Child health in urban areas

Close to 50% of the estimated 24 million Ghanaians live in rural areas but only 32.1% of the health sector workforce works in rural areas. Doctor patient ratio in a predominantly rural region is 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities have contributed significantly to Ghana’s slow progress in achieving the millennium development goals 4,5 and 6. This study was conducted in 64 clinics among 324 staff in 16 rural and urban districts. Objective was to ascertain rural-urban differences in health staff motivation and the implications on quality care in health facilities. Results showed significant differences in quality care performance of rural and urban facilities in terms of “staff training in resuscitative techniques”, “orientation to job”, and “safe use of medications”. Staff in rural facilities were more de-motivate by poor water and electricity supply than those in urban facilities (p<0.05). Motivating staff along these identified gaps will help improve quality care and clients participation in the national health insurance scheme, which is experiencing enrolment and re-enrolment challenges because of poor service quality in accredited health facilities.

Most analyses of differentials and trends in health and mortality find the anticipated relationship between measured outcomes and a range of socio-economic status variables including education, income status of employment and wealth. From a multi-year longitudinal study of health and mortality in Accra called the Women’s Health Study of Accra (WHSA), we produce a much finer grained analyses of health and mortality differentials within an urban area (Weeks, Hill et al. 2006; Douptcheva and Hill 2011). First, in some of the communities designated as ‘slums’ by UN Habitat, child mortality and adult morbidity are surprisingly good. The socio-demographic profile of the population, shaped heavily by migration, modifies the risk profile (Fink, Weeks et al. 2012). Secondly, the anticipated differentials in both self-reported and objectively measured dimensions of adult health are very narrow and often in the opposite direction anticipated (Darko, Adanu et al. 2012). Thirdly, there is evidence of pronounced neighbourhood effects where even for those poorer than the mean for the whole neighbourhood, place of residence can mitigate some of the otherwise adverse health outcomes associated with poverty (Weeks, Getis et al. 2010).These empirical facts present a challenge to conventional theory on the determinants of health outcomes.

The health care systems in developing countries are struggling with high incidences of infectious diseases and frequent out breaks of communicable diseases. There is limited resource needed to effectively manage these conditions, the recent upsurge in cardiovascular diseases puts more pressure on the weak and poorly resourced health system. This study explores illness action of people living with diabetes and hypertension, the structure and functions of pluralistic systems among Ghana’s urban poor focusing on the recent changes in the traditional healthcare systems. As part of an urban poor survey in Accra, a mixed method of quantitative, qualitative and spatial data are used. Evidence from pilot data suggests that people living with chronic conditions healer shop. Therefore health policies should improve the contributions of ethno-medicines and faith healing systems to enhance the quality of health care delivery.

Abstract
Background: With the rapid growth of the construction sector, the number of female construction workers has also increased. And the women working in the construction sector are vulnerable to several health problems which are inadequately addressed by the health sector.
Aim and objective: The proposed study intends to highlight the reproductive health problems of women in the construction sector. Apart from this, the study focuses on the health seeking behavior and the role of social support to address the reproductive health problems.
Methodology: The study was carried out both in the twin cities and the industrial city of Odisha by taking the women workers in the age group of 15-49. Around 300 respondents were selected randomly working at the construction site. A pre- designed structured questionnaire along with in depth interview technique was used to get the responses.
Conclusion: Women working in the construction sites are vulnerable to several factors like heavy workload, exposure to the substances at the workplace, stress, etc. Such work situations cause workers to experience abnormalities in their reproductive health and thus unknowingly remain infected for a longer period of time.
Keywords: Construction workers, reproductive health, coping strategy.

Transition of students from school environment to university environment could cause a psychological academic and social shock of them, since this educational system has huge differences, the student are facing new methods of teaching, new academic requirements, new type of relation between student and faculties and even new relations among students themselves. Due to these changes, students can potentially experience different types of stress that can affect their mental and social health and their academic achievement. Stress is one of the main aspects of our modern life, resulted from the rapid changes in human life.
Three main trends in studying stress level,
Physical factors, Social factors, Academic factor
The study aims to access the level of stress experienced by college students. A quantitative approach has been undertaken to access students stress level. The sample consisted of 100 students from Arts and Science college.
Of the students surveyed, 30 percent reported frequent feelings of being overwhelmed. Female students reported feeling overwhelmed more frequently, with 38 percent reporting feelings of stress compared with 20 percent of male students. Almost 70 percent of female students surveyed said they worried about how they would pay for college, while 57 percent of male students shared that worry.

