Child health in urban areas

In every corner of the world, city dwellers suffer disproportionately from poor health and these inequities leads to differences in their social and living conditions. The objectives of this study are: to compare the child immunization status among urban poor and non poor in the selected eight cities of India and to understand the effect of maternal health and socio economic characteristics in child immunization status by comparing urban poor/non poor and overall comparison of urban with the rural India. Data for analysis is drawn from NFHS –III. The analysis finds that the percentage of women age 20-24 married by age 18 and had home delivery is more than twice in urban poor and in rural as against urban non poor. Percentage of children immunized and births assisted by a health provider is 39.9 and 50.7 percent respectively in urban poor and is higher than rural India. Immunization coverage is much lower for urban poor than for non poor children in all the selected cities except Chennai. Educational status is low in urban poor as compared to urban non poor in both the sex in India. Thus, there is an obvious need to improve educational and health status of city dwellers.

In this study we inquire upon certain pathways, i.e. material psychological and behavioral, which are known to have impact on health. The study is placed in an urban village of Varanasi, which historically suffers socio-spatial exclusion. This study is built upon sequential exploratory research design, a genre of mixed methodology of research. A total of 150 adult males participated in two phase of data collection, accomplished through various instruments like in-depth interviews, group discussion and questionnaire based survey. The data collected in different face were analyzed combinedly to get a complete picture. The inhabitants of the study area were segregated from urban surrounding socially and spatially. They have health problems originating from insanitation and poverty. Their perception was controlled by old rural values and experiences; and practices were curious mix of rurality and urbanism.

With rapid urbanization in recent decades and over 40 million people living in urban areas in Bangladesh in 2011, the country faces challenges in providing adequate health services for the burgeoning urban population. Given the need to improve basic health conditions and provision of health services in urban areas, especially for the poor, the Government of Bangladesh launched the first Urban Primary Health Care Project (UPHCP I) in 1998 and continued with a second phase (UPHCP II) from 2005 to 2012. Provision of services is through contracted non-government organizations (NGOs) in partnership areas (PAs). Assessment of the evidence show that there have been interim achievements with UPHCP II, namely, improvements across several service quality indicators, increasing equity of maternal and child health service coverage for the poor, and decreased cost over time in some PAs. Most rankings of PA performance across health service quality, cost, and maternal and child health coverage are weakly correlated, with only a few PAs scoring in the top-ranked half across all indicators. However, service quality indicators, such as training of staff, functioning of equipment, availability of drugs, infection prevention, waste disposal, use of registers, and overall and waiting time satisfaction of non-poor patients, have improved over time.

The present study comes out with the urban-rural differentials in maternal health care services in the districts of Madhya Pradesh. Third round of District Level Household and Facility Survey has been used for the study. A Maternal Health Care Index (MHCI) is constructed to measure degree of health care services utilised by women during childbirth. Result reveals that Indore district tops the list in MP with 0.5671 in MHCI, followed by Ujjain (0.4727) and Hoshangabad (0.4617). Dindori district is in bottom of the list with only 0.1104 MHCI followed by Sidhi (0.1609) and Raisen (0.2116). In rural Madhya Pradesh, not a single district is touching even MHCI of 0.5 points. Among all the 45 districts, Shajapur district is in top of the list with MHCI of 0.427. Dindori district is in bottom most in the list with only 0.0983 MHCI. Though the MHC Indices are higher in urban area as compare to rural yet their overall performance are not so attractive. Even the disparity between highest and lowest district is very high. Hoshangabad district is in 1st rank with MHCI of 0.6801. Among the worst performing districts, Sidhi district is leading with MHCI of only 0.0966 followed by Tikamgarh and Raisen.

Paper examined self perception of body weight, future intention for weight management and actual weight management behaviour among normal, overweight and obese women in Urban India. 325 ever-married aged 20-54 years systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) were re-interviewed after four years in 2003. Information on woman’s perception about their own weight, intention of weight management and actual weight management behaviour were collected through personal interview. Anthropometric measurements were obtained from women to compute their current body mass index. Discrepancy between self perceived body weight and women’s actual body weight was noticed. One-fourth overweight women and one in ten obese women perceived themselves as normal. Though a majority of overweight and obese women wanted to reduce their weight, a significant proportion of overweight (one in four) and 4% obese women also wanted to maintain their weight as it is. Only one in three overweight and one in four obese women were performing exercise to reduce their weight. These finding are important for public health interventions in obesity care in urban India.

