Children In Urban India Research Articles

NEIGHBOURHOOD ACCESSIBILITY AND ACTIVE LIVING PATTERN OF CHILDREN: A PILOT STUDY IN NAGPUR, INDIA

Purpose: This paper explores the association between neighbourhood accessibility and the active living patterns (ALP) of children in urban India. Focusing on outdoor out-of-school physical activities (OOPA), mode of travel to school (MTS), mode of travel to the neighbourhood (MTN), and habitual active independent home range (HAIHR), it seeks to understand the relationship between active living and neighbourhood outdoor physical environment (OPE) during middle childhood.Methodology: Defining the variable within the framework of the ‘Adapted Ecological Model for Active Living in Urban Indian Children’, this study employed a cross-sectional quantitative method to examine two neighborhoods in Nagpur, India. The subjective data was collected from 43 in-person surveys of 8–12-year-old children and objective data was computed using GIS.Results: Children’s ALP had significant positive associations with built density, traffic exposure, parents’ perception of personal safety, neighbourhood physical activity (PA) environment, license for independent mobility (IM) and gender. Children’s OOPA was significantly positively correlated with built density, neighbourhood PA environment, motivation for PA, license for IM and gender. Children preferred active MTS to school if schools were close by and they had licenses for IM whereas their active MTN depended on parent’s positive perceptions of personal safety in the neighbourhood and permission for IM. Longer HAIHR was related to lesser traffic, licenses for IM and parents’ positive perceptions of neighbourhood safety.Conclusion: This study has identified several key neighbourhood OPE (density, traffic, parental safety concerns, PA environment), individual (gender, motivation), and interpersonal (license IM) correlates shaping urban children’s active living in India.

Fathers and childcare: Are gender social norms in India changing?

AbstractThe involvement of fathers in the care of new‐borns and young children is becoming a fact of life in contemporary urban India. However, there is little empirical research on changes in the gender social norms around childcare in India. We do not know if there are some childcare responsibilities that men are happy to take on while there are others which are still considered the ‘Mommy domain’? The article is based on an exploratory research study interrogating the increasing role played by fathers in the care of their young children in urban India. Based on in‐depth interviews with two generations of fathers, it focuses on the differences in their participation in childcare activities. The study finds that both, the practice as well as the discourse concerning childcare among urban middle‐class Indians are changing and thus the gender norms for childcare responsibility can be said to be somewhat shifting for a certain class of Indian families.

Family functioning within the context of families with adolescent children in urban India.

Research on family functioning within given cultural contexts is needed. This study aims to describe salient dimensions of family functioning in two urban contexts in India and to examine differences in family functioning by sociodemographic groups. We measured differences in family functioning using cross-sectional survey questionnaire data collected from 13 to 15-year-old adolescents and one of their parents/primary caregivers in Mumbai (n=843) and Kolkata (n=913) during 2019-2020. We drew a multi-stage sample representative of neighborhoods and households in both cities. We assessed a multi-dimensional family functioning latent factor that included parent-reported measures (parent-adolescent communication, family cohesion, and parent monitoring of peers) and adolescent-reported measures (parent support, family cohesion, and parent supervision). Our results support an overall measure of family functioning manifested by multiple dimensions for parent- and adolescent-reported data. Families with male adolescents had worse adolescent-reported family functioning in Mumbai and parent-reported family functioning in Kolkata. Higher socioeconomic status was associated with better parent-reported family functioning in both cities and better adolescent-reported family functioning in Kolkata. Muslim religious identification in Kolkata and the Hindi native language in both cities were associated with better adolescent-reported family functioning. Our findings indicate heterogeneity in family functioning across demographic and social-cultural groups within the two urban contexts of India. This study may inform the development of culturally congruent prevention interventions for families with adolescents in India.

Examining Lived Experiences of Infertility and Perceptions Toward the Adoption of Children in Urban India

Infertility is emerging to be a key health concern in urban India. As a result, infertile couples in urban India tend to rely on assisted reproductive technologies (ARTs) for a child. Several media reports have highlighted that infertile couples in urban India intend to adopt a child only when all possibilities of becoming biological parents have been exhausted. Several studies have examined the relationship between infertility and assisted reproductive technologies in urban India. However, there is limited academic scholarship on the attitudes of infertile couples toward the adoption of children in India. Adopting a qualitative lens and using the functionalist theoretical framework the present study examines the different factors that shape the perceptions toward child adoption among infertile couples in urban Goa, India. In the process, the study also reflects on the intersections between infertility and gender role fulfillment among these couples to understand the lived experience of infertility on a regular basis.

