A2.1: Kumar Das & Prachi Salve: Inequality and its Impact on Health Among Urban Children – The Case of Mumbai, India

Inequality and Its Impact on Health among Urban Children – The Case of Mumbai, India

Presentation Document – 9th June, 2014

Kumar Das and Prachi SalveIDS-UNICEF Conference, 2014

Session A2: Health and Nutrition Presentation: 1

Summary

• The paper will discuss the impact of inequality on child’s health• The paper will especially look at the migrant informal sector workers to highlight the vulnerability that their

children face due to migrant status of their parents.

Objectives

• Inequality and Its Impact on Health among Urban Children – The Case of Mumbai, India

Theme

• Children don’t have access to health services and this has resulted to increasing number of preventable diseases.

Implications

India: Growing Cities - Mumbai

- Cities are drivers of economic growth. Concentrations of people and investment, high levels of exchange, economies of scale and proximity, can all contribute to vitality and development. The city if Mumbai alone is responsible for 25% of industrial output, 70% of maritime trade in India and 70% of capital transactions to the nation’s economy

- India’s rapid industrialization, recurring famines, droughts, and crop failures have spurred large scale migration to Urban areas – Mumbai

- The Study in concentrated on Construction Workers – who migrated from Other Indian States and trying to fill the gap by sketching the profile of migrant worker and assess their vulnerabilities (Children Health)

Migrant Labour – Nature and Condition

- Family condition is one of the main factors - In our study we found that most migrant construction workers seem to be migrating to Mumbai with their family

- The average income is 6000 INR/Per Month

- More than half the workers we interviewed live at their work places (43% of the workers live in Kaccha houses)

- 54% do not have any toilet facilities

- Women and Children are most vulnerable among the migrant families

- When we interviewed the migrant workers, we observed that the children and women are not able to get the basic health services through the existing service delivery

Barrier to Access

- Concentration of Health Services in an small number of areas

- Parents (most often mothers) from bringing their children to Health Clinics for treatment of illness, immunization, or routine check- ups. Clinic hours often coincide with working ‐hours.

- Often times specific urban slum - dwelling communities hold strong traditional and/or religious beliefs against immunization, or do not understand the benefits of immunization and health in general

- 15.71 % Children opt for Anganwadi. They live on the construction sites itself and hence do not have access to Anganwadi. Parents also said that there was nobody to who could drop or pick up the children from the Anganwadi as construction sites are far from communities where Anganwadi is located

- Language is also another major barriers

Health Status of Children and Implications

- Only 68% Children are fully immunized (6 vaccine preventable diseases – Tuberculosis, Polio, Tetanus, Whooping cough, Diphtheria, and Measles)

- Only 15.71% Children are covered by the AWC – Though they don’t opt for AWC, the children are not able to avail the existing services (i.e. the mid meal scheme, Take Home Ration). Leading to Low Nutritional Status

- 26.5% children have birth Certificate

- Over 90% children faced diarrhea within last six months. Due to hygiene and sanitation condition

- Overall 60% Children are anemic

“There is no work here. We get sick and we have no money to obtain care, not to mention the fact that medicines are too expensive. We have nothing to eat. Everything is so expensive.” - Ramavati Devi, Construction Worker – Mumbai.

- Children’s health is related to Standard of Living

Observation:

- Lack of Awareness among parents

- Inability to Access basis health services – due to lack of identifications

- The study highlights other things about the lives of migrant construction workers that none of the current policies even begin to address. For example, the living conditions on construction sites and more importantly the conditions in which the children have to live in.

Conclusion:

- Community Mobilisation on basis health and WASH issues

- Comprehensive migration policy that has a holistic approach to address the problems of migrant workers