Diarrhoea and acute respiratory infections among under-five children in slums: Evidence from India

Abstract

Background: In the wake of burgeoning slum population, a substantial reduction in the prevalence of diarrhea and acute respiratory infections (ARI) is necessary for to achieve necessary reduction in child mortality in urban India. To achieve this, we need evidence based public health interventions and programs. However, a review of previous studies indicate that national level studies focused on slum population are very few. Therefore, the present study aims to study differentials and determinants of diarrhea and ARI in urban slums of India. Methodology: Using data obtained from the third round of National Family Health Survey conducted in 2005-06, we analyzed information on 2687 under-5 children living in urban slums located in eight selected India cities. Apart from bivariate analysis, logistic regression analysis was performed to identify factor associated with diarrhea and ARI among slum children. Results: The prevalence diarrhea and ARI is about 8% and 8.5%, respectively. Age, birth weight, access to safe water and improved toilet and region emerge as main factors affecting prevalence of diarrhea among slum children. Safe drinking water reduces the likelihood of getting diarrhea by about 19% compared to unsafe water [CI=0.563-1.151].Children with normal birth are about 51% less likely to suffer from diarrhea compared to those with unknown birth weight [CI=0. 368-0.814]. Older children are about 63% less likely to suffer from diarrhea [CI=0. 274-0.502]. Children from Southern cities are about half as likely to have diarrhea as children from slums in Northern cities. ARI is associated with age, birth weight, religion, caste, education, family type, safe water, improved toilet, mass-media exposure, region and separate kitchen. Older children and children with normal birth weight are less likely to suffer from ARI. Children from 'Other' religions and OBC are 39% [CI=1.000- The growth of urban slums is often considered a reflection of the urbanization of poverty and misery [Jorgenson and Rice 2012]. Slum populations often suffer multiple deprivations such as inadequate water supply, poor environmental sanitation, poor air quality and lack of waste disposal system, inadequate housing causing overcrowding and poor ventilation, overburdened healthcare services and public transport systems, and erratic electricity supply [UNHABITAT 2006]. Together these deprivations pose a significant threat to the health and well-being of people, especially of children, living in slums [Barlett 2003;Kundu and Kanitkar 2002;Karn et al. 2003]. For instance, higher under-5 mortality in slums compared to non-slum urban areas is mainly attributed to poor living conditions and hazardous environment prevalent in slums [Günther and Harttgen, 2012;Moore et al. 2003;Vaid et al. 2007]. Thus, slums may prove to be an important entry point in the effort to achieve Millennium Development Goals-4 (MDG-4) in cities [UNHABITAT 2006].However, the achievement of targets such as MDG-4 and recently announced GAPPD (Global Action Plan for Pneumonia an...

Rural-urban differentials in the prevalence of diarrhoea among older adults in India: Evidence from Longitudinal Ageing Study in India, 2017–18

“…Generally, the incidence of diarrhoea remains a tremendous burden on population from low- and middle-income countries due to multiple determinants such as low socioeconomic status, lack of safe drinking water, inadequate sanitation, poor hygiene and crowding but the present study contradicts the existing literature and shows that the odds of older adults suffering from diarrhoea is higher among those who belonged to a richer section of the population [ 38 , 45 ]. Probable explanations for this finding could be: 1) A high prevalence of diabetes among older adults, in general and those belonging to high Socio Economic Status [ 46 – 48 ] and because diabetic diarrheoa is a major gastrointestinal discomfort [ 49 , 50 ], older adults belonging to the richer section may have a high prevalence of diarrhoea.…”