Prevalence and associated factors of malnutrition among under-five children living in slum areas of Bahir Dar Town, Ethiopia

Introduction: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City. Methods: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis. Results: a total of 680 children participated. The prevalence of lameness, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% ( 95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother's educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition. Conclusion: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.

Prevalence and the Factors Associated with Self‑Medication Practice: A Community‑Based Cross‑Sectional Study in an Urban Area of Purba Bardhaman, West Bengal, India

Introduction:Self‑medication (SM) is popular globally but leads to the wastage of resources, health hazards, and resistance to pathogens. This study aims to ascertain the frequency and manner, in which SM practices were employed by the urban population of Purba Bardhaman district, West Bengal. Materials and Methods: The study was an observational cross‑sectional one conducted in Burdwan Municipality, West Bengal, India, using a sample size of 180 adults (aged at least 18 years), residing in the study area, i.e., urban slum area for at least 6 months and conducted over 2 months. The data have been collected through a semi‑structured schedule consisting of questions on the sociodemographic characteristics of the study subjects and their SM practices. The data were thereafter analyzed, wherein descriptive statistics and a Chi‑square test were used. Results: It was found that SM was prevalent among 48.9% of the study population, with most participants practicing SM for body pain, headache, and fever. Among the different classes of drugs used, analgesics were the most common (31.8%), followed by antipyretics (25.0%) and antacids (20.5%). The correlation between sociodemographic characteristics and the practice of SM showed that individuals below the age of 36 were found to be more likely to engage in SM, along with individuals who had a low monthly income, and no comorbidities. These subjects were practicing SM more than their counterparts and it was statistically significant with theP < 0.05. Conclusion: The study emphasizes the importance of awareness and education regarding the proper use of over‑the‑counter drugs and recommends educating pharmacists and the public about the same. Public health programs should be introduced for the people living in slums to create cautiousness about SM.

Determinants Of Under-Nutrition Among Under Five Children in The Urban Slum of Ahmedabad, India

Introduction: In India, 6.8% of total population are under five children and 60 million are malnourished. Around 45% of deaths among children under five years are linked to under nutrition. The study aims to as-sess the nutritional status of under 5 children and associate it with various factors like age, gender, Immuniza-tion, birth weight, feeding practices, Anganwadi registration etc. Methodology: A community based cross-sectional study was conducted on 191 under five children in urban slum areas. Parents of under five children were interviewed with the help of a pre-designed questionnaire. Malnutrition was assessed using WHO recommended Z score category.Observations: Total 191 under 5 children were studied. Among them, 107 were male and 84 were female. Out of the assessed children two third were normal weight for age while one third were underweight. Nutri-tion status was significantly associated with age, birth weight, feeding practices and immunization status of children. Conclusions & Recommendations: One fourth of under-five children were under weight for age. Age, low birth weight, preterm delivery, faulty feeding practices and incomplete immunization were statistically signif-icantly associated with the underweight.

Realistic Personal Exposure Assessment of Air Pollutants and Health Outcomes – A Cross-Sectional Study Among Kolkata Slum Dwellers

Background: Rapid, unplanned, and unsustainable patterns of urban development can result in many emerging environmental and health hazards. One of the important public health problems of urban environment is regular exposure to dust and pollutants and consequence of such exposure in the form of changes in the pulmonary function. Being the immediate environment, indoor pollution poses a higher risk to human health than the ambient environment. Realistic personal exposure assessment gives the actual idea about the exposure status. Objectives: This study determined the household principal environmental exposures (Dust, SO2 , NO2 , and total volatile organic compound) among urban slum dwellers and assessment of the respiratory function to determine any possible relationship between those exposures and outcomes. The study also described the knowledge, attitude, and practice of these urban slum people regarding air pollution and its effect. Methods: A cross-sectional study was carried out among 442 urban slum people residing in the slums of the Kolkata Municipal area. Household environmental exposures were collected by standardized methods and outcome was observed by conducting a pulmonary function test. Finally, knowledge, attitude, and practice regarding air pollution were carried out with the help of a questionnaire-based survey. Results and Discussion: Almost all the pollutants exposure was associated with impairment of lung function. Younger age and female gender were statistically associated protective factors for the development of any lung disease. Those who had an overall good awareness regarding the means and effects of air pollution were found to be protected from developing lung disease. Using exhaust ventilation, relocation to inner side of slums, using personal protective measures, and adequate pollution awareness can help the slum citizens to overcome the problem.

