ISSN: 2456–5474 RNI No.  UPBIL/2016/68367 VOL.- VIII , ISSUE- II March  - 2023
Innovation The Research Concept
Women Health Status of Slum Population in India
Paper Id :  17420   Submission Date :  2023-03-13   Acceptance Date :  2023-03-23   Publication Date :  2023-03-25
This is an open-access research paper/article distributed under the terms of the Creative Commons Attribution 4.0 International, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
For verification of this paper, please visit on http://www.socialresearchfoundation.com/innovation.php#8
Namrata Ahirwar
Research Scholar
Geography Department
G. B. Pant Social Science Institute, Jhusi,
Prayagraj,Uttar Pradesh, India
Abstract
Migration from the countryside to the cities led to a rapid growth of the urban population and slums. People living in slums face problems like overcrowding, poor sanitation, clean drinking water, proper housing, lack of drainage system and disposal of bed sheets etc. Slum dwellers face many health problems due to poor access and availability of health services. Socio-economic and environmental conditions also contribute to the poor health of the slum population. Internal migrants and slum populations are vulnerable in India. Women’s health is affected by a lack of proper food, insufficient nutritious food during pregnancy and breastfeeding, as well as a lack of a balanced diet, long working hours without adequate rest. The purpose of this study was to find out the health status of migrant women in the slums of India and also to find out the most important factors affecting the health of migrant women. This study was conducted to investigate the health status of migrant women living in slums in India. Information is collected from census reports, regional registers, national sample surveys, national family health surveys, international publications, etc.
Keywords Urbanization, Migration, Slum, Women Health.
Introduction
The rapid growth of urbanization and increasing migration from rural areas has contributed to the growth of slums in every city, not only in India but across the world. The urban population of India is about 38 (2011) and is now becoming the fastest growing province in the world. Urbanization is also increasing. The data shows that there is variation in India’s level of urbanization across states. Some states such as Bihar, Himanchal Pradesh and Assam have low levels of urbanization, while Goa, Kerala, Tamil Nadu and Maharashtra have high levels of urbanization compared to the national level. According to the 2011 census, migration is one of the most important factors in India’s urbanization process. Problems associated with urbanization include: flooding, overcrowding, slums, crime, overcrowding and poverty, high population density, inadequate infrastructure, lack of affordable housing. The slums of any city are the result of its environment, level of development and location characteristics. Highly industrialized cities have the most slums. The rapid growth of cities without the necessary development of urban infrastructure led to slums. These are neglected neighborhoods where living conditions are very poor. The number of urban poor is increasing in many cities in developing countries. Rural-urban migration has been found to be an important factor in urban growth in developing countries, and most people agree that both rural and urban pull factors are responsible for this phenomenon. The urban poor mostly refers to people living in cramped and dilapidated spaces, improperly arranged, with inadequate ventilation, lighting, and sanitation, or a combination of other factors detrimental to safety, health, and morals. Living conditions for people without basic services such as safe and adequate water supply, sanitation and drainage and toilets were precarious and bad for the health, safety and comfort of such communities. The needs and priorities of the urban poor appear to be hierarchical. First they needed permission to stay there, to secure land and housing, and then basic amenities such as toilet, water supply, sewage and drainage etc. A slum seems to be generally defined as an area where housing is of such poor quality as to be injurious to safety, health or morals.” – R.E. Murphy. It is a result of rapid urbanization, industrialization, poverty, rural unemployment, urban attraction, housing shortage, urban pollution, crisis in government efforts, etc. Urbanization is a process that refers to the movement of population from rural to urban areas. Economic activity, economic development, industrialization and demographically etc. Urbanization means a redistribution of population from rural areas to cities. The process of urbanization can vary from country to country. In this process, the rural population migrates to the city. Migration refers to geographic movement between geographic units, usually accompanied by a change of residence.” – U.N.O. There are many causes of migration. These are often grouped under the broad heads of push and pull factors. Forces that tend to push an individual away from a particular location are called push factors , and forces that tend to pull a person to another place are called pull factors. The health status of women is very important because the health of children depends on the health of the woman. Socio-economic and environmental. Effect the conditions of slums cause poor health of women living in slums. Common factors in slum areas are lack of sustainable housing, inadequate housing, and low socio-economic conditions of the majority of the population, unhealthy environment, limited health services, and poverty. Due to the reasons mentioned above, the health status of the slum dwellers is very bad. The situation of women and children is the most vulnerable. It is true that city dwellers have better access and availability of health services due to a better developed health infrastructure, which is more evident in large cities. But it is equally true that the availability and quality of these services varies greatly between and within cities. The situation worsens in terms of women’s health and especially reproductive health. Living in unsanitary, unhealthy conditions in slums with low education levels, the low social status associated with slum living negatively affects their health and reproductive health problems, as well as lower treatment rates and thus a higher disease burden.
Objective of study
1. To know the maternal health status of migrant women in the slums of India and also Identify the main factors that affect the heath status of migrant women.
Review of Literature

This section presents a detailed review of the literature.

