The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57921

Shivani Taneja¹, Dr. Siddharth Agarwal, MBBS¹, and Eckhard Kleinau, Dr PH, MD². (1) Environment Health Project,USAID-India, Environment Health Project, USAID-India, F-9/4 Poorvi Marg, New-Delhi, 110057, India, (2) Environmental Health ProjectII (EHP), 1611 N. Kent St., Suite 300, Arlington, VA 22209, (703) 247-8730, KleinauEF@EHProject.org

The paper describes a suggested approach to assessing health vulnerability among the urban poor in an Indian city. Between 40%-60% of the Indian population is currently living in slums where they often lack even the most basic health and infrastructure services. Information on maternal and child health indicators among slum-dwellers reveals that their health is 2-3 times worse than "average" urban statistics indicate. It is estimated that agencies are only reaching about 30% of the urban poor, and those reached belong to the comparatively "better off" slums. All slums were identified and mapped; criteria were developed for assessing vulnerability; a mechanism for ranking vulnerable slums on a scale of increasing deprivation emerged. Results: Ilness is one of the most powerful forces pushing low income households into poverty. Key factors which intensify health vulnerability include: economic conditions; social conditions; living environment; access and usage of public health services; health status and disease incidence; collective organised community effort. Of a total of 539 slums identified, 156 were assessed as vulnerable. These were then further categorised into three groups: extremely vulnerable, moderately vulnerable, and marginally vulnerable. Implications: The assessment technique has emerged as a valuable tool for targeting efforts and resources. The extremely and moderately vulnerable slums will be the focus of EHP's interventions. The assessment process involved capacity-building of primary and secondary stakeholders; helped to identify champions; and built ownership of program objectives, which should impact positively on project sustainability.

Learning Objectives:

• The reader will:
• (i) be able to define "health vulnerability"
• (ii) gain an understanding of some factors that predispose certain urban populations to health vulnerability.
• (iii) learn of one participative method for ranking urban poor populations according to selected health vulnerability criteria.

Keywords: Child Health, Urban Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.