Sanitation and hand washing behavior of urban slum dwellers in Vellore Corporation of Tamil Nadu, India: during coronavirus disease

Objectives: This study examines the sanitation and hand-washing behavior of slum dwellers before coronavirus disease 2019 (pre-COVID-19) and during the COVID-19 period. The study also examines health-seeking behavior. Materials and Methods: Purposive sampling method was used to select the study area and household. Out of 49 registered slums in the Vellore municipality corporation, three slums were selected, which represent the highest number of slum households. The names of the urban slum settlement were Salavanpet, Old Town, and Makkan. After selecting the study areas, households were selected on snowball techniques through telephonic conversation with a structured interview schedule. The total samples were 75 households. The study period was from June 2021 to August 2021. Results: The study shows that Vellore has the 18th highest number of positive COVID-19 cases in Tamil Nadu. This study found that regular wage incomes in urban slum dwellers have been severely affected by COVID-19 lockdowns. The majority of households without a toilet in slums have used open defecation during COVID-19. Hand washing behaviors for people living in the urban slums have increased during the COVID-19 than the pre- COVID-19 pandemic. This study found that middle-aged (age 31–40 years) people’s habit of hand washing as a precautionary measure against coronavirus disease increased during COVID-19 compared with pre-COVID-19. Suggestion and Conclusion: The study suggests that improving hand-washing habits could aid in the prevention of the COVID-19 virus and other illnesses and suggests advancing hand washing habits after the pandemic as basic protective measures, which continues to remain essential in urban areas.

Morbidity pattern and health-seeking behavior among the elderly residing in slums of Eastern Odisha: A cross-sectional study

Introduction: Of the total population, elderly people comprised of 8.14% in India where in India or globally. Main challenges faced by the elderly in our country are feminization, ruralisation, migration, and an increasing number of 80?plus adults. This sudden change of environment or being left stranded alone unattended or being dependent on children for their necessities is a major cause of mental illnesses. Objectives: To study the socio?demographic profile, find out the different morbidities and assess the health?seeking behaviour of the study subjects. Materials and Methods: A community?based cross?sectional study was conducted in the field practice area of urban health and training center using the simple random sampling method. Results: The mean age of study subjects was 67.58 ± 6.53 years. Majority of participants, i.e., 308 (73.0%) were young old. 207 (49.1%) were illiterate, 272 (64.5%) unemployed 272 (64.5%) and 224 (53.1%) were living with their children, i.e., 224 (53.1%). Inappropriate health?seeking behavior was significantly associated with under?weight (P < 0.001) which accounted for 2/3rd of participants. Severe depression was observed among 59.5% participants. Females showed a higher proportion of myalgia (5.7%), whereas males showed preponderance of upper respiratory tract diseases (19.2%). The prevalence of inappropriate health?seeking behavior was higher in females (65.1%). The proportion of the elderly with poor health?seeking behavior was found to be 50.4%. Conclusion: Morbidity among the elderly is very high and health?seeking behavior is very poor. Hence, strong efforts are needed to provide them holistic care. Hence, this study was conducted to threw some light on health status of the elderly, their morbidity pattern and health?seeking behavior. It will help the policy-makers to prepare the intervention strategies at the community level.

Sentido Comunitario de la Coherencia en asentamientos informales: aprendizajes y reflexiones desde Medellín (Colombia) / Community Sense of Coherence in slums: learnings and reflections from Medellín (Colombia) / Sentido comunitário da coerência em assentamentos informais: aprendizagens e reflexão desde Medellín (Colômbia)

Resumen Introducción: el modelo de urbanización ha provocado un aumento de las inequidades sociales, transgrediendo los principios éticos de la justicia social y espacial. La Organización Mundial de la Salud ha identificado la urbanización como uno de los principales desafíos de salud pública del siglo XXI. Objetivo: comprender el sentido de la coherencia comunitario generado a través de los activos comunitarios para la salud en el asentamiento informal El Faro al nororiente de la ciudad de Medellín. Materiales y métodos: se realizó una investigación bajo una metodología de estudio de caso de alcance interpretativo, y un análisis narrativo de construcción de la explicación a partir de siete entrevistas semiestructuradas, dos talleres de fotovoz y un mapeo de activos comunitarios para la salud desarrollado entre 26 habitantes de Medellín. Resultados: desde el modelo salutogénico se reconoció el empoderamiento de la comunidad, porque les ha permitido enfrentar las resistencias del contexto, creando prácticas positivas y saludables. Estas prácticas han movilizado sus activos comunitarios, permitiendo el desarrollo de un importante Sentido Comunitario de la Coherencia, con el cual la comunidad enfrenta los desafíos de la vida y construye experiencias coherentes. Conclusiones: los habitantes han buscado encontrar soluciones que respondan a la situación de pobreza, en un proceso de abajo hacia arriba que ha buscado crear espacios significativos, un mayor sentido de pertenencia y una percepción de seguridad de habitar este territorio. Finalmente, cuanto mejor se conoce el entorno, mejor se conocen las comunidades entre sí y se preserva mejor la salud comunitaria y el bienestar social.