Decomposing of Urban Poor / Non-Poor Differential in Childhood Malnutrition and Mortality in India, 2015-16

Background The high level of childhood malnutrition due to mortality in India is a major hurdle impeding the achievement of the Sustainable Development Goals–3 (SDG–3). The present study aims to quantify the contribution of factors that explain the poor/non-poor gap in malnutrition and mortality status of children 0-5 years in urban India using data from 2015-16 of fourth round National Family Health Survey (NFHS-4). Methods For understand the gap in child health between the urban poor and non-poor, and across the selected covariate were used the descriptive statistics. Furthermore Blinder–Oaxaca decomposition and non-liner Fairlie decomposition technique both were used to explain the factors contributing to the average gap in under nutrition between poor and non-poor children in urban India. Result The result suggested that explained the gap urban poor/non-poor in nutritional indicator stunting and underweight were 40 and 46 percentage and childhood infant and under-five mortality were 40 and 48 percentage respectively. The maternal factor mainly for lower education contributed much more changed in child health status those are living in urban poverty. Conclusion The overall finding indicate that children living poor household higher level malnutrition and mortality due to poor health status and poor education of mother, lower health care service and less exposed to mass media. This finding help to policy maker reducing the gap of child undernutrition between urban poor and the non-poor and low coverage of health services among the urban poor.

Explore the Parental Determinants associated with Malnutrition among Children Under Five Years Residing in Rural Areas

Introduction: It has been estimated that each year death of about 2.3 million under five children in developing countries is attributed to malnutrition.1 Rural Indian children are facing this problem of lethal evil more as compared to Urban children in India. Objective: To explore the parental determinants associated with malnutrition among under five children in rural area. Method: Descriptive survey approach was used for the study with cross sectional case control design. 166 underfive rural children between 6 months to 5 years of age, were selected by complete enumeration method from Bhagawati village, Bagalkot. The data regarding determinants was collected by structured interview schedule. WHO anthro Plus software was used to categories the children according to their Nutritional status. The association was explored by Chi square test, Fisher’s exact probability test and Linear regression. Results: Total 166 children were screened for nutritional status, in that 40 (24.10%) were found moderately underweight and 2 (1.20%) were severely underweight. A significant association was found between nutritional status of underfive children and Parental determinants: Mother’s education, Mother’s occupation, Mother’s age at delivery, Presence of illness or health problem during delivery and Post natal illness and Father’s educational status. Conclusion: The findings revealed that better socio-economic status, mother’s age, birth order, spacing, recommended exclusive breast feeding, early recommended supplementary foods, complete immunization and timely care seeking had positive effect on children health, which were also statistically significant.

SOCIOECONOMIC DETERMINANTS OF INFORMAL CAREGIVING IN INDIA

This study investigates the socio-economic determinants of informal caregiving for elderly parents in urban India, with a focus on caste differences. Bivariate and multivariate logistic regression models of caregiving are estimated with data from 2011 data of Osaka University’s Preference Parameters Study. Three types of caregiving are examined: helping with housework, financial assistance, and providing care. The control variables include: age, sex, marital status, wealth, religiosity, self-rated health, parents requiring care, number of siblings, and number of co-resident children. The bivariate analysis indicates that the highest caste is significantly less likely than the lowest caste to help with housework (OR=.734, SE=.127). In the fully specified models, there is not a significant difference between caste groups in the likelihood of helping with housework or providing financial assistance, but the highest caste is more likely than the lowest caste to provide care (OR=1.443, SE=.309). Being female and married significantly lowers the odds of each type of caregiving. Wealth increases the likelihood of providing help with housework and financial assistance. When both parents require care, children are more likely to provide financial assistance and help with housework, but when one parent requires care, children are more likely to provide care. Overall, sex, marital status, and wealth are the strongest predictors of helping with housework and financial assistance, whereas sex, marital status, and caste are the most important predictors of providing care. The implications of these findings for aging parents and adult children in urban India are discussed.

