Women In Urban Slums Research Articles

A Health Seeking Behavior of the Women of Urban Slums of Puducherry Regarding Reproductive Tract Infections

A Health Seeking Behavior of the Women of Urban Slums of Puducherry Regarding Reproductive Tract Infections

Effects of health education tool on select epidemiological factors associated with adult obese urban slum women.

National Family Health Survey-3 (2005-2006) India, found that 14.8% of Ever-Married Adults (age 15-49 years) had Body Mass Index (BMI) in the ranges of overweight and obese; compared to 10.6% in the National Family Health Survey-2. These figures highlighted the fact that India already faces a dual burden of chronic malnutrition, i.e., obesity, besides undernutrition. Higher BMI, especially, increased abdominal fat is an important determinant of the development of diabetes. This study aims to understand the effect of health education on obesity status of adult women above the age of 20 years in an urban slum area. Community-based, interventional study, to assess select epidemiological factors associated with obesity-including measurement of anthropometry and assessing random blood sugar level; followed by an intervention (health education to only obese women by means of flip-chart); followed by a follow-up 6 months later. About 22.6% women were found to be obese. Almost, all dietary and physical activity parameters as well as weight improved for the better after the intervention, and the change was statistically significant. This community based interventional study was able to understand certain factors associated with pathophysiology of obesity in slum dwelling adult women, and effectively documented a reduction in weight along with a change in their obesogenic practices postintervention.

The Effect of Changing Proximate Determinants on Fertility Levels among Urban Poor Women in Kenya: Evidence from Nairobi’s Informal Settlements, 2000-2012

Slum dwellers constitute an increasing share of urban populations in sub-Saharan Africa. This paper examines changes in proximate determinants of fertility in slums in Nairobi, Kenya between 2000 and 2012. We used data from the Nairobi Cross-sectional Slum Surveys (NCSS) conducted in in all Nairobi’s informal settlements, among 3,256 women aged 15-49 in 2000 and 4,240 aged 12-49 in 2012. We employed Stover’s revised proximate determinants of fertility framework to assess the relative contribution of contraception, marriage, sterility and postpartum insusceptibility to the fertility levels between 2000 and 2012. There has been a change in the influence of the proximate determinants in Nairobi’s slums. Marriage as measured by recent sexual activity had the largest inhibiting effect in 2000, whereas contraception had the largest effect in 2012. Findings suggest the need to sustain and/or strengthen FP/SRH initiatives that emphasize contraceptive use among women in urban slums in Kenya

Treatment seeking behavior for sexually transmitted infections/reproductive tract infections among married women in urban slums of Mumbai, India

Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) are a major public health problem and a leading cause of morbidity among men and women in developing countries. The aim of the study is to explore treatment seeking behavior among the married women of reproductive age presented with symptoms of STI/RTI. A hospital-based observational study was carried out at the STI/RTI Clinic of Urban Health Centre, Shivaji Nagar, Govandi, Mumbai, India. The study involved a total of 273 married females who attended clinic for their symptoms during January to March 2012. Patients were interviewed using a pretested questionnaire to explore the detail of the treatment seeking behavior regarding STIs/RTIs. Out of total women who participated in the study, only 47.6% of the women with STIs/RTIs symptoms sought health care. Among those who did not seek treatment, 58.65 % females were belonging to 21-25 years of age group. Maximum 65.6% females who were illiterate had not sought any treatment for symptoms of these diseases as compared to 65% who had taken treatment for the presented symptoms who were educated up to higher secondary and above level. 62.5% females belonging to class V had never sought treatment as compared to 100% women who were classified to class I. The poor health seeking behavior was associated with literacy and socioeconomic class of the participants. Private sector was the most favored place for taking treatment by them. Commonest reason for not seeking treatment was no female doctor at clinic. Information, Education and Communication (IEC) sessions, about STI symptoms and the benefits of treat-ment, especially targeted at women and low socioeconomic groups might be an immediately feasible measure that will help to reduce the burden of the disease.South East Asia Journal of Public Health Vol.5(2) 2015: 65-70

Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food.

The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers' diet.

