Slum Children Research Articles

Role of integrated therapy and nutritional counselling in treating malnourished children in M-East ward Mumbai, India: A Longitudinal Study

Background: Under-nutrition is a big risk factor for increasing the morbidity and mortality burden in the society. Acute malnutrition contributes to almost 61% of diarrheal and 53% of pneumonia deaths. In urban slums like M-East ward, Mumbai, acute malnutrition prevalence ranges from 16% to 59.8%. Objectives: To assess the outcome of weight gain by providing nutritional supplements to the undernourished children along with nutritional counseling. Materials and Methods: RUTF (Ready-to-Use Therapeutic Food) and Hyderabad mix with nutritional counselling to parents of children were used to reduce the undernourishment among the under-five children in slums of this ward. Six hundred and fifty malnourished children and their caregivers were provided nutritional supplement and nutritional counselling over 6 months. Results: There was steady wight gain of enrolled children. Highest weight gain occurred over 13th week of the program. Conclusion: A minimum of thirteen weeks nutritional supplement program including fortnightly counselling is necessary and sufficient for converting undernourished children to normal.1

Do the Caregivers Of Under-Fives Have Proper Health Care Seeking Behaviour for Their Children? A Study from Urban Slums of a City in Eastern India

Introduction: The morbidity and mortality among under-five children are many times higher in slums than more privileged urban neighbourhoods. This could be correlated with the caregivers’ behaviour too. Therefore, we intended to assess the health care seeking behaviour for their children among caregivers of under-five children in urban slums of Bhubaneswar city. Methods: It was a cross-sectional study conducted during Jan 2019 to April 2019 in Bhubaneswar, India. Data regarding health care seeking behaviour of 530 caregivers of under-five (U5) children residing in urban slums of Bhubaneswar, whose children suffered from any illness in last one month, were collected. Results: The most common childhood illnesses for which healthcare were sought were diarrhoeal diseases (30.4%) followed by respiratory infections (29.1%). A concept analysis of the predisposing factors was built up as “socio cultural context”, “economic context”, “education context”, and “individual preference” to know the health care seeking pattern. The health care seeking behaviour among the caregivers of under-five children was significantly associated with sex of child, size of the household, social group of caregiver, mother with mass media knowledge, age, education and occupation of mother, mother having BPL card, if suffering from chronic disease, decision making person for seeking health care, time lapse in approaching the health care facility and income loss due to U5 children illnesses. Conclusions: The challenge is to know about signs and symptoms of ill-health and to recognise when to seek health care services. Measures can be taken to promote awareness for seeking timely appropriate care. There is a need to develop locally adapted behaviour change communication interventions for childhood Illnesses.

Everyday Life of Slum Children: A Case Study from Education Perspective

Every year, the city of Pune attracts migrant workers due to urbanization, and these migrants form residential pockets called slums. Today, around 40% of Pune's population lives in urban slums, around 11% of children, who have little or no access to education with the everyday hand-to-mouth struggle for survival. This study explores the lives of slum children and their educational conditions. Three case studies were conducted with three slums from uptown areas of Pune. Focus group discussions, interviews, and visual survey methods were employed, leading to qualitative analysis. Analysis threw light on the everyday challenges faced by slum children in accessing education. The visual studies imply the need for architectural intervention. The findings also suggest policy implications towards the provision of education towards the betterment of the lives of slum children. Working and learning are the two social processes; without breaking the legal structures on child labor, children working within the home as domestic labor or in the household enterprise is a common occurrence in urban centers, particularly among those who are household income is derived from the informal sector and who have lower income levels. Working modes and times differ depending on the situation. Owing to the size of India's informal economy and attempts to reduce child labor trafficking, a strong emphasis has been placed on developing and implementing social policies that address child labor.

Use of the typhoid conjugate vaccine in endemic settings

Multidrug-resistant and extensively drug-resistant (XDR) strains of Salmonella enterica serotype Typhi (S Typhi) are increasingly creating serious clinical and economic challenges for patients with typhoid fever in south Asia.1 There is a high disease burden of typhoid fever, mostly among children in urban slums, where safe water and a proper sanitation infrastructure are lacking.2,3 The provision of these facilities requires large financial investments and the political will to eliminate the spread of infectious diseases.

