Slums Of Delhi Research Articles

Issues in upward mobility: Study based on longitudinal data from Delhi slums

This study based on two primary surveys of the same households in two different years (2007/08 and 2012) assesses the extent of inter-temporal change in income of the individual workers and makes an attempt to identify important correlates of upward mobility in alternate econometric models, envisaging endogeneity problem. The findings are indicative of a rise in the income of workers across a sizeable percentage of households though many of them remained below the poverty line notwithstanding this increase. Inadequate education reduces the probability of upward mobility while education above a threshold level raises it. Savings are crucial for upward mobility impinging on the importance of asset creation. Views that entail neighbourhood spill-over effects also received validation.

Deficiencies of Serum Ferritin and Vitamin B12, but not Folate, are Common in Adolescent Girls Residing in a Slum in Delhi.

Anemia among adolescent girls is one of the major challenges faced by India. The present study was undertaken to assess the prevalence of anemia and status of other hematological parameters among adolescent girls (11 - 18 years) residing in an urban slum of Delhi. A total of 794 adolescent girls were recruited for the study. The prevalence of anemia was estimated using the cyanmethemoglobin method. Serum levels of ferritin, folic acid and vitamin B12 were estimated for anemic subjects. The prevalence of anemia was reported as 58.7 %, with 31.6 %, 25.7 % and 1.4 % of subjects being mild, moderate and severely anemic. Hemoglobin levels of subjects who had attained menarche were found to be significantly lower than those who had not attained menarche. The prevalence of serum ferritin, folic acid and vitamin B12 deficiency among those who were anemic was reported as 41.1 %, 5.0 % and 63.3 % respectively. A total of 23.5 % anemic subjects had concomitant micronutrient deficiencies of serum vitamin B12 and ferritin. The results indicate that supplemental iron and vitamin B12 may better address the burden of anemia in adolescent girls in Delhi.

Quantitative estimates of dietary intake with special emphasis on snacking pattern and nutritional status of free living adults in urban slums of Delhi: impact of nutrition transition.

BackgroundThe nutritional landscape of India is experiencing the fallout of urbanization and globalization. The changes are manifest in dietary patterns as well as health outcomes. The study aimed at assessing household dietary intake pattern with special emphasis on snacking pattern, anthropometric and lipid profiles in low socio-economic status households in an urban slum of Delhi.MethodsCommunity based cross-sectional study in 260 households of a purposively selected urban slum in North-East district of Delhi, India. Family dietary surveys including consumption pattern of commercial food products rich in Partially Hydrogenated Vegetable Oils (PHVOs), 24 h dietary recall and assessment of dietary diversity using Household Diet Diversity Scores (HDDS) were done. Assessment of nutritional status using anthropometric and lipid profile on a subsample (n =130) were also conducted.ResultsMedian energy and fat intake were adequate. Micronutrient intake was found to be inadequate for vitamin A, riboflavin, calcium and folate. PHVO usage was low (<20 % households). Milk (39 %), green leafy vegetables (25 %) and fruits (25 %) intake were below recommendations. Mean HDDS was 7.87. Prevalence of overweight/obesity was high (66.7 %). Lipid profile showed mean HDL-C levels lower than recommendations for females.ConclusionCommunity based awareness programs for prevention of non-communicable diseases should incorporate healthy diet and lifestyle practices with emphasis on quantity and quality of nutrient intake. This must be considered as an integral part of chronic disease prevention strategy for underprivileged communities in urban India.

Measles Outbreak in High Risk Areas of Delhi: Epidemiological Investigation and Laboratory Confirmation.