In his study, Harpham (2008) examined how the economic, social, environmental, and health service factors impact the health of urban poor people. Low socioeconomic status contributes to a variety of health-related issues. According to Almeida LM and Caldas JP's (2013) research, migrating women have varying perspectives on possible barriers to obtaining healthcare services, most of which are based on personal experiences. In their study, Kumar et al. (2009) focused on how little maternity care services are really used. About 50% of pregnant women in the lowest quintile do not obtain IFA pills, and 75% do not receive additional nutrition through Anganwadi. Several relevant difficulties were raised, such as the lack of knowledge regarding the supplemental nourishment provided by Anganwadi centers. The lack of knowledge regarding the supplemental nutrition provided by Anganwadi centers despite its accessibility is one of the connected difficulties that came up. Reddy (2014) noted the significance of maternal health in the context of India. Maternal mortality is high in India, and one-third of women have some form of reproductive health issue. Due to bigger families, more frequent births, poverty, and illiteracy, this issue is considerably more concerning for slum women. According to M.Thamilarasan (2016), maternal deaths make about 15% of all deaths among women who are fertile. Sepsis, anemia, and hemorrhage are the main causes of maternal fatalities. Prenatal and postpartum care is typically unavailable to older women, women from isolated tribes, uneducated women, and women with modest incomes.

Methodology
This study is mainly based on secondary data collected from Census of India 2001 and 2011, regional data, national sample survey, health surveys, international and national publications etc. To understand the reality, slum development reports of government agencies were studied. The data is collected in different states of India.
Result and Discussion

 Different organizations define “slum” in different ways. A slum is defined as an urban area characterized by unplanned growth, poor buildings, poor sanitation and high population density. Although their characteristics vary from geographical region to region, they are usually inhabited by very poor or socially disadvantaged people. Most slums lack clean water, electricity, sanitation and other basic services. According to the UN organization UN-HABITAT, a slum is an area that combines the following characteristics to varying degrees: insufficient access to clean water; inadequate access to sanitation and other infrastructure; poor construction quality of the apartment; overcrowding; and uncertain residential status. Slums are typically characterized by urban decay, high levels of poverty, illiteracy and unemployment. According to Section 3 of the Slum Improvement and Elimination Act of 1956, slums are primarily residential areas where apartments are not suitable for human habitation due to decay, overcrowding, improper layout and design of buildings and narrowness. Or improper street design, lack of ventilation, lighting, sanitation or a combination of these factors detrimental to safety, health and morals.

 Khan et al. (2008) slums are spatial manifestations of urban poverty, social exclusion and inappropriate government policies and are often characterized by one or more of these disadvantages: dilapidated or poorly built houses that are overcrowded, precarious management, poor environmental management such as inadequate access.  For clean drinking water and sanitation, stagnant water and poor drainage with open sewers, excessive amounts of uncollected garbage, overcrowding, flies and poor lighting.  According to R.E Dickinson, “Slum indicates an exceedingly light-filled space where the dwelling is so unfit to be an instrument of the health and morals of the community.

 Urbanization, industrialization, higher productivity of the secondary/tertiary sector compared to the primary sector make cities centers of economic growth and jobs. Cities act as beacons for rural people because they represent a higher standard of living and offer people opportunities that are not available in rural areas. This leads to large-scale migration from rural areas to cities. The negative consequences of urban attractiveness lead to slums characterized by a lack of housing and a critical lack of public services, overcrowding, unhealthy conditions, etc.

Table 1. Percent Urbanization & Slum Concentration, in Indian states/territories, 2001

Name of the States/Union territories

Percent Urbanization

Slum Concentration

Maharashtra

42.4

26.3

Andhra Pradesh

27.3

12.2

Uttar Pradesh

20.8

10.3

West Bengal

28.0

9.7

Tamil Nadu

44.0

6.7

Madhya Pradesh

26.5

5.7

Delhi

93.2

4.8

Gujarat

37.4

4.4

Haryana

28.9

3.3

Kartnakta

34.0

3.3

Rajasthan

23.4

3.0

Punjab

33.9

2.7

Chhattisgarh

20.1

1.9

Orissa

15.0

1.5

Bihar

10.5

1.3

Jharkhand

22.2

0.7

J&K

24.8

0.6

Uttrakhand

25.7

0.5

Chandigarh

89.8

0.3

Meghalaya

19.6

0.2

Assam

12.9

0.2

Pondicherry

66.6

0.2

Karla

26.0

0.2

Tripura

17.1

0.1

A & N Island

32.6

0.0

Goa

49.8

0.0

Total

27.8

100.0

Source: Census of India, 2001

Between 2001 and 2011, urbanization increased more quickly. According to the census, between 2001 and 2011, there were 377 million people living in urban areas, representing a 2.76 percent annual growth rate. Overall, the country's urbanization grew from 27.7% in 2001 to 31.1% in 2011—a rise of 3.3 percentage points from 2001 to 2011 compared to a rise of 2.1 percentage points from 1991 to 2001. Urban population growth includes the natural rise, net rural-urban categorization, and rural-to-urban migration. The pattern of urbanization at the state level varies greatly, although economically developed states often exhibit greater rates of urbanization. ( Bhagat,2011).