Abstract Introduction: The urbanization model has caused an increase in social inequities, transgressing the ethical principles of social and spatial justice. The World Health Organization has identified urbanization as one of the major public health challenges of the 21st century. Objective: To understand the Sense of Community Coherence generated through community assets for health in the informal settlement El Faro in the northeast of the city of Medellin. Materials and methods: This research was conducted under a case study methodology with an interpretive scope, and a narrative analysis of construction of the explanation from seven semi-structured interviews, two photo-voice workshops and a mapping of community assets for health developed between 26 inhabitants of Medellin. Results: From the salutogenic model, the empowerment of the community was recognized because it has allowed them to face the resistance of the context creating positive and healthy practices. These practices have mobilized their community assets, allowing the development of an important Community Sense of Coherence with which the community faces the challenges of life and builds coherent experiences. Conclusions: The inhabitants have sought to find solutions that respond to the situation of poverty in a bottom-up process that has search to create significant spaces, a greater sense of belonging and a perception of security in inhabiting this territory. Finally, the better the environment is known, the better the communities know each other and the better the community health and social well-being are preserved.

Resumo Introdução: o modelo de urbanização tem provocado um aumento das inequidades sociais, transgredindo os princípios éticos da justiça social e espacial. A Organização Mundial da Saúde já identificou a urbanização como um dos principais desafios da saúde pública do século XXI. Objetivo: compreender o sentido da coerência comunitária gerada a través dos ativos comunitários para a saúde no assentamento informal O Faro ao nordeste da cidade de Medellín. Materiais e métodos: realizou-se uma pesquisa baixo uma metodologia de estudo de caso de alcance interpretativo, e uma análise narrativa de construção da explicação a partir de sete entrevistas semi-estruturadas, das oficinas de foto voz e um mapeio de ativos comunitários para a saúde desenvolvendo entre 26 habitantes de Medellín. Resultados: desde o modelo salutogênico se reconheceu o empoderamento da comunidade, porque lhes permitiu enfrentar as resistências do contexto, criando práticas positivas e saudáveis. Estas práticas tem mobilizado seus ativos comunitários, permitindo o desenvolvimento de um importante Sentido Comunitário da Coerência, com o qual a comunidade enfrenta os desafios da vida e constrói experiencias coerentes. Conclusões: os habitantes procuraram encontrar soluções que respondam à situação de pobreza, em um processo de abaixo para arriba que tem buscado criar espaços significativos, um maior sentido de pertinência e uma percepção de segurança de habitar este território. Finalmente, quanto melhor se conhece o entorno, melhor se conhecem as comunidades entre si e se preserva melhor a saúde comunitária e o bem-estar social.

STUDIES ON HEALTH AND HYGIENE IN SLUMS OF KOLHAPUR CITY

The slums taken for the study purpose are located in Kolhapur municipal corporation land, private land as well as government land . Total slum population is around 11% of total population of the city. Residents in slum areas live in poor living conditions that lack basic amenities like water availability, light, toilets, ration card, schools, etc. Unhygienic conditions in slum areas are responsible for the spread of diseases. For present study purpose four slums in the Kolhapur city namely Rajendranagar, Avchitnagar, Vicharemal and Kanannagar were selected. The information related to environmental health and hygiene of people was collected through questionnaire survey. Among selected sites the target group was residents in slums, officials of Kolhapur Municipal Corporation and resident doctors in the area. This study aims to present a data related to health and hygiene conditions of slums in the Kolhapur city which in future helps to mitigate various environmental health problems in this area.