To describe epidemiological and laboratory characteristics of the measles outbreaks recorded in the urban slums of Delhi (designated as high risk areas under the Polio program), from February through July 2014. As a part of surveillance and containment measures, an extensive field investigation for measles case search (WHO definition) through 'house to house survey' was conducted by district health teams and field volunteers of National Polio Surveillance Project (NPSP),WHO, Delhi from February through July, 2014. The data generated by the health teams was collected and analyzed. About 1.1 million households in the high risk areas of Delhi were surveyed for epidemiological investigations. A total of 1337 suspected measles cases were reported. The case fatality rate (CFR) was 1.2%. Statistical analysis showed significant relation between age of the child (measles case) and immunization status. Higher numbers of reported cases were above 5y and less than 9mo of age. Measles IgM was detected in 132 cases and D8 strain was isolated on genotyping. The outbreak was predominantly localized to the high risk areas (urban slums) of the city. Low CFR was reported during the outbreaks. The outbreaks highlight the need to extend the reach of immunization services to urban slums and strengthen measles surveillance including laboratory based surveillance.

Prevalence of Diarrhoea among Under-Five children and Health Seeking Behavior of their Mothers in an Urban Slum of Delhi.

Background: Diarrhoea forms major public health problem in children under 5 years of age, especially in developing countries. In Indian slums nearly 100,000 babies die every year before their fifth birthday as a result of dehydration, weakened immunity or malnutrition associated with diarrhea. Aim: To find out the prevalence of Diarrhoea among under five age group in past two weeks and to assess the health seeking behavior of their mothers. Material & Methods: Community based cross-sectional study was carried out from 25th to 31st May,2007 in an urban slum of Delhi. Considering frequency of 3 episodes of diarrhoea/child/year and taking accepted margin of error as 20%, sample size of 695 was calculated. Data was collected in a pre-designed pre-tested Performa by interviewing the mothers of under five children. Data analysis was done by simple statistical tools like percentage. Results: Prevalence of Diarrhoea in last two weeks was about 14.8%. Prevalence of Diarrhoea among under five females 18.4% was highest compared to 12.2% males. 65% mothers knew about use of ORS in Diarrhoea through Private Doctors. (60.2%) cases were given Oral Rehydration Solution (ORS) during diarrhea. 31% mothers knew about ORS but did not know the correct method of preparation and its usage. Breastfeeding was stopped in 43.6% cases. Conclusion: Awareness regarding safe drinking water, excreta disposal and personal hygiene needs to be improved among slum dwellers. Improvement of poor literacy status of mothers is an urgent need to improve their health seeking behaviour and thus the health of their children.

Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study.

BackgroundAntenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes.MethodsA household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented.ResultsAlmost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not.ConclusionsPregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in providing effective nutrition counselling should be explored given the overburdened public health system.

Marital Distress and the Failure to Eat: The Expressive Dimensions of Feeding, Eating, and Self‐care in Urban South Asia

This article examines appetite loss among married women living in a Delhi slum. Research has shown that through feeding, women in South Asia gain domestic authority and become part of the families into which they marry. I use observations and interviews collected over 14 months in one poor urban community to explore the social dimensions of feeding and abstaining from eating in a context of marital and food insecurity. Results show that women report appetite loss in response to domestic violence, the stress of marital fights, and fears about the dissolution of their marriages. In other instances, women report that they forget to eat because of dedication to caregiving or refuse to eat because of their husbands' failure to attend to their needs. In the context of this research, I show that food insecurity research would benefit from considering the kinship and gender politics involved in feeding and eating behaviors.

Vulnerability of Poor Urban Women to Climate-linked Water Insecurities at the Household Level: A Case Study of Slums in Delhi

In most developing countries rural, peri-urban slum women and girls spend several hours every day in water accession and management. Climate change coupled with demographic and technological factors further confound this scenario. This study assesses the vulnerability of poor women to climate-linked water insecurities in Delhi, the capital of India, where almost 20 per cent of its people live in slums and related settlements. This study made a qualitative and quantitative assessment of water-related needs of women living in slums across different regions of the city. Considering the rapid growth of slums, climatic changes and little change in the gendered distribution of domestic responsibilities, women are likely to spend huge amounts of time in meeting their practical gender needs of water and other resources. Their strategic gender needs of education, skill development and income will continue to be ignored leading to persistent gender gaps in attainments in different sectors. It is therefore very important to enhance the overall adaptive capacity of urban poor women to face the challenges of rapid urbanisation and climate change.

Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi, India.

Background:Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas.Aims and Objectives:The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India.Materials and Methods:The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA).Results:A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs.Conclusions:A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.

Are anemia and blood group types related to Japanese encephalitis and dengue?

International Journal of Medicine and Public Health,2015,5,4,328-331.DOI:10.4103/2230-8598.165093Published:Oct 2015Type:Original ArticleAre anemia and blood group types related to Japanese encephalitis and dengue?Shantanu Sharma, Vimal Kumar Gupta, Ajay Kumar Jain, and Anita Chakravarti Shantanu Sharma, Vimal Kumar Gupta, Ajay Kumar Jain1, Anita Chakravarti2 Departments of Community Medicine, 1Physiology and 2Microbiology, MAMC, New Delhi, India Abstract:Introduction: Dengue and Japanese encephalitis (JE) are flaviviruses causing significant morbidity and mortality worldwide. Previous studies had found an association between dengue infection and particular blood group antigen and also the susceptibility to aplastic anemia by dengue. Aims and Objective: The present study was conducted to find any association between dengue and JE immunoglobulin G (IgG) antibody with blood group antigen or anemia. Methodology: The study was conducted in 2 slums of Delhi in 2013 in the interepidemic period. 5 mL blood from 239 samples were taken and processed for IgG levels of dengue and JE and rest used to test hemoglobin and blood group. Results and Discussion: No association has been found between blood group types and dengue IgG antibody positivity (P = 0.42) or JE IgG antibody positivity (P = 0.148). Nor did anemia established any association with dengue (P = 0.185) or JE IgG antibody (P = 0.277). IgG status of dengue and JE could be used as proxy markers of any past subclinical infection (includes clinically manifested cases also). Further studies in large settings and other areas could be done to validate the results. This was the first study of its kind in such settings. Keywords:Anemia, Dengue, ELISA, Japanese encephalitisView:PDF (569.32 KB)

An Assessment of Comprehensive Knowledge of HIV/AIDS among Slum and Non-Slum Populations in Delhi, India

In order to design appropriate HIV prevention programs, it is important to examine the perception and knowledge of HIV/AIDS and methods of preventive. This article explores comprehensive knowledge of HIV/AIDS prevention methods among women and men in slum and non-slum areas in the National Capital Territory of Delhi, India. Data were drawn from the National Family Health Survey, 2005-06 (NFHS-3). The sample included 3096 women aged 15 - 49 years and 1321 men aged 15 - 54 years. Pearson Chi-square test and logistic regression analyses were conducted to examine the association between the study variables and the background characteristics of the slum and non-slum populations. Comprehensive knowledge of HIV/AIDS prevention methods was significantly lower among women and men in slum areas as compared with non-slum areas. Compared to men, women had less comprehensive knowledge of HIV/AIDS prevention methods in slum and non-slum areas, even after controlling for various demographic and socio-economic and exposure variables. Findings indicate that comprehensive knowledge of HIV prevention methods is low among women in slum areas. Interventions are needed to build knowledge of HIV transmission and prevention methods in this vulnerable group. Strategies to build awareness of HIV/AIDS could include mass media campaigns HIV/AIDS, and information, education and communication programs (IEC) on HIV/AIDS in slum areas.

A Descriptive study to Assess the Risk Factors and Knowledge on Cervical Cancer and its Prevention among Women Residing in a Selected Urban Slum of Delhi and to Develop an Informational Pamphlet on Cervical Cancer and its Prevention

A Descriptive study to Assess the Risk Factors and Knowledge on Cervical Cancer and its Prevention among Women Residing in a Selected Urban Slum of Delhi and to Develop an Informational Pamphlet on Cervical Cancer and its Prevention

Assessment of trans fatty acids in fats/oils being used by halwais for frying foods – A study in an urban slum of Delhi

Assessment of trans fatty acids in fats/oils being used by halwais for frying foods – A study in an urban slum of Delhi

