Nutritional Disparities Among Women in Urban India

Abstract

Food inflation, meagre wages, cash-based economy, and involvement in strenuous manual work in informal/unorganized sector, unprotected by labour laws of maternity leave, heighten the risk of undernutrition among urban underprivileged women, thus adversely affecting their future and that of their children.National and state-level information about maternal nutrition situation among urban poor in India, based on representative datasets, is still not available. This study is among the first attempts to analyze large scale secondary data, such as from Demographic and Health Survey (DHS) to unmask the extent of disparities in nutritional status and access to services of Indian women belonging to the poorest wealth quartile of the country’s urban population compared to the rest of the urban population. The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/ severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban population. Receipt of pre- and postnatal nutrition and health education and compliance to iron folic acid tablets during pregnancy was low across all quartiles. Night blindness or difficulty in seeing at dusk, a result of chronic vitamin A deficiency, was reportedby 7% women in the poorest urban quartile, which was 2.9 times higher than the rest of the urban population (2.4%).One-fourth (24.5%) of households in the lowest urban quartile consumed salt with no iodine content, which was 2.8 times higher than rest of the urban population (8.7%). The study highlights the need to use poor-specific urban data for planning and suggests (i) routine field assessment of maternal nutritional status in outreach programmes, (ii) improving access to food subsidies, subsidized adequately-iodized salt and food supplementation programmes, (iii) identifying alternative iron supplementation methods, and (iv) institutionalizing counselling days. contamination of water is also high, increasing the risk of intestinal worm infestation and calling for expeditious efforts to improve access of the urban poor and deprived populations to safe drinking-water and measures to prevent helminthic infestations would also require to be strengthened, more so in slum settings where many women work or walk barefoot (and hence at a risk of hookworm infestation).Given the large proportion of undernourished urban poor women, there is a need to assess undernutrition among women either periodically by grassroots-level workers in the nutrition and health programmes as part of the Government or NGO outreach programmes, e.g. health and nutrition days, or by students from social work, public health nutrition institutions or medical schools as part of their practicum. Corrective/mitigation measures for women identified as undernourished need to be instituted. These could include providing an additional food supplement to such women (on similar lines as being done for severely-underweight children), enrolling undernourished women for behaviour promotion plus self-confidence enhancement sessions, improving their access to food subsidy and linkage to poverty alleviation programmes since such women often come from food-insecure families owing to irregular/low wages and poor access to food subsidy.