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At least 19 recordsLinked to original sources
PubMed2002

HIV/AIDS perceptions and risky behaviors in squatter areas in Cairo, Egypt.

UNLABELLED: The aim of this work was to assess HIV/AIDS perceptions and risky behaviors of adults living in squatter areas in order to take decisions about the relevant messages and health education methods that should be used to prevent HIV transmission in the studied communities. Two methods were used to collect data in this cross sectional study, focus group discussion and structured interview. The study was carried out in six squatter areas in Cairo, four of them located in west Cairo and two in east Cairo. RESULTS: 237 community members and community leaders shared in the study, 44.7% were males and 55.3% females, 64.1% were married and 34% single. Community members represented two-thirds of the sample while one-third were community leaders. Participants expressed strong eagerness to know more about HIV/AIDS. Poor knowledge and misconception about HIV/AIDS was remarkable. The study revealed several misconceptions regarding modes of transmission and preventive measures that could be used to protect oneself from HIV/AIDS. Heterosexual extramarital relationships and i.v. drug transmission were the HIV/AIDS risky behaviors considered to be prevalent in these communities. AIDS risky behaviors appear to be more prevalent in the four squatter areas in west Cairo than in the two squatter areas located in east Cairo. Adolescents were considered at high risk of contracting AIDS because of the risky behaviors they practice. Social non-acceptance of females who practice HIV/AIDS risky behaviors is much stronger than non-acceptance of males who practice the same risky behaviors. TV movies were the main source of information about HIV/AIDS. Parents played no role in providing adolescents with information about AIDS. The possible role of teachers in HIV/AIDS education is unclear because of the negative attitude of people towards teachers.

Adolescent↗
PubMed1990

Childhood vaccination in a squatter area of Manila: coverage and providers.

In 1988 a vaccination coverage cluster survey was performed in a squatter area of Manila, Philippines. 24% of the surveyed children (aged 1-2 years) were fully immunized and 19% not immunized. 60% of the children were vaccinated through private organization. The dropout rates of these children were significantly lower than those of the children vaccinated through governmental agencies. This suggests that services have to be provided by agencies that are based in the squatter area. Efforts for improved coverage should focus on lowering the high dropout rates and strengthening coordination between the governmental and the various private health agencies that provide vaccination service in this squatter area. The survey also indicated approaches to strengthening collaboration between different service providers.

Child Health Services↗
PubMed2006

Distribution and circumstances of injuries in squatter settlements of Karachi, Pakistan.

OBJECTIVES: This research was conducted to study incidence, distribution, type, causes, severity and circumstances of injuries among people living in squatter settlements in Karachi, Pakistan. METHODS: Trained interviewers sought a 2 weeks recall for minor injuries for which no health care was sought, 2 months recall for major injuries for which a health provider was consulted and 1 year recall for hospitalization, disability and death from every third household in five squatter settlements in Karachi between May and August 1995. For understanding the injury circumstances 250 in-depth interviews of the injured or the close relatives were also conducted. RESULTS: Among 1182 households, having 9891 residents, 84 minor, 42 major injury episodes, 7 hospitalizations, 0.6 permanent disabilities and 0.3 deaths per 1000 person years were reported. Including all injury episodes, the common types of injury were cutting or piercing (n = 532), falls (n = 382) and burns (n = 235) estimating to 54, 38 and 23 injury episodes per 1000 person years. Injury mainly resulted from a piece of glass (n = 367), falling from height (n = 98) and knife (n = 97) estimating to 37, 10 and 10 injury episodes per 1000 person years, respectively. Fall (n = 32, 3.2/1000 person years) was the major reason for hospitalizations and all permanent disabilities resulted from closed injuries. Medically trained providers were mostly contacted (n = 339, 34/1000 person years), but traditional healers were preferred in bone injury. CONCLUSION: Injuries are a major cause of morbidity and mortality in Pakistan and the national health and development agenda should include assessment and prevention of injuries.

Adolescent↗
PubMed2002

Impact of improvement of water supply on household economy in a squatter area of Manila.

