Child health in urban areas

This study conducts a multilevel analysis to examine the association between community-level income inequality, social capital and health status among the urban elderly in Japan. An urban subsample of the Japan Gerontological Evaluation Study (JAGES) - a countywide social epidemiological survey of community-dwelling and functionally-independent individuals aged 65 and over - is used for the analysis (n=7,527). The community-level social capital is measured by the proportion of the respondents who “generally trust others in the community”. The ecological-level analysis finds significant community-level variations in income inequality and the social capital indicator, and they are correlated with the residents’ self-rated health. The results of the multilevel analysis confirm that, controlling for individual-level demographic and socioeconomic characteristics, a greater extent of income inequality increases the likelihood of reporting poor health. It is further observed that living in a community with a higher level of social capital attenuates the association between income inequality and health status. These results imply the importance of facilitating social connectedness and enhancing social cohesion in dealing with elderly health issues under the combination of population ageing and growing socioeconomic inequality.

The proportion of adolescent deaths (9%) due to pregnancy or during child birth to total maternal mortality is very high in India. Although some studies on local scale are available, no study as yet has explored the factors affecting maternal health care utilization in adolescent mothers at national level. Using the data from third wave of District Level Household Survey (2007 -08), this paper examines the factors associated with the utilization of maternal healthcare services among adolescent women (aged 13 -19 years) in urban India. Bi-variate analyses including chi -square test was used to determine the difference in proportion, and multilevel binary logistic regression models were applied to understand the net effect of predictor variables on selected outcomes. About 23% of all adolescent mothers in India availed full ANC; 70% had a safe delivery and 64% had postnatal care in 2007 -08.After controlling for a number of factors, we find that the women, who are rich, older, highly educated, exposed to mass media , were more likely to utilize prenatal and natal care. These groups may be small portion of population but contribute significantly to maternal and child mortality, therefore, it is imperative to focus on such vulnerable groups in the policy.

Pregnancy symptoms and complications can range from mild and annoying discomforts to severe, sometimes life-threatening illnesses. Problems during pregnancy may include physical and psychological conditions that negatively affect the health of the mother or the baby (Bruce et al. 2008). In this paper an attempt has been done to see the association of maternal obesity with pregnancy related complications viz. namely menstruation cycle disturbance, mode of delivery and adverse pregnancy outcome (miscarriage and stillbirth) among the women in reproductive ages with the National Family Health Survey-3 data. Results show that maternal obesity is frequently associated with menstruation cycle disturbance. Increasing maternal BMI results into increased risk of delivery by emergency caesarean section. Results also suggest that overweight and obesity may increase the risk of adverse pregnancy outcomes among younger women, whereas this relationship is not observed among older women.

The epidemiological transition in India has sharp consequences in terms of increasing longevity but subsequently accelerated pace of non-communicable diseases among graying cohorts. Amidst ageing phenomenon it is prerequisite to explore the levels and covariates of medically diagnosed and self reported health problems of elderly. A cross sectional study was carried out on a sample of 400 elderly people aged 60 and above from two different wards of urban Varanasi, India. Preliminary findings highlight age, gender, marital status, education and income as significant covariates as well as differential in self rated health among elderly. Elderly male enjoyed good health (26.9%) than the female elderly (9%). Married elderly respondents more frequently reported good health status (29.9%) than unmarried (6%), whereas elderly respondents with 10 years and above education reported better health status (24.6%) than those in 8 years (12%), 5 years (22.2%) and no education (9.8%).Among several chronic and degenerative diseases, diabetes (29.9%), hypertension (40.5%), arthritis (25.8%), respiratory tract infection (27%), chronic fatigue (69.2%), gastroesophageal reflux (41%) and anxiety (41.5%) frequently affected the health of elderly.

India was among the very first country in the world to launch an official family planning programme , however, it couldn’t realized the ambitious goals and targets that kept changing with time. The use of family planning still remains limited with higher unmet need for contraception and abortion rates, especially among poor Indian women. Though, many previous studies have examined the barriers from both demand and supply perspectives towards use of family planning. However, there is dearth of studies that examine the magnitude of socioeconomic gradient in the use of family planning, unmet need for contraception and induced abortion that needs urgent scientific scrutiny.

Using the District Level Household and Facility Survey (DLHS, 2007-08) data on 1,22,487 currently married, non-pregnant and fecund women (15-49 y), the present study attempts to examine the magnitude of socioeconomic disparities in contraceptive use, unmet need for contraception and induced abortion in urban India. Rate ratio and logistic regression models were employed to estimate the magnitude in terms of predicted probabilities after adjusting for important socioeconomic, demographic and contextual correlates.