The specific objectives of the present study are to analyze the differentials in prevalence; progression of use of tobacco and major determinants of quitting of smoking as well as use of smokeless tobacco. The rationale behind this study is to spread the awareness about the disease and deaths due to tobacco consumption. This study utilized the data from the Global Adult Tobacco Survey India (GATS India). This paper is an attempt to find the progression of use of tobacco in all the regions of India by using the Kaplan-Meier Survival Analysis and Cox's Proportional Hazards Regression. The Cox proportional-hazards regressions model is broadly applicable and the most widely used method of survival analysis. The prevalence is high in Bihar (54%), Chhattisgarh (53%), and Jharkhand (50%) and the lowest in Goa (9 %), Punjab (12 %).the probability of quitting tobacco among females is 1.35 times (p<.01) higher compared to their male counterparts. The probability of quitting tobacco is found to be 37.6 percent less among people from the North-East than among people from the northern region. However, the chances of quitting the use of smokeless tobacco are less in the North-East (HR=0.48), followed by the central (HR=0.94).

Theme: 3 Health, Mortality and Longevity
Sub theme: 03-08 Health in Urban areas
URBAN-RURAL DIFFERENTIALS OF DIETARY HABITS AND HEALTH AMONG KERALA POPULATION
Anusha A
Dr.T.N.Sugathan

Abstract:
An unhealthy life style, especially the eating habits of the adults is a serious and often unnoticed problem. There are differences in these lifestyles of the people from rural and urban areas of Kerala. The main aim of the study was to assess the pattern of dietary habits among the urban and rural population of Kerala, and to find how they affect the health status. The people between the ages 30 and 74 were chosen by a probability sampling method. The result showed that majority of the people followed a mixed food pattern i.e., both vegetarian and non-vegetarian foods. Variables like BMI, eating fast food, consumption of more quantity of sugar, consumption of fruits and certain non-vegetarian food showed a significant relationship with the chronic diseases. The females were more likely to affect any chronic diseases than males. It was found that only negligible difference was there between the food habits of urban and rural population. To summarize, the people make numerous unhealthy habits in their diet and eating habits, which in turn may affect health of future generations.

Public health impact of the dual epidemic of Tuberculosis and HIV poses a major challenge today, particularly in high prevalent countries like India. HIV is the most powerful risk factor for progression from TB infection to TB disease. TB in turn accelerates the progression of HIV to AIDS and shortens survival of patients with HIV infection. The two diseases are a fatal combination and far more destructive together than either disease alone. There have been many studies on HIV to TB transition but reverse link needs to be probed. Data from RNTCP (Revised National TB Control Program Management) and MDACS (Mumbai District AIDS Control Society) show that HIV infection rate among TB patients in Maharashtra is around five per cent. Cure rate of HIV infected TB patients dwindles by 14 per cent vis-a-vis NSP-TB infection alone. Mortality rate of TB-HIV co-infection is four times higher while defaulter rate is almost double against pure TB patients. Efforts to tackle TB and HIV have been largely in-congruent; despite their overlapping epidemiology. Availability of up-to-date, good quality data on HIV-TB co-infected patients and Institutionalized integration of TB and HIV control is therefore, imperative for improving compliance thereby enhancing TB-HIV control management program efficacy.

Key words: TB, HIV, Co-infection

After seven years of implementation, the National Health Insurance Scheme (NHIS) has achieved varying levels of enrolment coverage within the 10 regions of Ghana with different rural-urban populations. Recent research has identified the determinants of enrolment in the NHIS to include income, age, marital status, employment status, self rated health status and perceived quality of health care services. Implementation problems such as delays in the production and distribution of NHIS ID cards, long waiting times, poor staff attitude, inadequate information on NHIS benefit package and delays in reimbursing health providers has significant deepened the fiscal and coverage challenges of the NHIS and threatens the long term sustainability of the scheme.
Using a sample of 7,084 individuals from the COHEiSION Project baseline survey and employing logistic regression, separate estimations are performed on the rural-urban samples to determine whether there are rural-urban differences in the determinants of demand for health insurance in Ghana. Due to differences in economic and social opportunities, we expect differences in insurance covariates among rural and urban dwellers which will aid in the formulation of policy interventions to address low enrolment in rural and urban populations.

Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five in developing countries. The role of living environment in determining children’s nutritional health has gone largely unnoticed until recently. This study explores the relationship between living environment and children’s nutrition in India using third round of National Family Health Survey data on children less than five years of age. The study sets out to answer the following questions: First, what is the level of child malnutrition and how it varies among different socio-economic groups? Second, is living environment an important determinant of child nutritional status? The preliminary analysis shows that the level of child malnutrition differs considerably across the subgroups of population. Living environment also affects children’s nutritional status. Finding suggests that in the interest of improving the nutritional status of children, living environment should be improved in slum areas of India.