Fever awareness, management practices and their correlates among parents of under five children in urban India.

Awareness regarding fever is reportedly low among Indian urban parents, leading to its over- management among under five children. We attempted to study the awareness and fever management practices of South Indian urban parents. The objectives were to find the awareness of parents regarding childhood fever management, and correlates of practices. One hundred parents of under-five children with history of fever in past three months were randomly selected and interviewed using a predesigned tool. Children's weight and height was measured. Awareness scores for causes of fever and fever management were constructed. Logistic regression was done to identify correlates of incorrect practices. 95% parents were aware about correct temperature above which fever became harmful. Awareness score for causes of fever was poor (<1) among 41% parents. Mothers' complications awareness scores were better than fathers (p<0.05). 81% parents used antibiotics; only 18% consulted a doctor before doing so. 17% parents using antibiotics did not complete the prescribed course. The independent correlates of poor fever management practices were working parents (OR: 6.28; 95%CI: 1.7-23.16), lesser number of children (OR: 3.08; 95%CI: 1.01-9.37), poor compliance for antipyretics (OR: 9.20; 95%CI: 1.64-51.52) and giving antipyretics without consulting doctors (OR: 5.43; 95%CI: 1.69-17.47). Poor knowledge of available pediatric antipyretic preparations was negatively correlated (OR: 0.13; 95%CI: 0.02-0.64). Fever awareness was fair among urban parents. Mothers had better awareness than fathers. Increased awareness for correct fever management of under-five children is desirable among urban parents to reduce misuse of antibiotics and antipyretics.

Secondhand Smoke Exposure and Validity of Self-Report in Low-Income Women and Children in India.

There is limited validation of self-reported measures for secondhand smoke (SHS) exposure in low- and middle-income countries. We evaluated the validity of standard self-reported measures among women and children in urban India. Structured questionnaires were administered, and household air and hair samples were analyzed for nicotine concentration. In total, 141 households of 70 child and 71 adult participants were included. Air nicotine was detected in 72 (51%) homes, and 35 (75%) child and 12 (56%) adult participants had detectable hair nicotine. Correlation between air and hair nicotine was significant in children (r = 0.5; P = .0002) but not in adults (r = -0.1; P = .57). Poor correlation was found between self-reported measures of exposure and both air and hair nicotine. No questions were significantly correlated with hair nicotine, and the highest-magnitude correlation with air nicotine was for how often someone smoked inside for adults (r = 0.4; P = .10) and for home preparation of mishri (a smokeless tobacco product prepared for consumption by roasting) for children (r = 0.4; P = .39). The highest value for sensitivity by using air nicotine as the gold standard was for whether people smelled other families preparing mishri (47%; 95% confidence interval: 31-62) and prepared mishri in their own homes (50%; 95% confidence interval: 19-81). These results raise caution in using or evaluating self-reported SHS exposure in these communities. More appropriate questions for this population are needed, including mishri preparation as a source of SHS exposure.

New Media Usage among School Children of Bangalore

A study conducted by the Kaiser Family Foundation in the United States during the turn of the millennium showed that children in America spent almost five hours watching television and two hours in front of the computer. As recently as June 2010, the World Summit on Media for Children and Youth held in Karlstad, Sweden held sway on the topic- ‘Towards the new global vision for children, youth and media’. Alberto Pellai, the Summit keynote speaker (representing the department of Public Health at the University Degli Studi Di Milano, Italy) touched upon the need for media education emphasizing on media content that had to educate and help in the growth and development of children rather than mislead the beliefs and value system of children. Statistics reveal new media as being a strong contender for top spot of favoured past time among children. It no longer surprises people that the time spent by children on new media usage has tripled in the last ten years in the US (Kaiser Family Foundation report). Children in urban India from all accounts are no different from their American counterparts. This trend needs to be pondered, debated and questioned. The researcher would like to explore the different issues related to children and new media usage from an urban perspective since new media is more accessible to urban Indians for obvious reasons- finance, socio-cultural readiness towards new, innovative medium of communication (new media) and educational background. Through interactive sessions with school students, parents and teachers the researcher would like to find out- why children use new media, the content used by children, parent perception of new media usage by their children, teacher’s view on new media usage by students. According to Bagman, a popular blogger, there are two kinds of people, “Whenever there is a question of a new medium, there are those who are excited because of it and those who are wary of it.” The researcher too, through this paper, would like to know which way people in urban India are inclined.