Informal support for women and intimate partner violence: the crucial yet ambivalent role of neighbours in urban India

Women who experience intimate partner violence often rely on informal support to mitigate intimate partner violence's health effects. Yet there is little known about who gives the support and how it is provided. This paper explores from whom and how low-income women experiencing domestic violence in urban India seek informal support. In South Asia, women's reliance on kin for support is culturally valued, yet the urban social context makes it more likely that they will access such support from non-kin when they experience intimate partner violence. The paper draws on observations and interviews with 10 families collected over 14 months of in-depth ethnographic research in one Delhi slum community. Using a case study approach to explore women's responses to violence longitudinally, it was possible to track how women drew on support. Results show that even as women sought emotional support and direct intervention from their neighbours to deal with their domestic violence, they restricted these relationships, faced stigma, and emphasised the need to protect their families. Understanding the informal, but deeply ambivalent, systems of social support that women engage to deal with intimate partner violence is a first step toward strengthening such networks, a key recommendation to stem the health impacts of domestic violence.

Why women choose to give birth at home: a situational analysis from urban slums of Delhi

ObjectivesIncreasing institutional births is an important strategy for attaining Millennium Development Goal -5. However, rapid growth of low income and migrant populations in urban settings in low-income and middle-income countries,...

Ethnicity, Mobility and Role of Informal Channels: Evidence from Delhi Slums

&lt;p&gt;This study has focused on the well-being of the migrants and explored the role of informal channels among different ethnic groups and its effect on upward mobility. This was made possible by conducting primary surveys in the slums of Delhi. It was found that the extent of upward income movement seems to exceed the downward income movement though the cases of stagnancy and downward occupational mobility aren’t to be ignored. We concluded that evidences in favour of upward mobility are not overwhelming but it would be equally erroneous to overlook the change that has occurred. With regard to the role of informal channels, we found that in the initial stages while entering the urban labour market, close relatives (from their regional background) matter a lot but subsequently, it is individual inspiration that keeps him going in the labour market.&lt;/p&gt;

Factors influencing status of undernutrition among children (0-5 years) in a rural area of Delhi: a cross-sectional study

Background: Although more than one-third of under six year children in Delhi slums are undernourished; but what is the situation in rural areas of Delhi - a capital of India, it is not very clear. Moreover the research in rural area on topic has also not received much focus in past. Methods: The study was done in the Narela area (a Rural ICDS project in Delhi). All the eligible 450 children between the age group 0-5 years as found in the survey register of ICDS project for 2 Anaganwadi Centre’s (AWC-A &amp; AWC-B) at the time of data collection, were included in the study. The prevalence of undernutrition in 2 AWCs was determined and it was compared with records of 2 AWCs. The primary and secondary data was triangulated to confirm pattern scenario of undernutrition. Results: In Rural ICDS Block, the prevalence of underutrition came out 57.8%.The difference in nutritional grades of undernutrition in the study were not statistically significant (P &gt;0.05) as per their the registration status at AWCs in ICDS scheme. The type of family and family income of household however were statistically significantly associated with the nutritional status of child (P &lt;0.01). Conclusions: The undernutrition is prevailing in rural area of Delhi (India), despite the presence of ICDS scheme; suggesting that other host factors in family are also important and service delivery factors in nutrition and health programmes also needs radical relook for tackling undernourished children in Delhi.

Prevalence, awareness, treatment and control of hypertension among elderly persons in an urban slum of Delhi, India

The increase in the number of elderly persons is contributing to an increase in the prevalence of hypertension. The residents of urban slums are more vulnerable to diseases due to poverty and lack of access to health care. To estimate the prevalence of hypertension in elderly persons in an urban slum of Delhi, and to assess the awareness, treatment and control of this condition among them. All persons aged 60 years and above, residing in an urban slum of Delhi, were included in this cross-sectional community-based study. Blood pressure was measured and socio-demographic information was collected. The participants’ awareness and treatment of hypertension was recorded. Among the 496 participants studied, the prevalence of hypertension was estimated to be 39.5% (95% CI 35.2-49.0). It was 36.4% and 42.9% among men and women, respectively. The prevalence of hypertension increased with age. Of those having hypertension, 28.6% were aware of their condition; 60.7% of those aware were on treatment, and 52.9% under treatment had controlled blood pressure. Hypertension is common among elderly persons in urban slums. Its magnitude and low awareness warrants effective public health interventions for its identification, treatment and control. Copyright © 2014, Indian Journal of Medical Specialities. Published by Reed Elsevier India Pvt. Ltd. All rights reserved.