Effectors of income-child health gradient: Role of dietary diversity on child nutritional status in selected slums of Dhaka city

Child dietary diversity (CDD) is an important nutritional outcome measuring the economic ability of a household to access a variety of foods during a determined period. Relating household income to CDD and child anthropometric failure, a cross-sectional study was conducted among 275 selected Dhaka city slum children of 6-12 years. Prevalence of stunting (18%), wasting (19.4%), and underweight (22%) among them were found similar to the current national figure. However, a sizable number of households showed increased DDS (>5), thereby indicating an increased household purchasing power (PP). Bivariate regression analysis showed that children from lower family income (≤6000 BDT) were 3 times more likely to be stunted as compared to children with greater family income [Unadjusted OR=3.097, 95% CI (1.578-6.077), p=0.001]. Furthermore, logistic regression showed that children who had <5 DDS were 2 times more likely to be stunted than children who had ≥5 DDS [Adjusted OR=2.127, 95% CI (1.051- 4.305), p=0.036]. Therefore, an inverse association has been found between CDD and their anthropometric failure.
 J. Bangladesh Acad. Sci. 45(1); 85-94: June 2021

Understanding the Context of Education in an Urban Slum: A Case of Babu Sabu, Lahore

Article 25 A of the Constitution of Pakistan stipulates that free and compulsory education must be given to all children between the ages of 5 and 16. However, there are gaps in its implementation leaving out pockets such as children in slums. Non-government organizations (NGOs) play an essential part in bridging the said gaps. This study explored the context of education in a slum area located at Babu Sabu Interchange, Lahore where an NGO PAHCHAAN (Protection and Help of Children against Abuse and Neglect)is providing non-formal education to children via community engagement. The current study explored the context of education in a slum where intervention is already implemented through/using the case study method. A survey from all the households in this area (N=26) and a focus group discussion from six mothers were conducted. The results showed a positive attitude of the mothers towards the education of their children, as 65.4% of the participants strongly agreed that it is essential to get children enrolled in schools. The findings from the focus group discussion highlighted several challenges such as the lack of financial resources, distance of school from the slum area, lack of acceptance of over-aged children and a difficult admission procedure. Bullying and cursing were, however, the leading cause of dropping out of regular schools. This preliminary study highlights the importance of taking a strategic approach towards “education for all,” looking at deep-rooted issues so that no child is left behind.

Understanding the Context of Education in an Urban Slum: A Case of Babu Sabu, Lahore

Article 25 A of the Constitution of Pakistan stipulates that free and compulsory education must be given to all children between the ages of 5 and 16. However, there are gaps in its implementation leaving out pockets such as children in slums. Non-government organizations (NGOs) play an essential part in bridging the said gaps. This study explored the context of education in a slum area located at Babu Sabu Interchange, Lahore where an NGO PAHCHAAN (Protection and Help of Children against Abuse and Neglect)is providing non-formal education to children via community engagement. The current study explored the context of education in a slum where intervention is already implemented through/using the case study method. A survey from all the households in this area (N=26) and a focus group discussion from six mothers were conducted. The results showed a positive attitude of the mothers towards the education of their children, as 65.4% of the participants strongly agreed that it is essential to get children enrolled in schools. The findings from the focus group discussion highlighted several challenges such as the lack of financial resources, distance of school from the slum area, lack of acceptance of over-aged children and a difficult admission procedure. Bullying and cursing were, however, the leading cause of dropping out of regular schools. This preliminary study highlights the importance of taking a strategic approach towards “education for all,” looking at deep-rooted issues so that no child is left behind.

Understanding the Context of Education in an Urban Slum: A Case of Babu Sabu, Lahore

Article 25 A of the Constitution of Pakistan stipulates that free and compulsory education must be given to all children between the ages of 5 and 16. However, there are gaps in its implementation leaving out pockets such as children in slums. Non-government organizations (NGOs) play an essential part in bridging the said gaps. This study explored the context of education in a slum area located at Babu Sabu Interchange, Lahore where an NGO PAHCHAAN (Protection and Help of Children against Abuse and Neglect)is providing non-formal education to children via community engagement. The current study explored the context of education in a slum where intervention is already implemented through/using the case study method. A survey from all the households in this area (N=26) and a focus group discussion from six mothers were conducted. The results showed a positive attitude of the mothers towards the education of their children, as 65.4% of the participants strongly agreed that it is essential to get children enrolled in schools. The findings from the focus group discussion highlighted several challenges such as the lack of financial resources, distance of school from the slum area, lack of acceptance of over-aged children and a difficult admission procedure. Bullying and cursing were, however, the leading cause of dropping out of regular schools. This preliminary study highlights the importance of taking a strategic approach towards “education for all,” looking at deep-rooted issues so that no child is left behind.