Sweat, Skepticism, and Uncharted Territory: A Qualitative Study of Opinions on Data Sharing Among Public Health Researchers and Research Participants in Mumbai, India.

Efforts to internalize data sharing in research practice have been driven largely by developing international norms that have not incorporated opinions from researchers in low- and middle-income countries. We sought to identify the issues around ethical data sharing in the context of research involving women and children in urban India. We interviewed researchers, managers, and research participants associated with a Mumbai non-governmental organization, as well as researchers from other organizations and members of ethics committees. We conducted 22 individual semi-structured interviews and involved 44 research participants in focus group discussions. We used framework analysis to examine ideas about data and data sharing in general; its potential benefits or harms, barriers, obligations, and governance; and the requirements for consent. Both researchers and participants were generally in favor of data sharing, although limited experience amplified their reservations. We identified three themes: concerns that the work of data producers may not receive appropriate acknowledgment, skepticism about the process of sharing, and the fact that the terrain of data sharing was essentially uncharted and confusing. To increase data sharing in India, we need to provide guidelines, protocols, and examples of good practice in terms of consent, data preparation, screening of applications, and what individuals and organizations can expect in terms of validation, acknowledgment, and authorship.

Air Pollution and Respiratory Ailments among Children in Urban India: Exploring Causality

AbstractUsing a multicity sample from India, we exploit city and fortnightly variation in air pollution to identify its causal effect on the incidence of a common respiratory ailment among children—cough. We account for key sources of confounding in this relationship with a two-way fixed effects estimation strategy. Our results show that air pollution, specifically, particulate matter, has a large and negative health effect that is robust to alternative specifications. These effects are three times larger for children living in slums in comparison to children living outside slums. This suggests that improving urban air quality can lead to equity-enhancing health gains in developing countries. In addition, our falsification tests are able to rule out the possibility that the identified effects are due to other diseases unrelated to air pollution.

Faith, Trust and the Perinatal Healthcare Maze in Urban India

How women access and utilise health services through pregnancy, childbirth and infancy needs to be understood if we are to improve the delivery of and access to appropriate healthcare. Drawing on ethnographic observations of clinic encounters and in-depth interviews with women in Bangalore, South India, this paper reports on the complexities of negotiating healthcare throughout the perinatal continuum in urban India. Key themes identified include faith and trust in health services, confusion over right to healthcare; and the contested nature of choice for women. What is revealed is a socially restrictive framework that results in choices that seem arbitrary, irrational and self-defeating; poor women being particularly vulnerable. Given the current policy support for public-private-partnerships in reproductive healthcare delivery in India, both public and private health services need to move substantially to achieve true partnership and provide care that is respectful and valued by women and children in urban India.

