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 Table of Contents    
ORIGINAL ARTICLE  
Year : 2019  |  Volume : 44  |  Issue : 4  |  Page : 313-316
 

A cross-sectional study to assess reproductive and child health profile of working women residing in urban slums of Rajkot city


1 Department of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
2 Department of PSM, GMERS Medical College, Gandhinagar, Gujarat, India
3 Department of PSM, GMERS Medical College, Junagath, Gujarat, India
4 Department of Epidemiology, ICMR National Jalma Institute of Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India

Date of Submission06-Nov-2018
Date of Acceptance16-Sep-2019
Date of Web Publication12-Nov-2019

Correspondence Address:
Dr. Ankit Prabhubhai Viramgami
Department of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcm.IJCM_332_18

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   Abstract 


Context: In India, people residing in slum are not able to get safe food, drinking water, and shelter. Special vulnerable group such as women and children are at higher risk for infectious- and nutritional-related problems. Because of the dual responsibility of working women for her family and job, chances are always higher that the reproductive and child health (RCH) of such families are compromised.
Aims: The aim of this study is to assess RCH profile of working women residing in slums.
Subjects and Methods: A community-based cross-sectional observational study was carried out among slums of Rajkot city. With the usage of simple random sampling technique and informed verbal consent for the study, a total of 480 working and nonworking women were enrolled in this study. Semi-closed prestandardized questionnaire was used to capture their sociodemographic, reproductive health, and child health parameters. The World Health Organization growth standard was used to categorize the nutritional status of their children.
Results: Age of marriage and first conception were significantly delayed among working women. Only 37.8%working women had adequate birth spacing between two children. About 33.3% had received adequate antenatal care (ANC) services during pregnancy. Higher prevalence of malnutrition (65.2%) and lower prevalence of full immunization (39.4%) were found among children of working women.
Conclusions: Low birth spacing, lower utilization of ANC care services, higher malnutrition, and poor immunization coverage among working women had indicated underutilization of RCH services by working women of slum.


Keywords: Child malnutrition, reproductive health, urban slum, working women


How to cite this article:
Viramgami AP, Verma PB, Vala MC, Sharma S. A cross-sectional study to assess reproductive and child health profile of working women residing in urban slums of Rajkot city. Indian J Community Med 2019;44:313-6

How to cite this URL:
Viramgami AP, Verma PB, Vala MC, Sharma S. A cross-sectional study to assess reproductive and child health profile of working women residing in urban slums of Rajkot city. Indian J Community Med [serial online] 2019 [cited 2019 Dec 14];44:313-6. Available from: http://www.ijcm.org.in/text.asp?2019/44/4/313/270805





   Introduction Top


In the past few decades, India has shown enormous growth in the field of industrialization and it has provided plenty of job opportunities in urban industrial areas. Most of the industrial areas are adjoined to cities and which is one of the key reasons for the migration of people from rural to urban areas in search of job opportunity and prosperous life. However with limited resources in terms of land and other environmental resources, major proportion of poor migratory people accommodate their self into small dwellings where water-, food-, and shelter-related hygiene and sanitation parameters are compromised, these settlements on gradual expansion results in slums. Lack of basic amenities such as safe drinking water, proper housing, drainage, and excreta disposal make this population vulnerable to infections which further compromises the nutrition of those living in the slums.[1] Studies have shown children and women residing in slums were facing various health problems related to reproductive health and nutrition.[1],[2],[3],[4],[5],[6] Furthermore, studies have reported health-care access for various reproductive and child health (RCH) care services were poor among slum dwellers.[7],[8],[9],[10] In the case of working women of slum because of dual responsibility of family as well as work, high possibility that health of women and their children influenced by her working status. As very limited studies available in this context, the present study was planned with the following objectives: (1) To find out relation of women's work status with RCH profile of slum community. (2) To study RCH services utilization among working women.