Experience of intimate partner violence among young pregnant women in urban slums of Kathmandu Valley, Nepal: a qualitative study

BackgroundIntimate partner violence (IPV) is an urgent public health priority. It is a neglected issue in women’s health, especially in urban slums in Nepal and globally. This study was designed to better understand the IPV experienced by young pregnant women in urban slums of the Kathmandu Valley, as well as to identify their coping strategies, care and support seeking behaviours. Womens’ views on ways to prevent IPV were also addressed.Methods20 young pregnant women from 13 urban slums in the Kathmandu valley were recruited purposively for this qualitative study, based on pre-defined criteria. In-depth interviews were conducted and transcribed, with qualitative content analysis used to analyse the transcripts.Results14 respondents were survivors of violence in urban slums. Their intimate partner(s) committed most of the violent acts. These young pregnant women were more likely to experience different forms of violence (psychological, physical and sexual) if they refused to have sex, gave birth to a girl, or if their husband had alcohol use disorder. The identification of foetal gender also increased the experience of physical violence at the prenatal stage. Interference from in-laws prevented further escalation of physical abuse. The most common coping strategy adopted to avoid violence among these women was to tolerate and accept the husbands’ abuse because of economic dependence. Violence survivors sought informal support from their close family members. Women suggested multiple short and long term actions to reduce intimate partner violence such as female education, economic independence of young women, banning identification of foetal gender during pregnancy and establishing separate institutions within their community to handle violence against young pregnant women.ConclusionsDiversity in the design and implementation of culturally and socially acceptable interventions might be effective in addressing violence against young pregnant women in humanitarian settings such as urban slums. These include, but are not limited to, treatment of alcohol use disorder, raising men’s awareness about pregnancy, addressing young women’s economic vulnerability, emphasising the role of health care professionals in preventing adverse consequences resulting from gender selection technologies and working with family members of violence survivors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0293-7) contains supplementary material, which is available to authorized users.

Knowledge, Attitude and Practice of Maternal and Child Food-Based Dietary Guidelines among Pregnant Women in Urban Slum of Lagos State

Adequate nutrition is an important factor for health and well-being of the mother and child during and after pregnancy. However, studies on the influence of the Nigeria’s national dietary food guidelines on health and nutritional status of pregnant women, especially, in poor-settings are sparse. The study assessed knowledge, attitude and practice of Food-Based Dietary Guidelines (FBDG) among pregnant women in urban slum of Lagos state. A total of 430 consenting pregnant women attending five selected Primary Health Care Centres in AjeromiIfelodun Local Government Area of Lagos State volunteered for this cross-sectional study. A pretested, intervieweradministered questionnaire was used as the survey instrument. Data was analyzed using descriptive and inferential statistics. The results of study showed that, the mean age of the respondents was 27.9 ± 5.2 years. The respondents were mostly married (82.2%), with secondary level education (58.0%), unemployed (61.6%) and with an estimated monthly income of approximately 33 American dollars per household (42.2%). A majority (95.1%) of the respondents have had advice on nutrition during pregnancy, obtained through antenatal clinic attendance (93.3%). Rates on adequate knowledge and positive attitude towards FBDG were 55.8% and 61.2% respectively. Rates for high, medium and low dietary diversity levels were 57.7%, 33.5%, and 8.8%. There was a significant association between level of dietary diversity and employment status (p<0.05). Less than half (43.5%) of the respondents had good practice of the FBDG. Financial constraints (68.1%) and cultural belief and norms (61.5%) were major factors limiting adequate nutrition during pregnancy and compliance with dietary guidelines. The study concluded that, Nigerian pregnant women living in urban slum of Lagos state have above average knowledge of the nutrition information and positive attitude towards dietary guideline, as contained in the Nigerian food based dietary guideline. Unemployed pregnant women had a higher dietary diversity compared with their employed counterparts. Financial constraint and cultural belief and norms were factors that act against compliance to dietary guidelines. It is therefore, recommended that national food based dietary guidelines education be incorporated into routine of antenatal care in Nigeria. Some practical suggestions to ensure the implementation of the Food Based Dietary guidelines include providing Healthcare workers at the Antenatal clinics training and resource materials to educate pregnant women attending antenatal clinics on the Food Based Dietary Guidelines. Also, every pregnant woman should get a free copy of a pictorial version of the Food Based Dietary Guideline.

