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Urban women health and challenges

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Women & Health in India
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Urban women health and challenges

  1. 1. URBAN SLUM WOMEN HEALTH ISSUES AND CHALLENGES Dr . Shaila Parveen Associate professor Department of social work M.G.K.V.P. Varanasi
  2. 2. “ WOMEN HOLD UP HALF THE SKY” DOES NOT APPEAR TO GIVE THEM A POSITION OF DIGNITY AND EQUALITY.
  3. 3. URBANIZATION: TRENDS AND PATTERNS • Movement of people from rural to urban areas with population growth equating to urban migration • A double edged sword • On one hand- Provides people with varied opportunities and scope for economic development • On the other- Exposes community to new threats • Unplanned urban growth is associated with • Environmental degradation • Population demands that go beyond the environmental service capacity, such as drinking water, sanitation, and waste disposal and treatment
  4. 4. Source: UN, Urbanization prospects, the 1999 revision Year Urban Population Total Population in million 1800 2% 140 1950 30% 360 2000 47% 1027 2008 50% 1060 2030 60% 2050 URBANIZATION TRENDS IN INDIA
  5. 5. URBANIZATION: TRENDS AND PATTERNS  331 million people in India live in urban areas (around 30.31% of the population)*  The proportion of urban population in India is increasing consistently over the years  From 11% in 1901 to 26% in 1991 and 28% in 2001 to 30.31% in 2011  Estimated to increase to 357 million in 2011 and to 432 million in 2021*  After independence • 3 times growth - Total population • 5 times growth - Urban population* * Census of India 2011
  6. 6.  4.26 crore people live in slums  A large number of slums are not notified*- around 50%  Urban growth has led to rapid increase in the number of urban poor  In-migration and a floating population has worsened the situation  * NSSO Report No. 486 URBANIZATION: TRENDS AND PATTERNS
  7. 7. MIGRATION -CAUSES  Increased family size-limited agricultural property -Land use Pattern -Irrigation facilities  Better income prospects  Better educational facilities  Better “Life style”  Basic amenities – health, transport,water, electricity.  Victims of natural/manmade calamities- Refugees
  8. 8. CONSEQUENCES  Overcrowding  Mushrooming of slums  Unemployment  Poverty  Physical & mental stress  Family structure- Nuclear families -Single males
  9. 9. According to the World Health Organization, “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. “Good health requires provision of health care for prevention and treatment of disease and injury, good nutrition and a safe environment. The health of populations has many links with other sectors, such as economic, education, water and sanitation and gender” (Health, 2010).
  10. 10. SOCIAL DETERMINANTS OF HEALTH (SDH)  Social Determinants of Health are the conditions in which people live and work, and these conditions affect their opportunities to lead healthy lives. In March 2005, the World Health Organization set up a Commission on the Social Determinants of Health (WHO, 2005).
  11. 11. THE LIST OF DETERMINANTS OF HEALTH  Child development  Gender  Urban setting  Employment  Health system  Measurement and evidence  Globalization  Social exclusion
  12. 12. THE IMPORTANCE OF WOMEN’S HEALTH  Moreover, many believe that the health of families and communities are tied to the health of women. The illness or death of a woman has serious and far reaching consequences for the health of her children, family and community (The Importance of Women’s Health, 2005).  The realities of women's lives remain invisible to men and women a like and this invisibly persist at all level begning from the family to the nation . Although geographically men and women share the same space, they live in different worlds. Sprawling inequalities persist in their access to education, health care ,physical and financial resources and opportunities in the political, economic, social and cultural sphers.
  13. 13.  Finding from the world economic forum indicate that India is one of the worst countries in terms of inequality. The 2014 UNDP human Development Report ranked india135 out of 187 in terms of gender inequality. Gender is one of many social determinants of health which includes Social, Economic and political factors that play a major role in the health outcomes of women in India.
  14. 14. HEALTH ISSUES OF URBAN SLUM WOMEN  Housing: Rapid growth of urban centers has led to substandard housing on marginal land and overcrowding  Clean water : Due to increasing urbanization coupled with existing un- sustainability factors and conventional urban water management  Sanitation/ Hygiene : It exacerbates health risks related to insufficient and poor water supply and poor sanitation systems Nearly 1.1 billion people worldwide who do not have access to clean drinking water and 2.6 billion people i.e. over 400 million people, lack even a simple improved latrine can lead to increased episodes of diarrhea and economic burden  Social Security  HIV/AIDS :Lack of Education ,lack of access to contraceptive such condom