Comunidade Ampliada de Pesquisa-Ação: construindo saberes e práticas no diálogo cotidiano e afetivo com o território / Extended Action-Research Community: building knowledge and practices in daily and affective dialogue with the territory

RESUMO O artigo objetivou discutir os aprendizados com as Comunidades Ampliadas de Pesquisa-Ação (CAP) em favelas do Rio de Janeiro, como contribuição às discussões conceituais e metodológicas no campo da saúde coletiva, na perspectiva da Promoção Emancipatória da Saúde e da Educação Popular. Com as CAP, como foi sintetizada esta metodologia, buscou-se responder a um dos principais desafios de pesquisas qualitativas em favelas: uma construção metodológica que possibilite a compreensão da forma por meio da qual os moradores desses territórios experimentam e respondem às situações de saúde. O território, como categoria integrativa de análise para compreender os processos de determinação social da saúde, impõe à CAP se configurar como uma rede de diálogos interdisciplinares e entre diferentes agentes sociais. A análise da base material documental produzida no período 2003-2020, utilizando a sistematização de experiência como metodologia de pesquisa, resultou na identificação de três eixos que estruturam o método CAP, metodologia assim denominada: 1) o cotidiano como engrenagem da dinâmica da CAP; 2) o território e os agentes sociais do diálogo; e 3) as ferramentas artesanais de co-laboração com o território. A partir desses eixos, conclui-se ser o método CAP uma rede de produção de conhecimentos e interlocução entre pessoas-lugares-territórios.

ABSTRACT The article aims to discuss the lessons learned from the Extended Action-Research Community (CAP) in favelas in Rio de Janeiro, as a contribution to conceptual and methodological discussions in the field of Public Health, from the perspective of Emancipatory Health Promotion and Popular Education. With the CAPs, we seek to respond to one of the main challenges of qualitative research in favelas: a methodological construction that makes it possible to understand the way the residents of these territories experience and respond to health situations. The territory, as an integrative category of analysis to understand the processes of social determination of health, requires CAP to configure itself with a network of interdisciplinary dialogues and between different social agents. The analysis of the documentary material base produced in the period 2003-2020, using the systematization of experience as a research methodology, resulted in the identification of three axes that structure the CAP method: 1) everyday life as the dynamics gear of CAP; 2) territory and the social agents of dialogue; and 3) artisanal tools to collaborate with the territory. Based on these axes, we conclude that the CAP method is a network for knowledge production and dialogue between people-places-territories.

Presence of Pathogenic Leptospira spp. in an Urban Slum of the Colombian Caribbean: A One Health Approach

Introducción: La leptospirosis es una zoonosis que tiene alto impacto en la salud de las personas y los animales, especialmente en áreas tropicales y subtropicales. Esta enfermedad es causada por el patógeno Leptospira spp. y es transmitida principalmente por los roedores. Objetivo: Describir la presencia de Leptospira patógena y los posibles factores de riesgo de leptospirosis en un sector marginal de Colombia, con un enfoque One-Health. Métodos: Se llevó acabo un estudio exploratorio en un sector marginal de Soledad, municipio situado en la costa norte de Colombia. Se tomaron muestras de sangre de 83 sujetos. Se analizaron variables sociodemográficas, clínicas y ecológicas relacionadas con la leptospirosis. La presencia de anticuerpos IgM anti-leptospira en el suero humano fue detectado mediante la prueba ELISA. También, se tomaron muestras de tejido renal de 53 roedores sinantrópicos para identificar Leptospira spp. patógenas mediante PCR convencional a través del uso de cebadores específicos. Resultados: Se detectaron anticuerpos IgM-anti-leptospira en el 30,12 por ciento de los sujetos de estudio. La Leptospira spp. patógena fue identificada en el 7,55 por ciento de los roedores analizados. En la muestra seleccionada se encontró asociación de casos seropositivos con ser comerciantes, ama de casa y estar en contacto con cerdos. Las condiciones higiénico-sanitarias subóptimas también fueron evidentes en el área de estudio. Conclusiones: La circulación de Leptospira spp. patógena y la exposición a factores de riesgo humanos y ecológicos es elevada en el sector marginal (área de pobreza) del Caribe colombiano. Se recomienda dirigir las intervenciones en la interfaz hombre-animal-ambiente de acuerdo con el paradigma One-Health; se debe considerar la extrema pobreza como un factor determinante para la ocurrencia de la leptospirosis(AU)