Prevailing food taboos among pregnant women in urban slums of Bengaluru- a cross sectional study.

INTRODUCTION Poor maternal nutrition especially in urban slums adversely affects pregnancy and birth outcomes. In many local communities pregnant women have food taboos which consequently results in depletion of vital nutrients. Hence this study is aimed at describing women who are likely to have certain taboos or misconceptions during pregnancy.METHODS A cross sectional study was conducted in few urban slums of Bengaluru. 160 Pregnant women were selected by simple random sampling method. Prendashtested questionnaire was used to collect information. All the Pregnant women above 18 years of age were interviewed.RESULTS Out of 160 pregnant women interviewed 41.25 were in the age group of 18-22 years. Majority of the women 88.1 were literates and 61.8 were housewives. Most of them 53.75 belong to upper-lower class. About 75 women had some kind of food taboos associated with pregnancy. The common food taboos seen were avoidance of some foodfruits during the pregnancy. Most common foods avoided were Papaya 55 Jack fruit 37.5 and Ground nut 36.25. Reasons given for not consuming these foods were many and about 56.25 of pregnant women perceived that eating papaya will cause abortion. 43.75 amp 36.25 said it may cause harm to the mother and baby respectivelynbsp

Socio-economic Factors affecting Birth Weight of the Newborn: A Study among Muslim Women in Urban Slum, Meerut

Socio-economic Factors affecting Birth Weight of the Newborn: A Study among Muslim Women in Urban Slum, Meerut

A Qualitative Study on Health Perception and Practices Related to Reproductive Tract Infections in Urban Slum Women

Every year an estimation of about 50 million women are affected by reproductive morbidity, and at least 18 millions of them, these morbidities become long term and are often deliberating. As women's perception of illness influences their behaviour, it is important to understand their perceptions and practices to design effective intervention or to plan a strategy. Ten focus group discussions were held with 109 participants from different socio-economic diversity. Methods focused on understanding experiences, practices, perception, beliefs, health-seeking behaviour of women related to reproductive health and especially reproductive tract infections (RTIs). Qualitative thematic analysis technique was used for analysis. The major finding was, participants had poor knowledge about symptoms and causes of RTI. Several types of food, family planning method, and menstrual unhygiene were believed to be the cause of RTI. Vaginal discharge was perceived as most common symptom of RTI. The common treatment seeking behaviour was self-mediation through pharmacies or use of home remedies. Absence of female doctor, shyness for genital examination, financial constraint, gender inequalities, burden of responsibilities and decision-making were barriers identified for seeking treatment. As participants demonstrated limited knowledge and variety of misconception, raising awareness regarding symptoms of RTI remains the priority.

Exploring the Gender Aspect in Selected Qualitative Indicators of Wellbeing in Urban Slum Women with Special Reference to Pune City Year 2014–15

As reflected in the census of 2011, women as a stratum of the society have less education, earn less income and are less nourished as compared to the male population. In effect women are poor as compared to men in different walks of life and face inequalities on almost all levels be it inequality of resources or of opportunities to develop. The macroeconomic indicators like literacy rate, work force participation, income earning capacity, political participation etc. reflect the gender based inequalities in various dimensions on an aggregate level. Apart from the obvious importance of education, health and employment, issues like freedom of choice, participation in decision making, dignity and personal security have a big hand in determining the quality of life, in other words ‘wellbeing’. This paper tries to explore the extent of wellbeing in the lives of women in urban slum households based in Pune city. An attempt has been made through focussed interviews of forty women in informal surroundings in a group as well as individually. Analysis has been attempted on the degree of Independence enjoyed, Autonomy of Small decisions, Financial Security and Dignity and Personal security. The women were questioned according to the parameter analysed as mentioned in detail in each indicator. All the answers were quantified as ‘Yes’ or ‘No’. If the answer suggested discrimination it was given the weightage of zero while if the answer was positive ethically i.e. no discrimination then the answer was given the weightage of one. Thus all the responses were analysed and the degree of independence, dignity and personal security, financial security and financial awareness was estimated. The ultimate purpose of this paper is to explore the inter-generational change in attitude, the constraints experienced in case of girls, the scope of their expectations from life and especially the societal perception of what is ‘acceptable’ in other words ‘Freedom of Choice’