To estimate the impact of the improvement of water supply. a comparative study on water collection and household expenditure on water was conducted between a former squatter community with an improved water supply (Leveriza: LE) and a typical squatter community with public water faucets (Maestranza: MA) in Manila, the Philippines. Data were collected from 201 structured household interviews and a focus group discussion among housewives in each community. To measure the time spent collecting water, observations of private and public water faucets were conducted. The residents in LE enjoyed significantly larger quantities of water from private water connections than in MA, where only three public water faucets were available as a water source. Conversely, the unit price of water in LE was much lower than in MA. In LE, 72.1% of the households started working for more income using time saved through the improvement of water supply and the proportion of the households under the poverty threshold was reduced from 55.6% to 29.9%. In MA, 68.6% of the households expressed their willingness to work for more income when time spent collecting water was saved. It would be possible for MA to reduce the proportion of the households under the poverty threshold through the improvement of the water supply. The results of the study indicated that the improvement of water supply would possibly encourage urban slum residents to increase their household incomes through reallocating time saved to income-generating activities. The underserved residents spent more money for less water compared to those with access to private water connections. In MA, it took 3-4 h, on average, to complete one water collecting task, even though the nearest public water faucet was within 100 m of any housing unit. This suggests that the definition of accessibility to safe water be reconsidered when discussing the urban poor.

Family Characteristics↗
PubMed1991

The antecedents of adolescent pregnancy in a Brazilian squatter community.

A case-control study among first time pregnant adolescent girls in a squatter community in Recife, Brazil, showed that 46 per cent had already dropped out of school (P less than 0.001) and had a job at the time of their pregnancy (P less than 0.001; RR 5.5). Two-thirds came from single-parent households (P less than 0.001; RR 2.8) with weak supervision at home. There was some indication of modelling effect, in that more pregnant adolescents had mothers who became pregnant before the age of 15, or close family members who were adolescent mothers, but the difference was not statistically significant. By contrast, the peer group effect was significant (P less than 0.05; RR 1.9). More amongst the pregnant adolescents had commenced menarche before age 13, and twice as many compared to controls had started regular dating before that age (P less than 0.05; RR 2.3). There was a striking lack of knowledge concerning menarche, conception and contraception. The implications of the findings for school and health services in squatter communities are discussed. Four main antecedents on the path to parenthood when the adolescent can benefit from counseling are identified.

Adolescent↗
PubMed1997

Ecological determinants of intestinal parasitic infections among pre-school children in an urban squatter settlement of Egypt.

Population growth in Egypt has led to the creation of several urban squatter settlements. The aim of the present work was to study the prevalence and some potential risk factors of intestinal parasitic infections among preschool children in a randomly chosen urban squatter settlement in Alexandria, Egypt. A house to house cross-sectional survey was conducted during late 1995. Data were collected through questionnaire interview regarding socio-demographic and environmental conditions from 1324 families residing in the settlement. Stool samples were collected from 658 preschool children below 5 years of age and examined for intestinal parasites. Overall, the prevalence rates of infections with the intestinal Helminths and Protozoa were 47.3 and 31.5 per cent, respectively, which were very high compared to previously reported figures for this age group in Egypt. Multiple logistic regression analysis showed that certain groups of preschool children were much more likely to develop the infection with both groups of intestinal parasites. They included children over 2 years of age (OR = 2.75, 95 per cent CI = 1.23-4.12 and OR = 2.65, 95 per cent CI = 1.70-3.45 for Helminths and Protozoa, respectively), whose families had pools of sewage around houses (OR = 2.13, 95 per cent CI = 1.22-3.19 and OR = 2.83, 95 per cent CI = 1.45-3.95 for helminths and protozoa, respectively) and shared toilets with another family (OR = 1.95, 95 per cent CI = 1.38-2.75 and OR = 1.65, 95 per cent CI = 1.06-2.58 for Helminths and Protozoa, respectively). In addition, certain groups of children were much likely to develop protozoal infections including children whose families lacked tap water inside dwelling (OR = 1.85, 95 per cent CI = 1.26-2.77) and disposed human excreta in septic tank very close to the dwelling (OR = 2.17, 95 per cent CI = 1.43-3.75). Efforts to reduce intestinal parasites should focus on reducing exposures. Improvement in domestic water supplies with the introduction of piped sewerage system is likely to have a marked decreasing effect on the prevalence of infection among this age group.