Who actually cares for children in slums? Why we need to think, and do, more about paid childcare in urbanizing sub-Saharan Africa.

The early years are critical and inform the developmental trajectory of children. This is justifiably attracting growing policy attention. Much of this attention is focused on interventions and policies directed at parents, especially mothers. Yet emerging evidence suggests that increasing numbers of children in rapidly urbanizing low- and middle-income countries are now spending much of their day with other formal and informal childcare providers, including largely unregulated paid childcare providers. This paper summarizes the limited literature about the use of such paid childcare in low- and middle-income countries in sub-Saharan Africa, before considering possible reasons behind the lack of research evidence. Finally, key research gaps and their implications for public health practice are explored, with reference to the ongoing British Academy funded Nairobi Early Childcare in Slums research programme in Nairobi, Kenya. We argue that improving childcare may be an under-explored strategy to help some of the world's most disadvantaged children in the most important period of their lives, and that interventions in this largely informal market should be built on a rigorous research base.This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

Starvation and Its Effects on the Gut

There is growing awareness that intestinal dysfunction determines the clinical outcomes of situations as diverse as undernourished children in urban tropical slums and undernourished surgical patients in intensive care units. As experimental starvation in humans has only rarely been studied, and largely not using current biomedical research tools, we must draw inference from disparate clinical and experimental observations as to the derangements present in the starved gut. There is good evidence of intestinal atrophy and achlorhydria in starvation and severe undernutrition. Historical reports from concentration camps and conflict settings consistently reported a noncontagious phenomenon called "hunger diarrhea," but in settings where starved individuals are isolated from others (prisoners on hunger strike, anorexia nervosa) diarrhea is not a feature. Changes in intestinal permeability and absorption have been infrequently studied in experimental starvation; available data suggest that short-term starvation reduces sugar absorption but not permeability. Severe acute malnutrition in children is associated with severe changes in the intestinal mucosa. Experimental animal models may help explain some observations in humans. Starved rats develop a hypersecretory state and intestinal barrier defects. Starved pigs demonstrate prolongation of rotavirus diarrhea and reproduce some of the absorptive and barrier defects observed in malnourished children. However, there remains much to be learned about the effects of starvation on the gut. Given the high prevalence of undernutrition in hospitals and disadvantaged communities, the lack of attention to the interaction between undernutrition and gastrointestinal damage is surprising and needs to be corrected. Current sophisticated cellular and molecular techniques now provide the opportunity to create fresh understanding of gastrointestinal changes in pure undernutrition, using volunteer studies and samples from anorexia nervosa.

The Burden of Neonatal Mortality in Urban Slums of Bangladesh: Evidence from Bangladesh Urban Health Survey 2013 Data

Children in slums are in a vulnerable situation because of their low living standard and poor access to healthcare services. It is melancholic that newborns are the worst victims of this devastating condition. This paper aims at finding out the potential determinants of neonatal death in urban slums using Bangladesh Urban Health Survey 2013 data. For the purpose of analyses, bivariate analysis has been conducted using chi-square test and multiple logistic regression model is used to assess the adjusted effects of potential determinants of neonatal mortality in slum area. Results indicate that type of birth, mother’s education, working status, NGO membership, migration status, pregnancy complication and water source played significant role in occurring neonatal death in slum areas. In order to reduce neonatal mortality in slums, migrant mothers should get the highest priority; awareness building programs should be held frequently in slums regarding maternal health and health care practices for the pregnant mothers as well as their newborn babies.
 Dhaka Univ. J. Sci. 69(1): 31-35, 2021 (January)