Objective: This study aims to describe the presence of pathogenic Leptospira and potential risk factors for leptospirosis in a marginal sector of the Colombian Caribbean, with a One Health approach. Methods: an exploratory study was carried out in a marginal sector of Soledad, a municipality located in the north coast of Colombia. Blood samples were taken from 83 subjects, who were also questioned about sociodemographic, clinical and ecological variables related to leptospirosis. The presence of IgM Anti-Leptospira antibodies in human serum was performed by ELISA. A total 53 synanthropic rodents were also captured using Sherman traps. Renal tissue samples were taken from rodents to identify pathogen Leptospira spp. by conventional PCR using specific primers. Results: IgM-anti-Leptospira was present in 30.12 percent of study subjects and pathogenic Leptospira spp. was identified in 7.55 percent of captured rodents. In the selected sample we found an association of positive cases with being a merchant, housewife and being in contact with pigs. Suboptimal hygienic-sanitary conditions were also evident in the study area. Conclusions: Our results show the circulation of pathogenic Leptospira spp. and exposure to human and ecological risk factors in a marginal sector (slum) of the Colombian Caribbean. We suggest to direct interventions in the human-animal-environment interface according to the One Health paradigm, considering extreme poverty as a determining factor for Leptospirosis occurrence(AU)

Pandemic responses in vulnerable communities: a simulation-oriented approach / Respuestas a la pandemia en comunidades vulnerables: un abordaje de simulación / Respostas à pandemia em comunidades vulneráveis: uma abordagem de simulação

Abstract Populations living in favelas are facing even more vulnerabilities with the sudden escalation of the COVID-19 pandemic, as social distancing is challenging in such settings. Furthermore, these populations typically lack proper sanitation and hygiene conditions, which are requirements to adequately control the outbreak. This paper proposes the use of System Dynamics modeling to support the public policy-making process in order to avert negative effects of the pandemic in the Brazilian favelas based on measures elicited from the social movement named "Favelas Contra o Corona." The simulation model assessed the effectiveness of strategies and policy bundles encompassing temporary transfer of the favela population, supply of hygiene products, emergency sanitation structures, and expansion of Intensive Care Units. Results indicate that a suitable combination of strategies can bring significant effects to the number of avoidable deaths and the availability of Intensive Care Units for the population.

Resumen Las poblaciones que viven en barrios de bajos recursos enfrentan aún más vulnerabilidades con el surgimiento de la pandemia de COVID-19, ya que para ellos el aislamiento social es una tarea difícil. Además, carecen de condiciones adecuadas de saneamiento e higiene, que son requisitos para controlar la pandemia. Este estudio propone el uso de la Dinámica de Sistemas para apoyar las decisiones de políticas públicas que leen las medidas que se tomarán para aliviar los efectos negativos de la propagación del virus basado en medidas obtenidas del trabajo del movimiento social "Favelas Contra o Corona". Se desarrolla un modelo considerando estrategias y conjunto de políticas basado en: transferencia temporal de la población de barrios de bajos recurso, suministro de productos de higiene, estructuras de saneamiento de emergencia y expansión de la Unidade de Cuidados Intensivos. Se concluye que la solamente por la combinación de políticas efectos significativos serán alcanzados en el número de muertes evitadas y en el logro de la disponibilidad de Unidade de Cuidados Intensivos en el sistema de salud.

Resumo Populações vivendo em favelas no Brasil enfrentam ainda mais vulnerabilidade com o advento da COVID-19, já que para elas o isolamento social é uma tarefa difícil. Além disso, esses locais carecem de saneamento e condições de higiene, que são requisitos importantes para controlar a pandemia. Este artigo propõe o uso de Dinâmica de Sistemas para apoiar decisões de políticas públicas relativas a medidas para aliviar os efeitos negativos da disseminação do vírus baseado em medidas definidas a partir do trabalho do movimento social "Favelas Contra o Corona". O modelo proposto avalia a efetividade de estratégias e conjuntos de políticas que envolvem: transferência temporária da população da favela, suprimento de produtos de higiene, estruturas emergenciais de saneamento e expansão de Unidades de Terapia Intensiva. Os resultados apresentam o impacto de cada uma das estratégias. Entretanto, somente a combinação adequada de medida traz resultados significativos sobre o número de mortes evitadas e à disponibilidade de leitos de Unidades de Terapia Intensiva para a população.