Quality of spectacles in school going children in urban India

Dear Editor, Recently, Gogate et al. reported a poor compliance (300 out of 1018 [30%]) of spectacle wear amongst rural secondary school children.[1] About 17.4% of children in the same study reported “broken spectacles” as the cause of non-wear. In a fresh report, Mohan[2] stated that about 22% of spherocylinders in adults have optically and clinically significant errors in dispensing. We feel the issue of dispensing spectacle frames and lenses need further evaluation especially in young children. Incorrect frame fitting may have far-reaching consequences on the compliance to spectacle wear and inappropriate lenses would have an additional negative impact on the vision of the patient. We evaluated the spectacles (frames and lenses) of 54 consecutive children based on predefined criteria [Table 1]. The mean age of the children was 8.4 years (standard deviation [SD] ±2.7, range: 5-15 years) of which 31 were males and the average duration of spectacle wear was 9.4 (±6.2, 0.5-24 months). Table 1 Criteria used for spectacle frame and spectacle lens evaluation We required a sample size[3] of 51 patients for group comparison and performed Chi-square test to derive the P value. (n = 2 [Z1− α/2 − Z1 − B] 2Xp[1 − p]/d2, 80% power, 5% significance, 10% effect size). About 61.1% children used plastic frames, 14.1% used metal frames and 24.1% used combination frames (hybrids). Evaluation of frame fitting revealed good four point touch in 55.6%, fair in 18.5% and poor in 26%. The eye wire was optimal in 62.9% and suboptimal in 38.1%. The nose bridge was graded as not good in 66.7%. The temple parallelism was good in 27.7% and poor in 72.3%. The temple pressure was ideal in only 53.7%. The temple length was adequate in 48% and inadequate in 51.8%. The spectacle lens evaluation revealed a mean decentration of 3.5 mm (SD ± 1.4, range: 1-6). Plastic lenses were used in 94.4% and glass lenses in 5.6%. The lens surface was graded good in 16.6%, fair in 37% and poor in 46.3%. The mean error in the lens power was 0.02D (SD ± 0.5D range: −4.0D to + 1.0D). The mean error in cylinder axis was 4.4° (SD ± 11.0, range: 0-90). Overall, quality of spectacle fitting was 1.25 on a scale of 0-3 (0 = worst, 3 best) and quality-of-lens was 1.67 on a scale of 1-3 (1 = poor, 2 = fair, 3 = good). No statistically significant differences [Table 2] were found in the overall quality of frame fitting or quality of lenses between the age group (less than or more than 7 years [P = 0.7,1.0]), gender (male or female [P = 0.3,0.2]), type of frame (metal or plastic [P = 1.0]) and type of lenses (plastic or glass [P = 0.9]) and duration of wear (less than 6 months or more than 6 months [P = 0.5,0.2]). Table 2 Criteria for ideal spectacle frame and spectacle lens in children We concluded that the optical dispensing (frames as well as lenses in its entirety) in children was poor irrespective of the gender, age, type/material of the frame or duration of wear [Fig. 1]. More patient (parent) education and responsiveness of the opticians is needed to improve the quality of spectacle dispensing. Both, the frame evaluation and lens evaluation are necessary. Figure 1 Examples of poor spectacle frames and lenses in children. (a) Temple non -parallelism, (b) Loss of four-point touch, (c) Short temple length, (d) Lens scratches, (e) Lens pits and scratches, (f) Lens chipping, (g) Poor overall fit, (h) Not good nose bridge ... It may be advisable that the patient come back with the newly dispensed spectacle for a quality check to the ophthalmologist soon after they are dispensed. The ophthalmologists must refer to ideal fitting and quality criteria [Table 2] to ensure an optimum lens and frame dispensing. Further studies are needed to assess the impact of improved spectacle fitting and quality of lenses on the compliance of spectacle wear in children, which in turn may translate in the better and faster visual rehabilitation.

Multidimensional Segments among Children in Urban Indian Families

A multidimensional segmentation procedure was run on 276 cases using Factor Analysis and Cluster Analysis that produced 24 segments among the children in urban India as per their user class of Lifestyle goods, Lifestyle, Personality and Media Exposure. A Discriminant Analysis was also conducted to predict whether children from urban families were influencing their parents' purchase decisions of lifestyle goods or not. Predictor variables used for the Discriminant analysis are Self knowledge, Past influence, Newspaper preference, and Self driven score. Significant mean differences were observed for all the predictors on the DV. While the log determinants are quite similar, the discriminate function revealed a significant association between groups and all predictors, accounting for 78.85% of between group variability. The cross-validated classification showed that overall, 100% respondents were correctly classified. The study was carried out during 2008 to 2010.

Road use pattern and risk factors for non-fatal road traffic injuries among children in urban India

ObjectiveWe assessed the road use pattern and incidence and risk factors of non-fatal road traffic injuries (RTI) among children aged 5–14 years in Hyderabad, India. MethodsIn a cross-sectional population-based survey, data were collected on 2809 participants aged 5–14 years (98.4% participation) selected using multi-stage cluster sampling. Participants recalled non-fatal RTI during the previous 3 and 12 months. RTI was defined as an injury resulting from a road traffic crash irrespective of severity and outcome. ResultsBoys (11.5) had a higher mean number of road trips per day than girls (9.6), and the latter were more likely to walk and less likely to use a cycle (p<0.001). With increasing household income quartile, the proportion of trips using cycles or motorised two-wheeled vehicles increased while trips as pedestrians decreased (p<0.001). Based on the 3-month recall period, the age-sex-adjusted annual rate of RTI requiring recovery period of >7 days was 5.8% (95% CI 4.9–6.6). Boys and girls had similar RTI rates as pedestrians but boys had a three times higher rate as cyclists. Considering the most recent RTI in the last 12 months, children of the highest household income quartile were significantly less likely to sustain pedestrian RTI (0.26, 95% CI 0.08–0.86). The odds of overall RTI were significantly higher for those who rode a cycle (2.45, 95% CI 1.75–3.42) and who currently drove a motorised two-wheeled vehicle (2.83, 95% CI 1.60–5.00). ConclusionThese findings can assist in planning appropriate road safety initiatives to reduce cycle and pedestrian RTI among children to reduce RTI burden in India.

