Environmental threats to child health

Survival of infants and young children remains one of the most important issues in the developing world. Around the world, more than 10 million children under five years of age die every year, Twenty to 25 percent children born in developing countries die before their fifth birthday (Mosley 1985). Diarrhea, Pneumonia and malaria are the leading killers of children, accounting for nearly half of all child deaths globally. Most deaths of children under age five in developing countries have been linked to the household environment. This study attempted to understand the influence of women's socio-economic and demographic characteristics, and the influence of household environmental conditions on child survival in rural Maharashtra. Analysis is based on data from District Level Household Survey -3. Study finds that incidence of child loss is 78 percent among the children living in the household without toilet facility. It is 82 percent in household where wood is used as cooking fuel. An incidence of child loss based on water purification method adopted at household level indicates that those households used cloth for purification of water incidence of child loss is 47 percent. Child loss is around 48 percent for mothers in age group 20-24 years. It is found that child loss for working mothers was quite high (74 percent).

Based on its topographical, climatic factors and biomes Nepal is divided into three ecological zones [Mountain, Hill and Tarai]. Does the variation in ecology have direct influence on health of Children.To address this question, the present study used the recent Nepal DHS-2011 survey data. The results revealed that disadvantageous position of the mountain region in terms of child survival is consistently established through all three methodological exercises carried out in this study. Bivariate results revealed that across the three ecological zones, the Mountain zone experiences considerably higher childhood mortality rates. Cox proportional hazard model estimates also revealed that relative risk of dying for all groups of children in Mountain Ecological zone is greater compared to Hill and Tarai. Oaxaca decomposition results show that the variables considered can explain only 46 percent variation of mountain and hill differences in mortality it means there could be some direct environmental factors which are playing role in differential mortality, Variations are explained by some important demographic factors such as less than 20 months birth interval of women, work status of the mother, mother’s education, poor economic status etc.,

Research evidence around the world suggests clear linkages between social-determinants and child health and/or survival. Improving daily-living conditions as suggested by the Commission on Social Determinants of Health (2008) becomes a key to make much of the desired progress in achieving child-health equity in a single generation. The present paper reviews the evidence of socially determined effects on infant mortality in the nine states of India that register high rates for fertility and infant mortality. Infant mortality statistics are collated from the first round of Annual Health Survey (2010-11), while indicators for social determinants are based on National Census 2011 and Reproductive and Child Health Survey 3rd Round 2007-08. The district level variations in infant mortality rate are explained through multiple linear regression model, having considered social-explanatory factors grouped in three major domains, i.e., household physical environment, access to social services and built capabilities among mothers. The most critical task becomes creating an enabling environment for building capabilities among mothers, if to achieve equity in child survival in these selected states of India.

Children are particularly vulnerable to many environmental threats, including a contaminated physical environment. This special susceptibility of children, however, is not confined to the biology of growth and development. A variety of external factors, at macro as well as micro level, influence the exposure of children to various environmental threats that consequently affect their health. This paper examines the possible impact of arsenic (via drinking water) on children between the ages 0 and 14 years, as the risks tend to be the greatest during these ages. A cross-sectional case-control study was conducted in Murshidabad district, West Bengal. From the 367 surveyed households, completed information on 471 children could be collected including the anthropometric component. In case villages, nine percent of the children exhibited any clinical symptoms of arsenicosis and it was found that the corresponding mothers had exposure of more than eight years and all showed moderate skin manifestations. The prevalence rate was 26 percent in case of male children compared to 20 percent for female children in the high category of arsenic concentration level. A clear dose-response relationship was also found, independent of all background characteristics. The progression of symptoms among children was closely related to BMI and age.

Diarrhoea and Acute Respiratory Infection (ARI) are two common causes of mortality and morbidity among children under five years in India. The paper explores the prevalence and determinants of these two diseases using NFHS-3 (2005-06) data. Prevalence of both these diseases is highest in the Eastern region of India. Step wise regression analysis at all India level reveals that time for getting water outside premises, type of house and crowding at household are major household environmental determinants of child diarrhoea. Probability of suffering from ARI is significantly more among those using unclean fuel. The likelihood of having ARI is considerably less in seasons other than winter. Chances of suffering from ARI in the East, Central and North-East India compared to the North Indian region are mainly due to household environmental variations. Regional differences are observed in determinants of two diseases in six geographic regions. Indian Five year plan must prioritize provision and improvement of basic needs like clean cooking fuel, proximity to water source and concrete housing structure to reduce childhood diseases.

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.

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.

Indigenous population live in their remote inaccessible abode and are being deprived of the fruits of development. They belong to lower strata of the society at large and their socio-cultural practices make them vulnerable to health risk particularly of child health. As a result ensuring health of indigenous people still remains an elusive goal even today. This paper attempts to examine the relevance of socio-cultural and environmental factors in explaining morbidity and nutritional status among indigenous children in North Eastern States of India which is considered one of the most inaccessible and diverse region with high concentration of tribal people. Analysis of data from Indian National Family Health Survey-3 (2005-06) reveals that households without windows, house structure, electricity, wealth index and place of residence have important bearing in moulding child health. Affluent neighbourhood are found to be key determinants of child health (p<.001). For indigenous people, the broader approach must complement the existing emphasis on risk factors, life style or behaviours because of the financial barriers and inaccessibility to health facilities which adds the burden of the morbidity and out of which children becomes the victim.

Diarrhoea and Acute Respiratory Infection (ARI) are two common causes of mortality and morbidity among children under five years in India. The paper explores the prevalence and determinants of these two diseases using NFHS-3 (2005-06) data. Prevalence of both these diseases is highest in the Eastern region of India. Step wise regression analysis at all India level reveals that time for getting water outside premises, type of house and crowding at household are major household environmental determinants of child diarrhoea. Probability of suffering from ARI is significantly more among those using unclean fuel. The likelihood of having ARI is considerably less in seasons other than winter. Chances of suffering from ARI in the East, Central and North-East India compared to the North Indian region are mainly due to household environmental variations. Regional differences are observed in determinants of two diseases in six geographic regions. Indian Five year plan must prioritize provision and improvement of basic needs like clean cooking fuel, proximity to water source and concrete housing structure to reduce childhood diseases.

Large proportion of rural people in developing countries still uses solid biomass for cooking. Literatures reports health effects of indoor air pollution. But the estimates do not count the endogeneity bias arising from the effects of health conditions on fuel choice. This study estimates the effects of indoor air pollution on respiratory health for male, female and children after adjusting for endogenous health behaviors. The study is based on a survey of 600 rural households from Syangja and Chitwan districts of Nepal. We employ instrumental variable probit regressions to find the effects of interventions on chronic bronchitis, asthma and acute respiratory infections. The results show that in addition to age and gender, the use of improved stove and biogas significantly reduces respiratory health problems. In addition to these interventions, the problem of respiratory health is more severe among those of older age cohorts, particularly among those who are female. Hence, they require special attention from health workers and development partners who are interested in reducing the health effects of indoor air pollution. In addition, ICS and biogas have the added benefits of energy efficiency to the households and environmental benefits to the society.