Utilization of maternal health services and determinants of skilled care during delivery in slums of Gujarat, India

Background: In India one in three women is delivering without skilled care. This is happening even after the Safe Motherhood Initiative began two decades ago. Aim & Objective: The aim of the present paper is to assess utilization of maternal health services and factors affecting skilled delivery care among urban slum women. Method: We selected 562 women delivered two year prior to survey using two stage clusters sampling for a community based cross sectional study. Using a pre-tested structured interview schedule, information was collected on demographics, socioeconomic status, use of maternal health services, and reasons for non-utilization of health services. Univariate and multivariate analysis were performed. Result: Majority (92%) of women received at least one antenatal care during pregnancy, while only 4 out of five women sought skilled care during the last delivery. Women of educationally and socially backward classes (OR=0.46, 95% CI 0.230.94), women live in a distance more than two kilometers from maternity health facility (OR=0.38, 95% CI 0.22-0.65), and women been on their second pregnancy (OR=0.44, 95% CI 0.21-0.94) utilized less of skilled care during delivery compared to their counterparts. Increase in education level of women and number of Antenatal care received were tending more utilization of skilled care during delivery. Minimal sense of need, cost, social barriers and perceptions about care were found to be the reasons for not seeking care. P oor attitude of providers, poor quality of services and long waiting time were found to be the reasons for non-utilization of public health facilities. Conclusion: The factors determine skilled delivery care were caste affiliation, education, service availability, parity, perceived utility of services and health seeking behaviors. Government institutions were lying underutilized as women do not prefer them for delivery.

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.

The role of material deprivation and consumerism in the decisions to engage in transactional sex among young people in the urban slums of Blantyre, Malawi

Transactional sex has been associated with a high risk of HIV acquisition and unintended pregnancy among young women in urban slums in sub-Saharan Africa. However, few studies have explored the structural drivers of transactional sex from the perspective of both genders in these settings. This paper explores how young men and women understand the factors that lead to transactional sex among their peers, and how deprivation of material resources (housing, food and health care access) and consumerism (a desire for fashionable goods) may instigate transactional sex in the urban slums of Blantyre, Malawi. Data from 5 focus group discussions and 12 in-depth interviews undertaken with a total of 60 young men and women aged 18–23 years old, conducted between December 2012 and May 2013, were analysed using anticipated and grounded codes. Housing and food deprivation influenced decisions to engage in transactional sex for both young men and women. Poor health care access and a desire for fashionable goods (such as the latest hair or clothing styles and cellular phones) influenced the decisions of young women that led to transactional sex. Interventions that engage with deprivations and consumerism are essential to reducing sexual and reproductive health risks in urban slums.

Reproductive health care seeking behavior among urban slum women of Delhi.

Background:The study tries to understand what are the dimensions of Reproductive Health care seeking behavior among the urban slum women in Delhi, their level of awareness and treatment seeking patterns?Materials and Methods:The study was carried out in one of the slum in south district of Delhi. 253 women of reproductive age group were selected by systematic random sampling. Interpersonal interview was conducted to seek information on the selected parameter.Results:Around three/fourth women had undergone for blood pressure check up, weight recording and stomach/abdomen check up during pregnancy. Only 39.9% received advice on avoiding intake of medicine during pregnancy. About 14.6% mentioned that at least 40 days rest were required for resuming daily routine activities after delivery. Thus majority of these slum women are ignorant about the importance of post natal care which was necessary for post delivery care of the women and her infant.Conclusion:The correct knowledge on the importance of ANC and PNC and various checkups need to be carried out during pregnancy and postnatal period needs to be imparted to these women. Thus, health education and health promotion campaigns are needed for bring changes in the existing health-seeking behaviors among urban slum women.

Socio-demographic factors associated with domestic violence in urban slums, Mumbai, Maharashtra, India.