PSYCHOLOGICAL REBELLION AND ITS RELATION TO SUGGESTIBILITY IN A SAMPLE OF SLUM AREAS CHILDREN

Study aimed: The current study aimed to examine the relationship between psychological rebellion and the suggestibility among children of slum areas and to reveal the differences between children of slums and children of planned areas in both psychological rebellion and suggestibility. Method and procedures: The researcher used the descriptive comparative approach, And The study sample consisted of (50) a boy and a girl from slum areas and (50) a boy and a girl from planned areas with mean age (10. 180), they completed the psychological rebellion scale (by researcher), the suggestibility scale (by researcher) and the Assiut University scale for non-verbal intelligence (Prepared by: Taha Al-Mestkawi, 2000). The results: showed that there is a statistically significant positive relation between the psychological rebellion of children and the suggestibility of children It also showed that there are differences statistically significant between children from slums and children from the planned areas on the scale of children's psychological rebellion favoring of children in slums, as well as the there are differences statistically significant between children From slum areas and children from planned areas on the scale of suggestibility to children, favoring children in slum areas.

Determinants of minimum acceptable diet among young children in an urban slum: a community-based study

Background: Child health and growth deteriorate as a result of inadequate quantities and frequencies of complementary feeding.Methods: A community-based cross-sectional study was conducted in urban field practice area of a tertiary medical college hospital among 280 children by systematic random sampling method. Children belonging to 12-23 months were included while sick child, children whose mother/guardian did not give consent were excluded.Results: The proportion of children who met the minimum dietary diversity (MDD) and minimum meal frequency (MMF) were 52.8 % (95% CI) and 52% (95% CI), respectively. Out of 280 children, 90 i.e. (32.1 %) children had achieved the recommended Minimum acceptable diet (MAD). Maternal education (Chi square value=11.2; CI 95%); socioeconomic status (Chi square value=57.4; CI 95%) were positively associated with dietary diversity. Higher percentage of male children (44.8 %) achieved minimum acceptable diet as compared to female children (20.5%); (chi square value=18.8, CI 95%). The percentage of children receiving MDD and MMF was more among children of higher socioeconomic class (p value 0.0001) and from nuclear family (p value=0.45). The birth order of the child was inversely related to the attainment of MAD. (p value=0.0001).Conclusions: Results of the study strongly suggest that poor dietary diversity and meal frequency is associated with numerous factors and their interplay is a multitude of combinations rather than a single cause.

Malnutrition prevailing trend study among under five children of urban slum area of Gwalior city Madhya Pradesh

Background: Under five children constitute the most vulnerable segment and their nutritional status and mortality rate is a sensitive indicator of the community’s health and nutrition. Health indices of slum children are worst among all urban groups and are even poorer than rural average.Methods: A community based cross-sectional study was conducted from October 2019 to January 2020 in urban slum area of Gwalior city. Data were collected from 550 mothers of children aged 6-60 months using pre-tested semi structured questionnaires and measuring weight, height and mid upper arm circumference of the children.Results: 68.36% of 550 children were having under nutrition in the form of underweight (53.09%), wasting (22.18%) and stunting (59.45%). Maximum number of underweight children belongs to age group 24-60 months (64.54%) followed by <24 months age groups. Stepwise regression showed that the risk of underweight and stunting was significantly (p<0.001) higher among children of illiterate mothers and children from lowest and middle households wealth index.Conclusions: Malnutrition is widely prevalent among study population more than the state and national prevalence. With increasing age cumulative increase in prevalence of malnutrition is seen perhaps due to persistence and addition of causative factors. Maternal education and faulty feeding practice are contributory factor of this high prevalence of disease.

Problems of Education in Slums of Delhi

ABSTRACT Education has been considered as one of the primary goals of the ‘Millennium Development Goals’. In India, one is provided free and compulsory primary education, which helps in making it a literate nation. Primary schooling is the key to success for each developing country and covers the age category of 6-14 years. In India, this education is made free and mandatory to reach one hundred percent literacy. In Delhi, the capital of India, slums are usually located close to the railway paths and market locations. The children living in such regions suffer from several issues hampering their education as well as other comparative activities. Delhi being a metropolitan city is a huge source of attraction for people. Children of slums face many problems affecting their studies. The current study aims to find out the challenges faced by slum children in attaining education with the main focus on primary education.