Age Distribution↗
PubMed2000

Risk factors for stunting and wasting at age six, twelve and twenty-four months for squatter children of Karachi, Pakistan.

OBJECTIVE: A high proportion of stunting and wasting in children under-five has been reported from developing countries. This paper presents the nutritional status of a two year cohort of urban squatter children in Karachi, Pakistan and assesses risk factors for wasting and stunting at the reference ages of six, twelve and twenty-four months. METHODS: A birth cohort of 738 children were visited at specific intervals by trained nurses to collect information on anthropometric measurements, feeding practices and intercurrent illnesses. Socioeconomic and demographic information included water and sanitation facilities, availability of electricity, type of house construction material and average monthly income. Information about the mother's reproductive history was also obtained. RESULTS: At two years the proportion of stunting and wasting was 41.8% and 10.6% respectively. Intrauterine growth retarded children had a higher risk of stunting and wasting at all reference ages as compared to children who were appropriate for gestational age. In the logistic regression models, intrauterine growth retardation was the only significant risk factor that remained in all models at each reference age. CONCLUSION: The consistent association of IUGR for stunting and wasting adds to the growing body of evidence that by improving maternal health we will ultimately break the vicious cycle of malnourishment and improve the health and well-being of future generations. We suggest interventions to improve the nutritional status of Pakistani urban children living in squatter settlements focused on mothers and children.

Anthropometry↗
PubMed2000

Health care utilization during terminal child illness in squatter settlements of Karachi.

OBJECTIVE: Information on health seeking behavior and health care utilization has important policy implications in health systems development. The paper presents some of the issues related to health care utilization and health seeking behavior in case of terminal child illness in seven squatter settlements of Karachi. METHODS: From seven squatter settlements of Karachi, with a population of 100,000 approximately, we collected information, using pretested structured questionnaire, from the mothers on health care utilization during the final illness of under five children dying during 1995-1996. These deaths were identified from an earlier baseline health and demographic survey in these areas. RESULTS: Interviews were completed for 259 infant and child deaths of which 57% were boys. Of all deaths 72% were taken to a health care provider, of which 82% went as soon as the child got ill. Private sector is the most preferred first choice i.e., 83%. Of all those who had been to a health care provider, 65% were referred to some other place and 72% of them took more than 12 hours altogether to reach the referred facility. Children in older age categories (OR 4.4 95% CI 2.22-8.67 and OR 5.0, 95% CI 2.09-12.31), boys (OR 2.6, 95% CI 1.46-4.77) and those with appropriate or incomplete immunization (OR 4.1, 95% CI 2.13-7.94) were significantly associated with the health care utilization as compared to their counterparts. CONCLUSION: Living in urban areas does not ensure accessibility to effective health care. In poor urban communities, referral to other facility delay the initiation of effective treatment in case of child illness leading to death which could be prevented otherwise. Private sector constitutes an important segment of our health care system, which requires strengthening and back up support. Furthermore, the study finding is suggestive of gender discrimination in health seeking behavior.

Age Distribution↗
PubMed2003

National Polio Day campaign in a squatter settlement through medical students.

OBJECTIVE: To provide maximum polio vaccination coverage to under-five (<5) year children of a squatter settlement through Ziauddin Medical University (ZMU) medical students. SETTING: ZMU has established a Primary Health Care Program in a squatter settlement, which is predominantly inhabited by migrants from North Western Province of Pakistan and Afghanistan. The total population is approximately 20,000 and the proportion of <5 year children is nearly 19%. METHODOLOGY: ZMU started Oral Polio Vaccination (OPV) campaigns from 1996; up to 1999. The OPV campaigns were confined to the National Immunization Days (NIDs). A different strategy of "door-to-door" OPV services by medical students was undertaken in 1997. In December 1999 the polio vaccination coverage of <5-year children was evaluated through duster sampling. This paper describes the steps for improving OPV coverage in Sikanderabad. RESULTS: The estimated number of <5 year children in the area is 4,600. In a duster sample survey after the 1999 NID campaign out of 620 under 5 year children living in 429 households, 529 (85%) received OPV, with a 95% CI for OPV coverage of 82 to 88%. The coverage before the campaigns initiated by ZMU was 52%. CONCLUSION: The results indicate that the polio coverage of <5-year children has risen with the change in strategy. Door-to-door coverage strategy with the help of medical students proved effective in providing vaccination. No case of suspected poliomyelitis has been reported from the area since October 1999.