Knowledge, attitude and practice towards mental health illnesses in an urban community in West Bengal: a community based study

Background: Mental illness is a significant challenge and becoming more relevant in today’s fast paced world. According to WHO, mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. The aim of the present study was to assess the knowledge about mental illness and attitude and practice of the public toward people with mental illness. Methods: An observational, descriptive study with cross-sectional design was done among 200 adults of Bagh bazar slum, urban field practice area of department of Community Medicine, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India in May 2019 with a predesigned, pretested schedule.Results: Only 2.5% says that they are willing to live with a people with mental illness and only 1% has actually done so. Health-care seeking behavior shows that 54.5% will go to a general practitioner in case of any mental illness though only 2.5% believed that people with severe mental illness can fully recover. Attitude toward mental illness showed mixed picture as also in knowledge.Conclusions: Health education and public awareness regarding mental illness can decrease the stigma, prejudice; discrimination attached with it and improves help-seeking behaviour of the community. This study provides insights into the cognitive and affective aspect of mental illness among adult population of the study area. It will also help in implementing better policies for increasing public awareness regarding mental illness.

Prevalence of hypertension and its associated risk factors among adults residing in urban slum: a population-based door-to-door study

Background: High blood pressure (HBP) is the single most common risk factor for disease burden all over world. In India, HBP has now emerged as a leading risk factor for morbidity and mortality. This study was carried out to find out prevalence of hypertension and its association with major risk factors among adults residing in urban slum.Methods: A population based door to door study was carried out in urban slum coming under field practice area of urban health training centre, Department of Community Medicine People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh.Results: The mean systolic BP was 121.4 mmHg whereas mean diastolic BP was 79.4 mmHg. Overall, 64.6% respondents were normotensive, 15.4% were in the category of pre-hypertension, and 5% in stage 1 hypertension (HTN) and 15% were in stage 2 HTN, giving the overall prevalence of high blood pressure 20.07%.Conclusions: It can be concluded from present study that the prevalence of hypertension is quite high. Hence it is necessary to increase the public awareness about hypertension.

An epidemiological study on diabetes and its determinants among urban slum women of Rajkot city, Gujarat

Background: India has the maximum number of diabetic patients in the world and this had given the country the dubious distinction of being the “diabetic capital” of the world. It is evident that the urban poor living in slums and slum like areas adopt a more urbanized lifestyle which places them at a higher risk for non-communicable diseases and have poor access to healthcare, partly related to their poor purchasing ability. Women slum dwellers are particularly vulnerable to negative health outcomes. The study was conducted with objectives to assess prevalence, determine factors and know treatment and control status.Methods: This is a cross sectional study conducted among 405 slum women of age 35 years or more in Rajkot city. Interview, anthropometric measurements and selective clinical examinations i.e., blood sugar estimation were done for all participants.Results: In present study, total 64 (15.80%) women were diagnosed with diabetes. A statistically significant association was found between body mass index, remaining busy in household work, walking, practicing healthy habits, parental history, sibling history and diabetes. Out of 64 women who were diagnosed with diabetes, about half i.e., 36 (56.25%) were aware of their diabetic status. Out of those aware, 29 (80.66%) were on treatment. Among those on treatment, about half i.e., 16 (55.17%) had their blood sugar under control.Conclusions: Studied population high prevalence and inadequate control of diabetes.

Awareness regarding self care among diabetics in urban slum of Kolkata: a community-based, cross-sectional study

Background: Diabetes mellitus is a disease associated with significant morbidity and mortality. Patients with diabetes have higher rates of coronary artery disease, peripheral vascular disease, retinopathy, neuropathy and nephropathy. Many of these complications can be prevented with appropriate medical care that often requires significant alterations in lifestyle and strict adherence to self-care tasks to obtain good control of disease. Awareness regarding the complications of this disease will play a vital role in its prevention and control. While lack of adherence to the treatment and self-care leads to poor glycemic control, thereby, increasing hazardous complications. Objective of the study was the present study was conducted to assess the knowledge of diabetic patients regarding the disease and its complications, and to estimate the knowledge and adherence to self-care practices concerned with Type 2 diabetes mellitus.Methods: The study was conducted in Tangra an urban slum of Kolkata from July 2018 to December 2018. A house to house survey was conducted to identify the known diabetics in the community and data of 362 patients were collected.Results: A total of 362 diabetic patients consented and participated in the study of whom 191(52.76%) were male and 171(42.74%) female. Majority of the respondents (26.52%) between the age of 50-59 years, 140(38.67%) belonged to upper middle class. Though 332(91.71%) respondents were aware regarding diet control but only 170(46.96%) were actually practicing the recommended diet schedules. Knowledge of the respondents regarding eye, foot, skin and dental care was very low, only 67(18.51%), 102(28.28%), 62(17.13%) and 46(12.71%) respondents were aware respectively and practices were still lower.Conclusions: Overall the level of self-care activities among diabetic patients in our study was quite low. Government policies should help in creating guidelines on comprehensive diabetes management within the primary health care setting including availability of medicines and diagnostic services and creating public awareness.