   Subjects and Methods Top


A cross-sectional community-based observational study was carried out using multi-stage sampling method among working and nonworking women residing in urban slums of Rajkot city. For planning purpose, city is divided into three main zones which further divided into a total of 23 wards and almost all wards have slum areas (total 84 identified slums). With simple random sampling, we had selected 10 wards which were equitably represent zone population. From slum areas of ward, random selection of households was carried out for the study participants. After getting informed verbal consent for the study, youngest mother of household was interviewed through pretested semi-structured questionnaire which incorporates sociodemographic, job details, health services utilization, RCH, etc. A total of 480 married women of reproductive age group were interviewed. Modified Prasad socioeconomic classification was used with considering consumer price index 194.66 as value.[11] Precalibrated Salter's scale was used to measure weight of the child with minimal clothing and 0.1 Kg accuracy. Similarly, with standard technique, height/length of the child was measured through nonstretchable measure tape with 0.1 cm accuracy. The World Health Organization growth standard (weight for age) was used to categorize nutrition status of the child.[12] IMNCI guideline was used to assess adequacy of food consumed by child.[13] Data entry and statistical analysis were carried out using Epi-Info software (version: 7.1.0.6, Centers for Disease Control and Prevention, Atlanta, Georgia, US).


   Results Top


From a total of 480 study participants, working women were 66 (13.8%) as shown in [Table 1]. Nearly, 73% of employed women were working for 3–6 h a day. Major proportion of working women was from joint (45.5%) and three-generation family (31.8%). The higher proportion of working women was from the age group of 26–30 years (65.1%) and majority of working women were illiterate (30.3%). No significant difference observed for socioeconomic class among working and nonworking women, but the same observed for the type of house and toilet facility usage. Age at the time of marriage and first conception were significantly higher among working women (P < 0.05) [Table 2]. History of miscarriage was higher among working women (18.2%) compared to nonworking women. It was found that 72.2% working women had <36 months of birth spacing between two children. Inadequate antenatal care (ANC) (66.7%) and low birthweight child (36.5%) were more common among working women in comparison to nonworking women. The significant higher proportion of mother (81.8%) had early initiated complementary food for her child (P< 0.0001). The study has found higher proportion of underweight children (65.2%) to working women in comparison to nonworking women (55.1%). In case of working women, dietary intake of 59.1% of children was inadequate and only 39.4% children were fully immunized.
Table 1: Basic sociodemographic profile of participants

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Table 2: Reproductive and child health-related variables of participants

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   Discussion Top


Results of the study have shown that 30% of working women residing in slum have not even received primary education. Nearly 86% of working women were from lower socioeconomic class and toilet facility were not accessed by 21% of working women. Delayed age of marriage along with delayed first conception among working women were good indications for family planning services. However, total number of children to working and nonworking women were not differing significantly, which indicates the requirement of promotion of modern family planning methods for both groups. Minimal birth spacing, underutilization of ANC services, and inadequate rest because of her dual responsibility of job as well as family may be the possible explanation for higher miscarriage and low birthweight children to working mother. Lower utilization of ANC services was also shown in the study of Hazarika[9] Devasenapathy et al.[10] Mukesh et al.,[14] and Kumar and Bharadwaj[15] Higher prevalence of malnutrition and poor vaccination coverage among children of working women were suggestive of requirement of focused intervention for nutrition and immunization among this vulnerable group through health system. Similar results regarding malnutrition, immunization, and underutilization of health services were shown by different studies carried out at Rajkot, Jamnagar, and Mumbai.[16],[17],[18] Lower utilization of family planning services was also shown in the study of Hazarika[9] and Devasenapathy et al.[10]


   Conclusion Top


Our study to evaluate the effects of “working status” of women on reproductive and child health, demonstrated certain advantages such as delay in the age of marriage, age of first conception, birth spacing and improved immunization, while certain disadvantages such as inadequate antenatal care, early initiation of complimentary feeding ansd malnourished children. The study recommends to improve the ease of access to antenatal care, anganwadi services and provide support to working nursing mothers at the proximity of workplace.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Ghosh S, Shah D. Nutritional problems in urban slum children. Environmental health project, special article series. Indian Paediatr 2004;41:682-96.  Back to cited text no. 1
    
