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| LETTER TO THE EDITOR |
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| Year : 2017 | Volume
: 6
| Issue : 4 | Page : 270-271 |
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Under-five malnutrition in Indian slums
Manas P Roy
Department of Pediatrics, Safdarjung Hospital, New Delhi, India
| Date of Web Publication | 26-Dec-2017 |
Correspondence Address:
Dr. Manas P Roy
Dr. Manas P. Roy, Department of Pediatrics, Safdarjung Hospital, New Delhi – 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_60_17
How to cite this article:
Roy MP. Under-five malnutrition in Indian slums. J NTR Univ Health Sci 2017;6:270-1 |
Sir,
Although sustainable development goals (SDG) aim to end all forms of malnutrition by 2030, it continues to be a public health threat among under-five children.[1] SDG supports the target of reducing global burden of under-five children by 40% by 2025 from a pool of 171 million in 2010 and to reduce childhood wasting to less than 5%, as envisaged by the World Health Assembly.[2] However, slums seem to be the worst victims of this silent killer in India. Studies from Delhi, the national capital, found 58–75% of slum children as underweight.[3],[4] A recent report suggests that 56,000 children succumb to death every year in urban slums in India due to malnutrition.[5]
For overcoming this paramount challenge, we need to analyze the underlying reasons. In most settings, illiteracy and lower socioeconomic status play the major role in precipitating ill health and undernutrition.[6] Rural poor, after migrating to different slums with the hope of better living, fall easy prey to unhygienic life, overcrowding, and malnutrition. “Neighbourhood effect” makes them more vulnerable to diseases than experienced by urban poor community. Unhygienic conditions invite hookworm infestation, resulting in anemia and stunting among children.[7] As a result, disease burden in a city area gets concentrated around the slums. Evidence suggest that lack of access to potable water and sanitation makes children more vulnerable to water-borne diseases.[8] Ezeh highlighted lack of immunization, dependence on street-foods, and early weaning contributing to malnutrition.[9] These factors come to play together to result in the endemicity of stunting and wasting in urban slums. Lack of recognition helps in sustaining the misery of the slum-dwellers and their daily tryst with malnutrition. At times, they lag much behind the urban poor who have achieved recognition in city life. Despite different strategies adopted by the governments, such as providing alternate housing close to the slum locality or improving health condition at the existing slums by recognizing them within municipality, the same story from the slums continues to echo across the country.
To stop this cycle, there is a need to have a strong nutrition surveillance system, dedicated particularly to urban illegal settlements. Behavioral interventions have been successful in different parts of the world in yielding positive results.[10] Under Reproductive, Maternal, Newborn, Child and Adolescent Health program, The government is already coming up with Nutrition Rehabilitation Centres for addressing severe acute malnutrition. To maximize the benefits, we need to link the burden of malnutrition from the slums to those centres. As National Health Policy 2017 puts emphasis on slum dwellers, the researchers and donors also need to step forward for highlighting health at the long-neglected slums.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | |
| 2. | WHO. Comprehensive implementation plan on maternal, infant and young child nutrition. 65 th World Health Assembly. World Health Organization, Geneva; 2012.  |
| 3. | Kapur D, Sharma S, Agarwal KN. Dietary intake and growth pattern of children 9-36 months of age in an urban slum in Delhi. Indian Pediatr 2005;42:351-6. [ PUBMED] |
| 4. | Davey S, Davey A, Adhish SV, Bagga R. Factors influencing status of undernutrition among children (0-5 years) in a rural area of Delhi: A cross-sectional study. Int J Community Med Public Health 2014;1:12-7. |
| 5. | |
| 6. | Urke HB, Bull T, Mitlelmark MB. Socioeconomic status and chronic child malnutrition: Wealth and maternal education matter more in the Peruvian Andes than nationally. Nutr Res 2011;31:741-7. |
| 7. | Feldmeier H, Heukelbach J. Epidermal parasitic skin diseases: A neglected category of poverty-associated plagues. Bull World Health Organ 2009;87:152-9. [ PUBMED] |
| 8. | Fry S, Cousins B, Olivola K. Health of children living in urban slums in Asia and the near east: Review of existing literature and data. Environmental Health Project, US Agency for International Development, Washington, DC, USA; 2002. |
| 9. | Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, Sartori J, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet 2016;389:547-58. [ PUBMED] |
| 10. | USAID and IYCN. Behaviour change interventions and child nutritional status: Evidence from the promotion of improved complementary feeding practices. Washington; 2011. |
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