A study to assess receipt and utilization of janani suraksha yojana cash incentive among mothers in urban slums of Raipur city, Chhattisgarh, India

Background: Janani Suraksha Yojana (JSY) replaces the National Maternity Benefit Scheme. It was launched by the Government of India in April 2005. The aim was to reduce maternal and neonatal mortality by increasing institutional delivery by providing cash incentive to the beneficiaries as well as the link worker ASHA. Objectives of this study was to assess receipt of Janani Suraksha Yojana (JSY) cash incentive and to assess fields of utilization of Janani Suraksha Yojana (JSY) cash incentive.Methods: A Community based cross-sectional study was conducted among 384 mothers delivered within last one year in urban slum of Raipur city. Study centre was department of community medicine, Pt. J.N.M. medical college Raipur, Chhattisgarh. A pre-designed and pre-tested questionnaire was used to interview the study subjects.Results: Out of total 384 study subject’s cheque of JSY cash incentive was received by 70.83%. All (100%) beneficiaries who received cheque was stipulated amount as per JSY guideline. Reasons for not receiving cheque was no availability of BPL card for those who delivered in accredited private health facility. Other reasons were absconded after delivery, unaware of cash incentive, did not go back to get the cheque when called later, patient shifted to another ward. None of the study subjects who delivered at home received the cash incentive cheque. Realization of cheque was not done by 22.79% of study subjects due to complex procedure to open an account in bank. Cash incentive money was utilized in neonatal care, drugs, food, household activities and some deposited in bank.Conclusions: JSY scheme is definitely functioning well in terms of providing cash incentive cheque of JSY on delivery in Government Health facility. There is need to simplify the procedure to open an account so that beneficiaries can avail cash incentive money. There is need to address the problems to receive cheque in home delivery and accredited Private health facility in addition to motivation for institutional delivery.

Juventude(s) periférica(s) e subjetivações: narrativas de (re)existência juvenil em territórios culturais / Favela urban youth and subjectivities: narratives of (re)existence in cultural territories

Este artigo apresenta certas linhas singulares de subjetivação experimentadas pela juventude enquanto produção estético-cultural que configura a periferia como território existencial. Pretendemos contribuir para a discussão da relação entre hierarquização socioespacial das cidades e os processos de subjetivação de forma crítica aos processos de vitimização, criminalização e estigmatização juvenil. Buscamos nos orientar por um estudo com os sujeitos e não sobre os sujeitos. Três jovens envolvidos em ações culturais autônomas no território (como sarau, cinema, hip hop) foram acompanhados nestas e em outras atividades de seu cotidiano numa perspectiva etnográfica, descrita no diário de campo, bem como por meio da realização de entrevistas em história oral. Estas foram transcritas, textualizadas, transcriadas e organizadas em categorias temáticas. Privilegiamos as categorias relativas ao "território" e às "invenções estéticas na periferia" que nos permitiram evidenciar que o engajamento da juventude na produção estética na periferia opera como tática, estratégia de luta diante dos estados de dominação hegemônicos e de estigmatização aí presentes. A arte agencia possibilidades de invenção de territórios existenciais e de novos modos de subjetivar-se quando o estigma se converte em emblema; no orgulho de ser jovem, negro, pobre e periférico.(AU)

This article presents certain singular lines of subjectivation experienced by youth as aesthetic-cultural production that configures the slum as existential territory. We intend to contribute to the discussion of the relationship between socio-spatial hierarchization of cities and the processes of subjectivation in a critical way to the processes of victimization, criminalization and juvenile stigmatization. We seek to guide a study with the subjects and not on the subjects. Three young people involved in autonomous cultural actions in the territory (such as sarau, cinema, hip hop) were accompanied in these and other activities of their daily life in an ethnographic perspective, described in the field diary, as well as through interviews in oral history. These were transcribed, textualized, transcribed and organized into thematic categories. We privilege the categories related to "territory" and "aesthetic inventions in the slum" that allowed us to show that the engagement of youth in the aesthetic production in the periphery operates as a tactic, a strategy of struggle against the hegemonic states of domination and stigmatization present there. The art agency possibilities of invention of existential territories and of new ways to subjectivate itself when the stigma becomes emblem; in pride of being young, black, poor and peripheral.(AU)

