Child health in urban areas

The study analyzes the association between domestic environment and child health in terms of drinking water, toilet facility, cooking fuels, and separate kitchen, type of house with the incidence of Acute Respiratory Infections (ARI) and Diarrhea among under age five years of children. Study utilizes the data third round of Districts Level Household Survey conducted in 2007-08 by IIPS Mumbai. Bi-variate and multivariate technique have been carried out for this study. 17% children had suffered from ARI and 16% children in rural areas and 15% in urban areas had suffered from diarrhea in the last two week prior to the survey. Prevalence of ARI in western region 22% and diarrhea 20% where as southern part ARI 14% and diarrhea is 12%. Availability of separate kitchen in the house and used at clean fuels has less risk of ARI than non availability of separate kitchen in the house and use non - cleaner fuels. Use of tube well water is also leading cause of diarrhea among children. The findings further reveals that infants and children living in the rural areas and children of less educated mothers have higher prevalence of ARI as compared to their respective counterparts. Educated mothers are reducing the risk of ARI among their children.

Over the past two decades a significant changes have occurred in the Indian economy. With the ongoing structural transformation, Indian economy has achieved a significant stature in the post liberalization area. Yet, one of the interesting unresolved puzzles encompassing this shift is the compromise in nutritional status and food security in the phase of an ‘apparent economic growth’. This study tries to examine the nature of ‘conspicuous consumption’ of households and its implication on nutrient intake and undernutrition in India, over the period 1993-2009.Here we will try to explore the changing consumption pattern i.e. from food to non food and the decline in calorie and protein intake, within the ambit of a structural shift in the economy.In this study we also try to inquire the main determinants of undernutrition by taking certain parameters like adequacy and choice. Consequentially we will apply the Engel curve analysis and logistic regression analysis for showing the nature of undernutrition and food security.

Introduction
Reduced Physical Activity (PA) is one of the modifiable risk factors of non communicable diseases. In Sri Lanka, NCDs are expected to increase due to the rapid urbanization and unhealthy lifestyles.
Objectives
To assess the level of PA and associated factors of adults aged 18-44 years living in an area undergoing rapid urbanization
Methods
A community-based cross-sectional study was carried out among 340 adults in the DS division of Gampaha. PA was assessed using the long International Physical Activity Questionnaire (IPAQ) validated for adult Sri Lankans. Diet was assessed using a food frequency questionnaire. Associations of ‘low’ PA were assessed using chi-square test and logistic regression model.
Results
PA was ‘low’ in 25.9%; ‘moderate’ in 40.6%; and ‘high’ in 33.5%. Female gender, urban residence, income over Rs. 40,000, unemployment, upper and middle level skilled occupations and suboptimal consumption of commercially baked food were significantly associated with ‘insufficient’ level of PA. In the logistic regression model, being a female and being unemployed were independently associated with ‘insufficient level’ of PA.
Conclusions and Recommendations
26% of the adults had reduced PA. Interventions at community level targeting the vulnerable groups are recommended.

Migration and health share a complex relationship and interactions. The increasing urbanization and rural to urban migration provides a scope to analyze the health and nutrition status of migrants living in urban India. The present study tries to understand disparities in child immunization and nutritional status among children by migration status in urban India using the most recent available data of National Family Health Survey (2005-06). Descriptive statistics and binary logistic regression models were used to study the levels and factors associated with child nutrition and immunization by migration status. Results suggest that malnutrition and no immunization are very high among children of rural to urban migrants and full immunization is lower than urban non-migrants and urban-urban migrants. More than half of the children from of marginalised households suffer from the problem of undernutrition among rural-urban migrants. Multivariate results show economic status economic status, age of the mother, education, caste and media exposure are negatively associated with malnutrition and positively associated with immunization. Children from south, north-east and east have lesser chance of being malnourished than north region of India.

Large body of health literature has extensively reported the linearly aligned education gradient supporting thick theoretical building on the education gradient that has become one of few established facts. In this draft, we attempt to describe apparently contradictory empirical observations to the gradient argument: the recipients of the General Educational Development (GED) certificate. The NHIS data show that GED recipients enjoyed no advantage in the global health status measured by self-reported health over high school dropouts, which do not appear support the widely accepted education gradient. More rigorous analyses using the Add Health indicated that GED recipients who took GED credentials approximately seven years after high school enjoyed health benefits compared to high school dropouts but these benefits watered down six years later. GED credentials by 13 years after high school, however, did not make any distinguishable health differentials. We argue that these observations are related to psychological distress due to low socioeconomic status GED recipients went through in labor market.