Burden of malnutrition among school-going children in a slum area of Kolkata: A matter of concern

Background:Malnutrition is still a great barrier to the growth and development of children, especially in India. Children from the underprivileged sections of the society like slum children are more vulnerable to both undernutrition and overnutrition. This study aimed to estimate the magnitude of malnutrition among school-going children in a slum area of Kolkata and to elicit the association of nutritional status with parental education.Methods:A cross-sectional observational study was conducted from November 2017 to May 2018 among 508 school-going children of 6 years to 19 years of age in slums of Chetla, Kolkata. Out of three coeducation high schools catering to those children, two schools were randomly selected. 254 participants from each school were selected using systematic random sampling. Students, unwilling to participate and/or whose parents denied providing informed written consent were excluded. After the interview by a predesigned, pretested schedule, their anthropometric examination was conducted.Results:Prevalence of stunting and severe stunting was present in 9.4% and 1.2% of subjects whereas the prevalence of thinness was 23.6% among them. The prevalence of overnutrition was 11%. Boys are more stunted (OR = 2.13, P = 0.013) and thin (OR = 1.73, P = 0.011) than girls. Poor parental education was significantly associated with both undernourishment (stunting and thinness) as well as overweight and obesity.Conclusion:Substantial burden of double malnutrition was observed among school-going slum children. Parental education had an important role to prevent malnutrition of their children. Thus, periodic growth monitoring with the strengthening of the Mid-Day Meal program and awareness generation campaigns regarding malnutrition among parents of slum children are highly needed.

A Study to Assess the Immunisation Status and the Factors Responsible For Incomplete Immunization amongst Children in Urban Slums

Background: As per the WHO estimates more than a billion children were vaccinated over the last decade. Currently immunization prevents 2- 3 million deaths every year. Health is a major economic issue for slum residents.
 Objectives of the study: To assess the immunisation status and the factors responsible for incomplete immunization amongst children in urban slums.
 Methods: A list of all slums and the number of households therein was collected from City Municipal Corporation Shivamogga of which 10 slums were selected by simple random sampling all the households in the selected slums were included in the study. Quantitative data were collected from the households of selected slums after taking informed consent using a pretested semi-structured questionnaire. Information about immunization of the under five children. Data were analysed by using SPSS software.
 Results: In this study, among the 247 children studied, 61.94% were fully immunised, 38.05 were partially immunised. The most common reason for defaulting vaccination were knowledge (25.5%) followed by illness of the child (14.1%)
 Conclusion: The availability of better healthcare facilities like government medical college in the proximity of these slums has led to good health seeking behaviour among them.

NUTRITIONAL STATUS OF TEENAGERS IN URBAN AREA IN BAGHPAT, U.P.

The active rising stage of childhood is referred to as school age. Children's malnutrition is one of India's most significant problems. This issue is still being addressed throughout the country. Malnutrition, which is caused by insufficient nutrition, weakens the immune system and causes significant developmental delays. The key metric for determining a child's nutritional and health condition, as well as an indirect indication of well-being for adults, is development assessment. We used a predesigned and pre-tested questionnaire, anthropometric assessments, and clinical analysis to conduct a cross-sectional study in urban slums of Baghpat, U.P. India, from August 2021 to October 2021 to investigate nutritional status in school-age slum children and examine factors associated with malnutrition. The mean height and weight of boys and girls in the sample population were lower below the CDC 2000 (Centers for Disease Control and Prevention) guidelines in all age groups. In terms of nutritional status, the age group 11 to 13 years had the highest incidence of stunting and underweight, whereas the age group 5 to 7 years had the highest prevalence of wasting. However, all illnesses are more common in children with refractive defects, although only anaemia and rickets have a statistically significant gender disparity. Malnutrition was shown to be substantially greater among children born in communal homes, infants whose mothers' training was [below or comparable to] 6th grade, and infants of working moms. The majority of our impoverished school-aged children were found malnourished. Food and nutrition knowledge based on skills, nutritional fortification, proactive infection prevention, public healthcare staff preparation, and delivery of comprehensive services are all encouraged.

Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal

Introduction Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city.
 MethodsDescriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software.
 ResultsThe prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status.
 ConclusionThis study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.

Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal

Introduction: Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city. Methods: Descriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software. Results: The prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status. Conclusion: This study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.