Effect of animal contact and microbial exposures on the prevalence of atopy and asthma in urban vs rural children in India

Environmental factors, including microbial exposures and close animal contact, are implicated in the lower prevalence of asthma and allergy in rural vs urban children. To determine (1) the prevalence of asthma, rhinitis, eczema, and atopic sensitization in rural and urban children in India; (2) differences in microbial and animal exposures in these locales; and (3) whether differences in environmental exposures account for the different rates of asthma and atopy in these locales. One child from each of 50 urban (Mysore) and 50 rural (Vinobha) households in southern India was randomly selected for data analysis. Allergy, asthma, health, environment, and lifestyle information was obtained using a questionnaire and household inspections. Atopy was determined via skin prick testing for common allergens. Endotoxin content was measured in house dust samples. Children from rural vs urban areas had lower prevalences of self-reported asthma (8% vs 30%; P = .005), rhinitis (22% vs 42%; P = .03), and atopic sensitization (36% vs 58%; P = .03). Higher median dust endotoxin loads were found in rural vs urban households (6.50 x 10(4) EU/m2 vs 1.27 x 10(4) EU/m2; P < .001). In multivariate analysis, close indoor animal contact (adjusted odds ratio [OR] 0.2; 90% confidence interval [CI], 0.05-0.9), outdoor animal contact (OR, 0.3; 90% CI, 0.1-0.8), and exclusive breastfeeding for at least 6 months (OR, 0.2; 90% CI, 0.1-0.5) were associated with lower atopic sensitization; mud flooring was associated with lower self-reported wheezing (OR, 0.1; 90% CI, 0.02-1.0). Children in India who live with close animal contact and mud flooring and who were exclusively breastfed in infancy are less likely to develop asthma, rhinitis, and atopic sensitization.

Portrait of an Indian education

Chipping away at layers of nostalgia solidified by time, distance and the compromises of adulthood, my memories of school life in Bombay come back, fleeting and episodic at times, but increasingly clear and not particularly benign. What I recreate here is therefore not meant to be representative of every Indian educational encounter. On the contrary, the educational experiences of rich and poor, rural and urban children in India are so vastly different that to claim to talk about them all would be folly. However, in the course of this past decade I have interviewed young people in Bombay who are at school now, as I write, and some who were at school during the 1980s and 1990s. I found that my recollections, of secondary school in particular, were both comfortingly and alarmingly familiar to all of them. So, although the perspective and inflection is mine, some of this account is not simply my individual story either. It is probably similar to the experience of several hundred million lower‐middle‐class school students of this generation in urban India.

The Need for Cross-cultural Research on the Pervasive Developmental Disorders

Research on the pervasive developmental disorders within a cultural context and in developing countries has received limited attention from both the fields of mental health and anthropology. Although autism holds considerable potential for expanding the field of transcultural psychiatry, the bulk of research has consisted of case studies and brief reviews, with few studies undertaking a serious discussion of cultural factors. The current article reviews the literature to date on autism within a cultural context and highlights both rationale and directions for future efforts in this area, drawing from research with 109 families of autistic children in urban India.

The Need for Cross-Cultural Research on the Pervasive Developmental Disorders

Research on the pervasive developmental disorders within a cultural context and in developing countries has received limited attention from both the fields of mental health and anthropology. Although autism holds considerable potential for expanding the field of transcultural psychiatry, the bulk of research has consisted of case studies and brief reviews, with few studies undertaking a serious discussion of cultural factors. The current article reviews the literature to date on autism within a cultural context and highlights both rationale and directions for future efforts in this area, drawing from research with 109 families of autistic children in urban India.