2.
Garg SK. Nutritional status of children in slums of Gaziabad. Ind J Com Med 1997;212:60-2.  Back to cited text no. 2
    
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Yadav SK, Angolkar M, Chaudhary K, Jha D. Prevalence of Malnutrition among under five children of Rukmini nagar, Belagavi – A cross sectional study. International Journal of Health Sciences & Research. 2015;5:462-65.  Back to cited text no. 3
    
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Kotwal N, Gupta N, Manhas S. Impact of work and environment on women living in Urban Slums of Jammu city. Stud Home Community Sci 2008;2:93-7.  Back to cited text no. 4
    
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Pandit M, Nagarkar A. Determinants of Reproductive Tract Infections Among Women in Urban Slums of India. Womens Reprod Health 2017;4:106-14.  Back to cited text no. 5
    
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Dwivedi SN, Banerjee N, Yadav OP. Malnutrition among children in an urban Indian slum and its associations. Indian J Matern Child Health 1992;3:79-81.  Back to cited text no. 6
    
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Elizabeth AM, Khan AM, Rashid W. Reproductive health care seeking behavior among urban slum women of Delhi. J Educ Health Promot 2015;4:87.  Back to cited text no. 7
    
8.
Badge VL, Pandey M, Solanki MJ, Shinde RR. A cross-sectional study of migrant women with reference to their antenatal care services utilization and delivery practices in an urban slum of Mumbai. J Family Med Prim Care 2016;5:759-64.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
Hazarika I. Women's reproductive health in slum populations in India: Evidence from NFHS-3. J Urban Health 2010;87:264-77.  Back to cited text no. 9
    
10.
Devasenapathy N, Ghosh Jerath S, Allen E, Sharma S, Shankar AH, Zodpey S, et al. Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante natal and child health care in urban slums) project. BMC Pregnancy Childbirth 2015;15:212.  Back to cited text no. 10
    
11.
Prasad BG. Social classification of Indian families. J Indian Med Assoc 1961;37:250-1.  Back to cited text no. 11
    
12.
World Health Organization. The WHO Child Growth Standard Chart for Weight for Age. Available from: http://www.who.int/childgrowth/standards/weight_for_age/en/. [Last accessed on 2018 Jun 12].  Back to cited text no. 12
    
13.
Ministry of Health & Family Welfare, Govt. of India. Integrated Management of Neonatal and Childhood Illness: Physician Chart Booklet. Ministry of Health & Family Welfare, Govt. of India; 2003. Available from: http://nhm.gov.in/nrhm-components/rmnch-a/child-health-immunization/child-health/guidelines.html. [Last accessed on 2018 Jun 12].  Back to cited text no. 13
    
14.
Mukesh S, Monica A, Imchen T, Rehman HM, Yadav K, Singh S. Utilization of maternal health care services in slums of Lucknow, capital of Uttar Pradesh. Int J Interdiscip Multidiscip Stud 2015;2:23-7.  Back to cited text no. 14
    
15.
Kumar A, Bharadwaj P. To estimate the extent of utilization of maternal health services in the urban slums of Lucknow city Uttar Pradesh. IOSR-JHSS 2016;21:1-6.  Back to cited text no. 15
    
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Banerjee A, Patel U, Verma P, Viramgami A, Vala M. Health status of children under three years of age residing in slums of Rajkot city, Gujarat, India. JMR 2015;1:118-21.  Back to cited text no. 16
    
17.
Damor RD, Pithadia PR, Lodhiya KK, Mehta JP, Yadav SB. A study on assessment of nutritional and immunization status of under-five children in urban slums of Jamnagar city, Gujarat. Healthline 2013;4:35-9.  Back to cited text no. 17
    
18.
Ghane VR, Kumar R. Nutritional status of under five children of Mumbai suburban region. Int J Res Med Sci 2017;5:3190-6.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2]



 

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