Background & objectives:Domestic violence is identified as a public heath problem. It is associated with adverse maternal health. This study examined the prevalence and determinants of domestic violence among women in urban slums of Mumbai, India.Methods:A community based cross-sectional household survey was carried out among eligible women for the study during September 2012 to January 2013. A total of 1137 currently married women aged 18-39 yr with unmet need for family planning and having at least one child were selected using cluster systematic random sampling from two urban slums. Information on socio-demographic, reproductive and domestic violence was collected through face-to-face interview using a pretested structured questionnaire after obtaining informed written consent. Bivariate and multivariate analyses were carried out to find the socio-demographic factors associated with ever experienced domestic violence among women.Results:The prevalence of women ever experiencing domestic violence in the community was 21.2 per cent. Women whose husband consumed alcohol [RR: 2.17, (95% CI: 1.58-2.98)] were significantly at an increased risk of ever experiencing domestic violence than their counterparts. Risk of domestic violence was twice [RR: 2.00, (95% CI: 1.35-2.96)] for women who justified wife beating than women who did not justify wife beating.Interpretation & conclusions:The findings showed that domestic violence was prevalent in urban slums. Factors like early marriage, working status, justified wife beating and husbands use of alcohol were significantly associated with domestic violence.

Assessment of Unmet Needs of Contraceptive Practices among Married Women in Urban Slums of Lucknow District

Assessment of Unmet Needs of Contraceptive Practices among Married Women in Urban Slums of Lucknow District

‘SMS’ for mental health – Feasibility and acceptability of using text messages for mental health promotion among young women from urban low income settings in India

ObjectiveThe current study assesses the acceptability and feasibility of mobile text messages for promoting positive mental health and as a helpline among young women in urban slums of Bangalore. MethodologyForty girls in the age range of 16–18 years from urban slums received messages every day for a month. They could call or message back or give a ‘missed call’ to the same number whenever they had emotional problems or felt like talking to a counselor. The received responses in the form of return texts, missed calls and return phone calls were recorded. Feedback about the feasibility and acceptability of the mobile messages was collected after a month. Results25 out of 40 (62.5%) participants called back, asking for mental health services and to say they felt good about the messages. 23 of 40 (57.5%) messaged back regarding their feelings. 62% reported that they felt supported with the mental health messages. Male family members of nearly half of the participants called back to check the authenticity of the source. Most women did not face any problems because of the messages. ConclusionThis pilot qualitative study indicates that mobile text messages are a feasible and culturally acceptable method for mental health promotion and prevention among young women from urban slums in India. Issues such as consent from the woman and family, ensuring confidentiality and providing authentic and reliable support services, need to be taken into account before attempting to scale up such a service, particularly in vulnerable groups.

Behavioral risk factors for noncommunicable diseases in working and nonworking women of urban slums.

Background:Noncommunicable diseases (NCDs) are an emerging public health problem, accounting for 80% of deaths in low and middle-income countries leading to a global epidemic. The increasing burden of NCDs is affecting poor and disadvantaged women population disproportionately, contributing to widening health gaps between and within countries. Globalization and urbanization have led to lifestyle changes among urban poor, which need to be understood, as the urban areas are undergoing rapid transitions.Objectives:To know prevalence and pattern of behavioral risk factors for NCDs in working and nonworking women of urban slums to initiate steps for preventive interventions.Materials and Methods:This was community based cross-sectional study conducted among women of urban slums in the age-group of 30-45 years on a voluntary basis. Data were collected by the house-to-house survey using predesigned and pretested proforma World Health Organization-Stepwise Approach to Chronic Disease Risk Factor Surveillance (WHO-STEPS 1 and 2 questionnaires). Descriptive statistics and Chi-square test were used for analysis.Results:Majority, 49% women were in the age-group of 30-35 years, with 60.5% belonging to Class IV socio-economic status. Stress was present in 38% working women as compared to 17% nonworking women (χ2 = 22.12, df = 1, P < 0.0001, HS). Nonworking women (25%) were less aware about common NCDs compared to (48%) working women (χ2 = 22.82, df = 1, P < 0.0001, HS). It was also found that 11% women were newly diagnosed with hypertension.Conclusion:Most of the women were not aware of the risk factors leading to NCDs. Screening and IEC activities need to be strengthened and hence that diagnosis and preventive measures can be implemented at an early stage of life.

Traditional Newborn Care Practices in Home Births among Muslim Women in Urban Slum of Meerut UP

Traditional Newborn Care Practices in Home Births among Muslim Women in Urban Slum of Meerut UP