Due to rapid urbanisation and urban growth in India, it becomes challenging for the Government to provide proper health and health facilities to the urban population. Ensuring proper health is the responsibility of the state government, Uttar Pradesh which has the largest population base but economically less developed finds a challenge to cater the health needs of urban population. A more recent challenge is the regional disparities probably caused by special privilege given to certain regions. This paper is an attempt to examine the degree of health inequalities across districts of urban Uttar Pradesh, based on recent data provided by Census (2011) and Annual Health Survey (2010). For estimating health inequalities, Principal Component Analysis is performed in which five indices have been constructed using 24 socio-economic and health indicators. These indices are: Socio-Economic Index, Acute Illness Index, Diagnosed Chronic Illness Index, Maternal and Child Health Index and finally a composite Health Index. The results of the paper clearly show that there are some pockets of better health level in urban Uttar Pradesh despite their geographical location. However, these pockets are quite visible in eastern and western region which are also the leading regions in economic development.

This study examines the health stratification in urban China in light of the rapid population migration under current institutional arrangement. We use data from a nationally representative sample to compare the health disparities between migrants and urban natives in terms of health status, health need and accessible resources. A series of health measures, including both subjective reports and objective biometrics of different dimensions, are used in our health comparison to give a comprehensive picture of the health disparities among the urban residents. Migrants at different socioeconomic ladders, from rural and urban areas, are compared with urban natives of comparable socioeconomic statuses to decompose the health impacts from institutional and socioeconomic factors. The empirical finding from this study is expected to shed light on the pattern of health disparities in urban China and the related determinants from institutional and socioeconomic aspects.

Pregnant Mother’s Need and Demand Analysis in Utilizing
The Surabaya Maternity Public Health Center (PHC)


ABSTRACT

The function of Maternity PHC is specified at PHCs with strategic locations and certain obligatory requirements. This maternity service helps people to obtain equal healthcare. The purpose of this research is to formulate a recommendation of efforts to increase usage of Maternity PHC based on need and demand analysis at the Surabaya Maternity PHCs. This is a descriptive research using questionnaires, indepth interviews and observations.
The result showed that pregnant mother felt the needed things were childbirth delivery at midwife’s private practice, delivery helper was midwife, the needed facility was medical tool sterility, labor tariff about 100$ and they also needed pregnant mother’s exercise. The prioritized respondent’s demand was at midwife’s private practice and the demand for labor helper was midwife. The demand factor for labor at midwife’s private practice was due to family habit, while the demand factor for labor at PHC was the inexpensive tariff. There were 14 mothers who needed to give birth at PHC but in vain (the demand was not materialized). This was due to non-PHC demand had more experience.

Keywords: Maternity PHC, need, demand

Rural-to-urban migrants are a new and constantly growing segment of the population that has emerged in Chinese cities since the beginning of the reform era. Their lack of access to health care has resulted in various alternative health seeking practices. While existing research on health seeking is characterized by an abundance of empirical studies and a lack of theoretical grounding, in this paper I present a new approach that conceptualizes the various interlinkages and interdependencies of structure (e.g. regulation in health care and occupational systems, cultural norms and health beliefs), different types of agents (e.g. administration, health practitioners, NGOs, social organizations and networks) and individual practices. A mixed methods research approach is applied. The primary data that is used consists of 39 qualitative interviews with migrants and a quantitative survey with 450 migrants living in Guangzhou as well as 29 qualitative interviews with representatives of administrative units of different levels, health services providers, representatives of NGOs and social organizations. The transfer of the theoretical approach to the example of Chinese rural-to-urban migrants showed that it has the potential to detect a substantial number of factors influencing health seeking that have not been regarded in existing works.

Much of the research in recent times have focused on the changes in diets of people of developed as well as developing nations. This study tries to explain the changing food preferences of people in Indian context using data from a couple of secondary sources, and the health outcome of these changes on adult and young children. Further the study tries to examine the association of feeding practices on nutritional outcome during early childhood considering that these two are not mutually exclusive. We also examine the clustering of some quantitative measures of nutrition and the transmission of height, weight and other health outcomes from parents to children. The results confirm the westernisation of traditional diet in India particularly in urban areas, and its influence on nutritional status distribution of children from more underweight towards coexistence of overweight and underweight. Along with westernisation, differential feeding practices is another determinant of change in health outcome of children, but less improvement have been noticed in percentage of children getting a diverse diet. The results further indicate significant correlation between health status of parents and children and propose that children inherit a prominent fraction of their health status from their parents.