Effectiveness of peer-counseling for promoting optimal complementary feeding practices among infants belonging to urban slums of Delhi

Background: Promotion of appropriate complementary feeding practices is important in reducing malnutrition in infants and young children. Yet, India has dismal rates of optimal complementary feeding practices which are not rising. Aim: This study aimed to find the impact of the educational intervention directed through peer counselors to promote optimal complementary feeding practices. Methods and materials: This is an Interventional study, which has been conducted in an urban slum of Delhi using multi-stage random sampling. From the study area two sectors were randomly selected. From one sector, 54 pregnant women were selected who were not given any counselling forming the non-intervention group. From the other sector, 159 pregnant women were selected to form the intervention group (Igr) which were further divided into 3 sub-groups; one sub-group was imparted counselling by a nutrition professional (Igr A; n=53) and the other two (Igr B1;n=53 and Igr B2; n=53) by the peer counselors who where the local health workers trained for promoting optimal infant feeding practices. The infants were followed up till their first birthday and in order to study the impact of counseling, the complementary feeding practices of the intervention and the non-intervention groups have been compared Results: In the intervention groups, the prevalence of exclusive breastfeeding at 6 months was significantly higher as compared to the non-intervention group (67.5 % vs. 4.2 %). In the intervention groups, 2.6 per cent infants received semisolid/ solid foods before the age of 6 months, 75.1 percent between 6 - 7 months and the rest by the age of 9 months. However, in the Non-Igr, the respective figures were 48.9, 19.4 and 25.4 per cent; and at the age of one year, 6.4 per cent infants were still being given predominantly mother’s milk. 99.3 per cent infants in the Igrs as compared to 82.3 per cent in the Non-Igr (P<0.05) continued to receive breast milk till the age of 12 months. Conclusions: The promotion of optimal complementary feeding through appropriately trained peer counselors is feasible, although it is can only be achieved through consistent efforts and adequate training/monitoring of such interventions.

Prevalence of Osteoarthritis of Knee Among Elderly Persons in Urban Slums Using American College of Rheumatology (ACR) Criteria.

The prevalence of osteoarthritis among elderly is high and it majorly affects the quality of life. Knee osteoarthritis is the most common form of osteoarthritis. Timely diagnosis using clinical criteria and effective intervention is of utmost importance. To estimate the prevalence and determinants of osteoarthritis of knee joint among elderly persons residing in an urban slum of Delhi using ACR clinical criteria. We did a community-based cross-sectional study among 496 elderly (>= 60 years) persons residing in urban slum of Delhi, India from December 2009 to February 2010. The American College of Rheumatology (ACR) criteria was used to clinically diagnose osteoarthritis knee. Bivariate analysis using Chi-square test and multivariate analysis was done to identify the determinants. Sensitivity and specificity of individual factors to diagnose osteoarthritis knee was calculated. The prevalence of osteoarthritis was estimated to be 41.1% (95% C.I., 36.7-45.6). Female sex and age >= 70 y were found to be independent risk factor for osteoarthritis knee. Among those having knee pain, presence of crepitus and tenderness were the most sensitive factors whereas bone overgrowth and bone warmth were most specific factors. The prevalence of osteoarthritis knee was high among this elderly population and increased with age. Overall, individual factors of ACR criteria were both sensitive and specific in diagnosing osteoarthritis knee. In resource constrained setting of urban India, it can be an effective tool in clinical diagnosis of osteoarthritis knee.