By using the third round of National Family and Health Survey (NFHS-III) the study tries to bring out the differentials of maternal health care challenges among urban poor and non-poor women in India. Bivarite and multivariate analysis has done and a separate wealth index has developed by using PCA method from a set of household economic proxies for urban areas to define urban poor and non-poor. Preliminary result shows a large inequality prevail in utilization of antenatal care and skilled birth assistance by economic status of women. It is also found that urban non-poor women visit more ANC check up than poor, which is also observed for receiving TT injection, consuming IFA tablets and use of delivery care services. Urban poor mothers were significantly at disadvantageous position relatively than non-poor urban mothers in India. Urban non-poor women are more likely to use public and private health care centres for their delivery purpose as compare to urban poor and this differential prevails because of high cost of health facility. From the study it can be conclude that maternal and delivery care services needs more specific policy implementation to reduce inequalities and inaccessibility in use of health care services in India.

Objectives: To describe cholera outbreak trends; show geographical distribution of cholera cases; describe a new cholera communication strategy; and show that the new strategy protects the community from cholera in subsequent outbreaks.

Methods: We reviewed case reports from facilities within KHDSS and samples were sent for laboratory confirmation. We performed GIS spatial analysis on the data showing the distribution of cases. Cholera hotspot areas were identified for intervention. Cholera communication strategy focusing on empowering the community to realize unhygienic conditions of water, food, poor sanitation and personal hygiene was introduced and its impact assessed in subsequent outbreaks.

Results: Suspected cases were 125 between June 2009 and February 2010. The positives were (43%), negatives (47%) and Epi-linked (10%). In the subsequent outbreak between April-May 2010, we observed 90 suspected cases, (9%) positives, (4%) negatives, (81%) epi-linked and (6%) samples were not collected. No cholera cases were reported in the cholera hotspot areas.

Conclusion: Cases of cholera declined with subsequent outbreaks and no case was reported in the hotspot areas. Our intervention worked well suggesting a replicable approach in other epidemic areas.

Good nutrition means “maintaining nutritional status that enables us to grow well and enjoy good health”. The nutritional status of women is important both for the quality of their own lives and the survival and healthy development of their children. Nutritional status of women in India is posing a serious challenge not only for nutritional policy but also for socio-economic and welfare policies. Therefore, this study assesses the determinants of nutritional status and anaemia level among women in Maharashtra.
Data and Methodology: Third round of National Family Health Survey (NFHS-3, 2005-06) data, descriptive statistics such as multivariate statistics such as multinomial logistic regression are used for the purpose of this study.
Results and Conclusion: In Maharashtra half of the women are not anaemic. A close association was found between low body mass index of the women who are illiterate, not involved in economic activity. This study revealed that women of low economic status households have the highest prevalence of under nutrition, majority of women fall under this group are undernourished and severely anaemic. This may be due to food insecurity in these households that negatively impacts the nutritional status of women, in particular, and the other household members in general.

One of the main problems concerning the accumulation of population in the urban areas is directly related with the increment of the socio-economic, socio-spatial, and socio-demographic segregation.
The investigation presented here answers those questions by establishing the mortality profile in the four main Colombian cities. This research focuses on georeferencing, presenting the place of residence of the deceased on the city map, determining in this way the differences in the parameters of mortality related to the inhabited space. Building the mortality profile and locating it spatially, keeping in mind the deep socio-spatial segregation that is a constant in Colombian cities, allowed establishing a list of the socio-economic status of the deceased and determine the differences in the mortality parameters as another element contributing the socio-demographic urban segregation.
This study also analyses the question of the difference in life expectancy of population concerning their socio-economic condition. By means of analyzing the differences in the mortality profiles related with the housing site and linking them directly with the socio-economic status it was possible to establish the great differences existing in the life expectancy for someone born in Bogota.

Many people in the developing world go without health care from which they could benefit greatly. Beyond this, there are evidences that the health care needs of individuals differ greatly at different stages of their life cycle. High rural-urban migration further compounds the health problems of urban residents. The lifecycle has been divided into four stages which are 0-5 years, 6-15 years, 16-59 years and those that are 60 years and above.The classification is determined by the structure of health risk faced by different age groups. This study examines health care demand over the life cycle in urban areas of Nigeria. Although there is no panel data on household living standard in Nigeria, we have done our analysis for a single year but consider different age group using a cross sectional data. The data set used for this study is the 2004 Nigerian Living Standard Survey (NLSS). The study used the Nested Multinomial Logit Models (NMNL) estimation techniques. Our tentative findings while parental education and occupational structure are important determinants of child demand for health care, self- income and educational level are the most important determinants for those aged 16-59 years old.