Child, Preschool↗
PubMed1992

The nutritional situation in metropolitan Kuala Lumpur, with focus on squatters.

Kuala Lumpur is the capital city of Malaysia with an estimated population of 1.55 million. Approximately 12% of the population live in squatter settlements occupying about 7% of the city total area. The squatter settlements generally are provided with basic amenities such as piped water, toilet facilities and electricity. Health indicators for the overall population of Kuala Lumpur are better off than for the rest of the country; however, intra-city differentials prevail along ethnic and socio-economic lines. Malays and Indians have higher rates for stillbirths, and neonatal, infant and toddler mortality than the Chinese. The wide disparity in the socio-economic status between the advantaged and the poor groups in the city is reflected in the dietary practices and nutritional status of young children from these communities. The percentage of preschool children from urban poor households with inadequate intakes of calories and nutrients is two to three times higher than those from the advantaged group. Compared to rural infants, a lower percentage of urban infants are breastfed. A lower percentage of Malays from the urban advantaged group breastfed, compared with the urban poor group. The reversed trend is found for the Chinese community. Growth attainment of young children from the urban poor is worse than the urban advantaged, though better than the rural poor. Health and nutritional practices implications related to both undernutrition and overnutrition are discussed, to illustrate the twin challenges of malnutrition in the city.

Adolescent↗
PubMed2004

Evaluation of the microbial quality of water supplies to municipal, mining and squatter communities in the Bindura urban area of Zimbabwe.

A survey of the microbiological and chemical quality of water supplies in the Bindura urban and peri-urban area was carried out over a three-year period from January 2000 to July 2003. Bindura is the provincial city of Mashonaland Central, situated 88 km from the national capital, Harare. Large-scale farming and mining activities in the area predispose water bodies to eutrophication and chemical pollutants, raising concerns about the safety of local water supplies. In this study, thermotolerant (faecal) coliform levels, total aerobic bacterial counts and physicochemical profiles were determined for municipal and borehole water as well as water supplies to mining and squatter communities. Although municipal and mining compound water supplies were of satisfactory microbial and chemical quality, borehole water supplies showed a seasonal fluctuation, with higher coliform counts in the wet season from November to March. Stream water supplies to a squatter camp in the peri-urban area consistently recorded coliform levels >1,800/100 mL and total aerobic plate counts of <2.8 x 10(6) CFU/mL. All cholera incidents recorded in 1999 and 2000 at the Provincial hospital were from peri-urban settlements and surrounding commercial farms while 1,045 to 2,632 cases of dysentery were also reported each year at the provincial hospital during the period 1997-2002.

Cholera↗
PubMed2005

Risk factors assessment for hypertension in a squatter settlement of Karachi.

OBJECTIVE: To assess the risk factors for hypertension in adults (age more than 15 years) in a squatter settlement of Karachi. METHODS: Cross-sectional survey of adults more than 15 years old in a squatter settlement of Karachi through random sampling method. RESULTS: A total of 327 adults were approached, 165 (50.5%) were males and 162 (49.5%) females. Blood pressure was measured in 63 (38%) males and 135 (83%) females. Out of which, 11 (17.5%) males and 19 (14%) females were screened hypertensive. Hypertensives were older as compared to normotensives (p < 0.001). The mean BMI of hypertensives (25.6 +/- 4.5 kg/m2) was significantly higher (p = 0.008) than normotensives (22.9 +/- 5.0 kg/m2). Hypertensives were 9.7 times more likely to be diabetic as compared to normotensives in this study (p < 0.001). On analyzing the relationship of hypertension with other variables, no significant difference was noticed for education (p = 0.68), smoking status (p = 0.46), family history (p = 0.31) and occupation (p = 0.27). CONCLUSION: Prevention and control of hypertension is essential as the life expectancy is increasing in developing countries as well. The main emphasis according to this study, should be on controlling the BMI through weight reduction and regular exercise. Awareness about the risk factors for hypertension among the population is required to decrease the double burden on the society.