  15. 15.  Access to Health Facilities: Despite the concentration of health-care facilities in urban areas, the access of the urban poor to basic health services is hampered by several factors. The cost of travel may be prohibitive, women may not have anyone to leave young children with and/or slum dwellers may be treated shabbily or overtly discriminated against in health centers. Where free health services are not available, the cost of care may be unaffordable.  Anemia  Reproductive health: As a nation India contribute nearly 20% of all maternal deaths between 1992-2006. It is directly related to socio economic condition and cultural constraints and limiting access to care.  Mal Nutrition: 70% of non pregnant and 75% pregnant women are anemic ( distribution of food.  Mental Health: With the high incidence of depression, anxiety, neurosis psychosomatic disorder, increasing rate of suicides among clearly shows that in keeping of the projections of world mental health report this is emerging as a major causes of morbidity. Lack of privacy leading to depression, anxiety, stress etc
  16. 16.  Marriage & Fertility  Maternal health  Child survival  Family planning  Environmental Conditions, Infectious Diseases and Access to Health Care URBAN SLUM WOMEN’S KEY ELEMENTS OF HEALTH
  17. 17. Indicators Urban Poor Urban Non poor Overall Urban Overall Rural All India Urban Poor NFHS 2 Women age 20-24 married by age 18 years (%) 51.5 21.2 28.1 52.5 44.5 63.9 Women age 20-24 who became mothers before age 18 (%) 25.9 8.3 12.3 26.3 21.7 39.0 Total fertility rate (children per woman) 2.8 1.8 2.1 3.0 2.7 3.8 Higher order births (3+ births) (%) 28.6 11.4 16.3 28.1 25.1 29.5 Birth Interval (median number of months between current and previous birth) 29.0 33.0 32.0 30.8 31.1 31.0 MARRIAGE & FERTILITY INDICATORS OF URBAN POOR IN INDIA: NFHS 3
  18. 18. Indicators Urban Poor Urban Non Poor Overall Urban Overall Rural All India Urban Poor NFHS 2 Mothers who had at least 3 antenatal care visits (%) 54.3 83.1 74.7 43.7 52.0 49.6 Mothers who consumed IFA for 90 days or more (%) 18.5 41.8 34.8 18.8 23.1 47.0 Mothers who received tetanus toxoid vaccines (minimum of 2) (%) 75.8 90.7 86.4 72.6 76.3 70.0 Mothers who received complete ANC (%) 11.0 29.5 23.7 10.2 15.0 19.7 Births in health facilities (%) 44.0 78.5 67.4 28.9 38.6 43.5 Births assisted by a doctor/nurse /LHV/ANM/other health personnel (%) 50.7 84.2 73.4 37.4 46.6 53.3 Women age 15-49 with anaemia (%) 58.8 48.5 50.9 57.4 55.3 54.7 MATERNAL HEALTH INDICATORS OF URBAN WOMEN IN INDIA: NFHS 3
  19. 19. FAMILY PLANNING INDICATORS OF URBAN POOR IN INDIA: NFHS 3C Indicators Urban Poor Urban Non Poor Overall Urban Overall Rural All India Urban poor NFHS 2 Any modern method (%) 48.7 58.0 55.8 45.3 48.5 43.0 Spacing method (%) 7.6 19.8 16.9 7.2 10.1 4.6 Permanent sterilization method rate (%) 41.1 38.2 38.9 38.1 38.3 38.4 Total unmet need (%) 14.1 8.3 10.0 14.6 13.2 16.7 Unmet need for spacing (%) 5.7 4.1 4.5 6.9 6.2 8.5 Unmet need for limiting (%) 8.4 4.2 5.2 7.2 6.6 8.2
  20. 20. Indicators Urban Poor Urban Non Poor Overall Urban Overall Rural All India Urban poor NFHS 2 Households with access to piped water supply at home (%) 18.5 62.2 50.7 11.8 24.5 13.2 Households accessing public tap / hand pump for drinking water (%) 72.4 30.7 41.6 69.3 42.0 72.4 Household using a sanitary facility for the disposal of excreta (flush / pit toilet) (%) 47.2 95.9 83.2 26.0 44.7 40.5 Prevalence of medically treated TB (per 100,000 persons) 461 258 307 469 418 535 Women (age 15-49) who have heard of AIDS 63.4 89.1 83.2 50.0 60.9 42.1 Prevalence of HIV among adult population (age 15-49) 0.47 0.31 0.35 0.25 0.28 na Children under age six living in enumeration areas covered by an AWC (%) 53.3 49.1 50.4 91.6 81.1 na Women who had at least one contact with a health worker in the last three months (%) 10.1 5.8 6.8 14.2 11.8 16.7 Environmental Condition, Infectious Diseases and access to Health Care in Urban Poor : NFHS 3
  21. 21. SOCIAL DETERMINANTS WHICH EFFECTS WOMEN HEALTH Preference to son  Female feticide  Once born daughters are prone to being fed less than sons.  In adulthood many barriers prevent them from achieving equitable level of health  Superior rights to men. Under reporting of illness  lesser visits to doctors.  Of all health workers in country nearly 23 are men  only 6% female doctors.
  22. 22. CRIME ASSOCIATED WITH WOMEN HEALTH  Female feticide  Rape  Incest  Sexual harassment  Child sexual abuse  Importation of girls /Trafficking  Kidnapping  Dowry related murder  Acid attacks  Domestic violence  Suicide
  23. 23. SUGGESTION  Empowerment Measures  Improving Living Conditions  Popularizing Regular Medical Checkups  Cluster Services & Child Care Centers:  Elimination of Gender Disparities:  Bringing Convergence:  Access to Safe & Legal Abortions  Redefining Standards
  24. 24. WHO, the Indian government and health/municipal authorities, women’s organizations, the NGOs, and the community groups need to work in tandem. More importantly, men and women need to become aware of the equality of sexes and need to respect the same. Both sexes need to learn how to live in co-operation and harmony, which is often difficult to secure in traditionally very patriarchal parts of the world.
  25. 25. THANK YOU

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