Women from the poorest wealth quintile were significantly less likely to use any form of family planning methods, and more likel

The present study aim is to analyze the association between anaemia and infectious diseases - diarrhoea among children under five years in Bihar (India) relation with certain background characteristics of mothers using the third National Family Health Survey (NFHS-3, 2005-06 ). The highest prevalence of anaemia is found in Bihar (Any anaemia -78 percent) as compared to other states of India. However, sever is just 2 percent but moderate is 47percent and mild anaemia level is 30 percent. It is observed that about 82.4 percent of children who had diarrhoea in last two weeks are anaemic which is quite high as compared to those children who are not anaemic. According to mother’s background characteristics, proportion of children suffered from diarrhoea is higher for those who are living in rural areas, belongs from poor household and have unimproved toilet facility. The odd ratio shows the probability of children suffered from diarrhoea in last two weeks are significantly higher among urban Muslim male children who are anaemic and could not access the improve source of toilet facility.

The level of nutrition of women is associated with a set of factors like socio-cultural, and economic. The status in the family and in the society and decision making autonomy of women contribute to overall health outcomes on themselves and also on the children. The result focused whether any significant relationship exits between decision making autonomy and level of nutrition in the Dhaka district where level of urbanization is about 92 percent.
Decision making autonomy is an important component of women’s empowerment. The proportion of Chronic Energy Deficiency (CED) women reduce as women participated more decisions in the family relating to health, major events etc. Not only the level of malnutrition decreases along with autonomy, but also the proportion of obesity (BMI>=25) reduces. These two categories of women (CED, Obese) are more vulnerable for maternal morbidity and mortality.
The logistic regression (multivariate) analyses show that likelihood to have CED is lower in higher level of decision making autonomy i.e. women with higher autonomy have lower chance to have chronic energy deficiency and vise-versa.
The findings demonstrated that wider decision making made by women in the family enabled them to improve their nutritional level (low malnutrition and reduce obesity).

This paper will focus on neighbourhood effects on the health status of adolescents and young adults in a European metropolis: Brussels. Contextual effects on health and health behaviour of young persons received much attention in the US, but few is known about its impact in a European context. Brussels is an interesting test case, as it contains sharp socioeconomic discrepancies despite its social welfare regime that offers a good safety net for the disadvantaged. Data are derived from the Belgian census in 2001. It contains information on self-rated health (SRH) and individual characteristics such as nationality, educational level, activity status and household type. Indicators on neighbourhood level include a.o. unemployment rate, proportion of adults with maximum primary education, proportion of single-parent families, mean comfort level of housing and ethnic diversity. Multilevel logistic regression is used to disentangle the association between our contextual indicators and SRH. The Median Odds Ratio is 1.80 [95% CI 1.73-1.87], implying that the heterogeneity between neighbourhoods affects the individual health status of young persons. Our results suggest that contextual indicators of disadvantage contribute to a worse health status of adolescents and young adults, after controlling for several individual measures.

Providing basic health facilities especially to the socio-economically disadvantaged section of the society is a great challenge for large country like India. The country's health care programme is rural focused as about 70% of the population live in rural areas. But the country is urbanizing rapidly and the total size of the urban population is about 377 million(census 2011) out of which a significant proportion of population live in slums. The 2001 census shows that there was a total of 42.6 million slum population living in 8.2 million households which constitutes 15% of the total urban population. About half of the population in Mumbai and about a third of the population in Kolkata live in slums. Increasing slum population is an indication of urban poverty and declining urban quality of life. Most of the slum dwellers do not have access to basic health and sanitation facilities resulting in poor health conditions. The present study makes an attempt in understanding the water and sanitation facilities among the slum and non-slum households in three cities(Pune, Jaipur and Bhubaneswar) of India by using the data collected in a household survey covering approximately 2200 households in each city.

The latest official figures on mortality and morbidity attributed to malaria in Senegal have made the country into a potential candidate for the pre-elimination stage of malaria. By 2015, the country aims to reach the sixth MDG related to malaria (Stopping the spread of the epidemic). Yet many questions remain at the sub-national level, particularly around the capital. First, the complexity of urban malaria and the obstacles caused by the lack of high-quality data about the incidence and prevalence rate make difficult such goals. Without being pessimistic, caution should be required.
A cross-sectional study conducted in 2008, shows areas where the prevalence rate is above 5%, the threshold necessary to pre-elimination phase according to WHO criteria. While the transmission is thus low on average, some hyper localized outbreaks persist and maintain a risk of epidemic development during the seasonal transmission (the rainy season).
The determinants of the risk of transmission are studied in the light of regional data coming from the last census. A final model locates the vulnerable urban areas and highlights the sensitive areas to target. This interest corresponds to the objectives defined by the protocol of Hyogo, to create specific programs for vulnerable groups.