Urbanization is increasing rapidly in India, leading to a growth in urban slum populations. Women living in urban slums face numerous health challenges. They have poor access to clean water, sanitation, and healthcare facilities. Social determinants like gender inequality, poverty, and lack of education negatively impact slum women's health. Common health issues for these women include anemia, poor reproductive and maternal health, malnutrition, and infectious diseases. Improving living conditions, empowering women, and ensuring access to medical services are needed to address the many health issues faced by women in India's urban slums.

1. URBAN SLUM WOMEN HEALTH
ISSUES AND CHALLENGES
Dr . Shaila Parveen
Associate professor
Department of social work
M.G.K.V.P. Varanasi

2. “ WOMEN HOLD UP HALF THE
SKY”
DOES NOT APPEAR TO GIVE
THEM A POSITION OF DIGNITY
AND EQUALITY.

4. 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

5. 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

6. 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

7.  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

9. 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

10. CONSEQUENCES
 Overcrowding
 Mushrooming of slums
 Unemployment
 Poverty
 Physical & mental stress
 Family structure- Nuclear families
-Single males

11. 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).

12. 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).

13. THE LIST OF DETERMINANTS OF HEALTH
 Child development
 Gender
 Urban setting
 Employment
 Health system
 Measurement and evidence
 Globalization
 Social exclusion

14. 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.

15.  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.

16. 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

18.  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

19.  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

20. 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

21. 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

22. 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

23. 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

25. 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.

26. 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

27. 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

28. 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.

29. THANK YOU