Adolescent↗
PubMed1992

Prevalence of malnutrition among children in an urban squatter settlement in Petaling Jaya.

In a study of mild to significant malnutrition in an urban squatter settlement, the weights for age of 297 children between birth and ten years, and the heights for age and weights for height of 197 children between two to ten years were analysed. Using NCHS standards, the overall prevalence of underweight was found to be 18.9%, stunting 15.2%, and wasting 11.2%. Age and ethnicity were significantly associated with the prevalence of underweight and stunting. The growth achievement of children below the age of two years were significantly better off than the older children, and Chinese children significantly better off than Malay and Indian children.

Child↗
PubMed1989

Self-help efforts in a squatter community: implications for addressing contemporary homelessness.

This analysis addresses the nature of contemporary homelessness in the United States, the historical foundations of the shelter system, and survival strategies utilized by homeless persons in meeting their physical, social, and psychological needs. A framework that examines the degree of publicness/privateness and permanency/temporariness of spaces utilized by homeless persons is applied to a case study of a self-help squatter community living on an empty lot in New York City. By looking at the members of the group, their relationship to their neighbors and the local community, and their approaches in dealing with their needs, an assessment is made of this labor-intensive, self-help effort for providing shelter. Implications of self-help approaches are related to policy development and further research.

Activities of Daily Living↗
PubMed2003

Do mothers-in-law matter? Family dynamics and fertility decision-making in urban squatter settlements of Karachi, Pakistan.

The perspectives of mothers-in-law about intra-household decision-making, family size and family planning are investigated, and their views compared with those of their sons and daughters-in-law. Women (717 daughters-in-law), their husbands (717 sons) and their 522 mothers-in-law were interviewed in eight squatter settlements in Karachi, Pakistan. Decisions about the schooling and health care of children, and the purchase of jewellery, are perceived to lie within the nuclear family domain (i.e. husband and wife). There was a difference in mothers-in-law's, daughters-in-law's and sons' desire to have more children. Twenty-eight per cent of mothers-in-law versus 58%, of daughters-in-law did not want more grandsons/sons and 36%, of mothers-in-law versus 66% of daughters-in-law did not want more granddaughters/daughters. The difference was markedly greater among the mother-in-law/daughter-in-law pairs than in the mother/son pairs. Overall, the mother-in-law's role seems to be somewhat overshadowed by that of her son (family male member), except for limiting family size. It is suggested that mothers-in-law should be included in Information-Education-Communication (IEC) campaigns about family planning.

Adult↗
PubMed2001

Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan.

We conducted a study in a squatter settlement in Karachi, Pakistan where residents report commonly washing their hands to determine if providing soap, encouraging hand washing, and improving wash-water quality would improve hand cleanliness. We allocated interventions to 75 mothers and collected hand-rinse samples on unannounced visits. In the final model compared with mothers who received no hand-washing intervention, mothers who received soap would be expected to have 65% fewer thermotolerant coliform bacteria on their hands (95% CI 40%, 79%) and mothers who received soap, a safe water storage vessel, hypochlorite for water treatment, and instructions to wash their hands with soap and chlorinated water would be expected to have 74% fewer (95% CI 57%, 84%). The difference between those who received soap alone, and those who received soap plus the safe water vessel was not significant (P = 0.26). Providing soap and promoting hand washing measurably improved mothers' hand cleanliness even when used with contaminated water.

Female↗
PubMed1999

Power, self-care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem's theory.

This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author's concern for the generally poor health status of Pakistani women. Orem's nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self-care agency (specifically, perception of power as a foundational capability of self-care agency and the enabling capabilities of self-care agency), self-care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self-care agency and self-care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self-care agency, will be directly and positively related to enabling capabilities of self-care agency; (3) perception of power as a foundational capability and enabling capabilities of self-care agency will have a direct and positive relationship with self-care; and (4) self-care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self-care agency, self-care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self-care.

Adult↗