mothers received ANC. Out of those who received ANC, 32.5 percent of them received 2 ANC and 25.3 percent received 3 ANC. The tetanus toxoid (TT) vaccination was received by 80.4 percent mothers. Out of those who received tetanus toxoid, 67.9 percent received two doses of tetanus toxoid and 18.7 percent one dose of tetanus toxoid. The study findings shows that about half (51.7%) of the deliveries took place at home followed by govt. health facility (28.4%). Only 19.8 percent of the deliveries took place at private health facility. Majority (73.4%) of the deliveries were conducted by trained birth attendant. Only 19.6 percent and 7 percent deliveries were conducted by relatives and untrained birth attendant respectively. Conclusion: In majority of cases correct Antenatal and Intra-natal care practices were lacking among mothers and this should be promoted through improved coverage with existing health services.