Reproductive-related deaths and illnesses are highest among poor women worldwide, and especially among women in developing countries. About a third of the total burden of disease  among women aged 15-44 in  developing countries is related to health problems caused by pregnancy, childbirth, abortion and genital infections (World Bank, 1993). Reproductive health is described by several indicators such as total birth rate, contraceptives, antenatal care and delivery practices, etc. Unsanitary, unhygienic and cramped living conditions in slums negatively affect the health of residents in general and the reproductive health of women in particular (Khanam 2016). Maternal deaths would result due to inadequate prenatal, delivery and postnatal care services, which would represent disparities in the accessibility and availabilities of these health care services. despite having many maternal health program India still high maternal mortality. Antenatal care services, delivery, and postnatal care (PNC) services are all related to maternal health care services, which includes the wellbeing of women during pregnancy, childbirth, and after delivery.

Socioeconomic and demographic variables are highly significant and consistent predictors of health-related behaviors among Indian women (Mahpatro, 2012). Variables measuring the socio-economic status of the respondent include female education (illiterate, primary, secondary and higher education), male education (illiterate, primary, secondary and higher education), women’s current employment status (not working and working), husband’s employment. Status (not working and working), Economic status of household (poorest, poorest, middle, richest, richest), caste (SC, ST, OBC etc.), age of women, order of birth, place of residence (city vs. rural). Several literatures have emphasized the health status of migrant women. The health status of migrant women depends on socio-economic conditions such as place of residence, religious standard of living, and economic status of the household and caste system.   

Conclusion
After the migration, people could not feel comfortable in the urban system and vulnerable in the new environment. Vulnerability – the state of being exposed to or susceptible to neglect or abuse. Immigrants are disadvantaged in terms of healthcare and other services compared to the native population. Poverty and livelihood insecurity are crucial among migrants due to the high cost of services and cash used in cities. Migrant women living in urban slums need special attention for access to basic services, including health services that ensure their physical and mental well-being, regardless of their place of residence (a registered slum is not required in slums). Some studies on immigration and social, economic and health related behavior of immigrant women in different states of India. It provides information on the health vulnerabilities of migrant women in accessing social and economic benefits and services. The poor socioeconomic status of immigrants was reflected in the lack of basic health services in Indian slums.
References
1. Almeida, Ligia Moreira, and Jose Peixoto Caldas. "Migration and maternal health: experiences of Brazilian women in Portugal." Revista Brasileira de Saúde Materno Infantil 13 (2013): 309-316. Gupta, (2015). Health Status and Sccess to Health Services in Indian Slum. Scientific Research Publishing , 236-255. 2. Bhagat, R. B. (2011). Emerging Pattern of Urbanisation in India. Economic 10 & Political Weekly , vol xlvI no 34,12-13. Bang R. (2010). Putting Women First.Mandira Sen for Stree, New Delhi. 3. Khanam, S. (2016). Reproductive Health of Women in Indian Slums:An Overview. International Journal of Advanced Research in Management and Social Sciences , Vol. 5 | No. 2 |. 4. Kumar, R. (2013). Urban poor women do not increase their diet during pregnancy: A study from an urban resettlement colony in Delhi, India. International Journal of Medicine and Public Health 5. Harpham, Trudy. "The measurement of community social capital through surveys." Social capital and health (2008): 51-62., 3 (3). 6. Kumar, Kalle Anand, et al. "Chronic maternal vitamin B12 restriction induced changes in body composition & glucose metabolism in the Wistar rat offspring are partly correctable by rehabilitation." PLoS One 9.11 (2014): e112991. 7. Haque1, M. (2014). Nutritional Status of Women Dwelling in Urban Slum Area. Journal of Nutritional Health & Food Engineering , Vol.3 (4), DOI: 10.15406/jnhfe.2014.01.00014. 8. Micheal A. & Koening, S. (2008). Reproductive Health in India. New Delhi, India: Rawat Publication. Mukharji, s. (2013). Migration in india. New delhi: Rawat publications. 9. Mitra, A. (2010). Migration, Livelihood and Well-being: Evidence from Indian City Slums. Urban Studies (47(7),DOI: 10.1177/0042098009353621. 10. Prakash V. & Kotecha, S. (2012). Health seeking behavior and utilization of health services by pregnant mothers in Vadodara slums. Volume 3 (Issue 1). 11. Baru, A. (2010). Inequities in Access to Health Services in India: Caste, Class and Region. Economic & Political Weekly , vol xlv no 38.