Study of contraceptive use in married women of reproductive age group in urban slum area of western Maharashtra

Background: India is world’s second most populous country next to China. Family planning is a key intervention for population control. In urban field, most of population (60%) resides in urban slum area with deprived and vulnerable population. This study was conducted to determine the prevalence of contraceptive use in married women of reproductive age group also to study socio-demographic factors and sources associated with the contraceptive use and the reasons behind not using.Methods: A community based descriptive cross sectional study of 5 months duration was conducted among married women in reproductive age group (15-45 year) resident of urban slum area. 234 samples were selected by simple random sampling method. Data was collected through interviews of study subjects using a semi structured questionnaire.Results: Out of 234 women, 98 (41.9%) women said that they are using some method of contraception, which are condom (6.8%), OC pills (4.3%), copper-T (4.7%) and female sterilization (26.1%). Religion, socio-economic status is not significantly associated with acceptance of contraception, but the education and employment are the key influencers for the contraceptive use. The major sources of information are doctors from the government hospitals and auxiliary nurse midwives.Conclusions: The prevalence of contraceptive use in married women of reproductive age group (15-45 year) in urban slum area is found to be 41.9%. Spacing methods including the modern methods of contraception are not getting accepted. More efforts should be taken to remove fear and misconceptions about contraceptive use.

Tracking of antenatal services and outcomes using community health information system in a slum population of North India

Background: Despite of improvement of public health service, the reach of these services has remained low in urban slums due to various socio cultural and environmental factors.Methods: An information and communication technology (ICT) based community health information system was installed in a urban primary health centre catering to urban slum populations in North India. The system was used to track all the antenatal cases registered over a period of one and half years for antenatal services, risk factors and antenatal outcome. The system allowed for tracking of antenatal cases for antenatal care (ANC) visits, investigations, high risk factors, delivery and perinatal care. Real-time monitoring of antenatal cases was made possible through dynamic dashboard with indicators.Results: Among 614 women tracked for ANC and outcome, majority were below 30 years of age (78.3%), belonged to lower caste (85.7%) and many were illiterate (42.8%). Out of all antenatal cases 68% got registered in 1st trimester and only 47% completed 4 ANC visit. Majority delivered in government hospitals (95.4%) with 22.8% delivered through caesarean section. Illiteracy was found to have significant association with higher gravida (>2) (p<0.001). The high risk factors were present in 29.5% of antenatal cases and it was found to be significantly associated with increasing age (p=0.02) and preterm deliveries (p<0.001). Twin pregnancy was also found to be significantly associated with increasing age (p<0.001).Conclusions: An ICT based community health information system can be an effective tool for real-time monitoring of health services, identifying the gaps and tracking of antennal cases especially in difficult to reach slum population.

Assessment of the utilization of health services among urban slum population in Southern Rajasthan

Background: Urban slums consist of the vulnerable population for whom the affordability and accessibility of health care is constrained due to various reasons. The occurrence of various diseases in slums can be prevented by increasing access as well as utilization of available health care services. Objectives: The aim of the study was to assess the sociodemographic profile of families residing in a selected urban slum area and to study the association between sociodemographic characteristics of families with utilization of available health services by them. Materials and Methods: A cross-sectional study was conducted from May 2013 to December 2013 among 300 families residing in selected urban slums. The information regarding sociodemographic factors and utilization of health services, causes of non-utilization of health services, and preferred mode of treatment during the past 6 months were collected from the head of the family. The association of sociodemographic factors with utilization of health services was tested using Chi-square test. Results: There were 898 (53.20%) males and 790 (46.80%) females in 300 selected families. It was found that 84 (28.00%) head of family were illiterate and 216 families (72.00%) belonged to lower socioeconomic status. The number of families not using any type of health facility was 82 (27.33%). Conclusion: The literacy level of the head of family and socioeconomic status of family was found significantly associated with utilization of health services. Hence, focus should be given to improve the education level and behavior of the persons to adopt the health services and increase the efficiency of the health system.