Effect of kerosene and biomass fuel as cooking medium on pulmonary function of adult nontobacco addict homemaker women residing in slums of Ahmedabad City, Gujarat.

BACKGROUND: Combustion of kerosene and biomass fuel in the kitchen as cooking medium is one of the major sources of indoor air pollution. Such contaminated indoor air quality adversely affects the respiratory health of exposed individuals over a period of time. Homemaker women especially residing in slum areas are always vulnerable to indoor air-pollution-related health hazards. OBJECTIVES: The objective is to assess the relationship between various socio-demographic factors and usage patterns of cooking fuel; and to determine the effect of cooking medium namely biomass, kerosene on pulmonary function parameters. METHODS: A cross-sectional observational study was carried out during April 2012 - April 2016 among 531 nontobacco addicted adult primary homemaker women residing in slums of Ahmedabad city of Gujarat. Basic information-related socio-demographic parameters were collected on a pretested questionnaire. Pulmonary function test (PFT) parameters were evaluated with standard techniques. The statistical analysis was carried out with SPSS software (version 17.0). Statistical tests of significance between groups and mean along with multivariate linear regression analysis were applied. RESULTS: Predominant cooking medium for nearly 40% of slum households were kerosene and biomass. Mean value of forced expiratory volume in the 1st s (FEV1) and FEV1/forced vital capacity (FVC) were significantly lower among Kerosene and biomass users compared to LPG users. Multivariate regression analysis with involvement of PFT parameters, cooking medium, and environmental tobacco smoke exposure (ETS) shows, deprivation of both FEV1 and FEV1/FVC were significantly related with the usage of kerosene and biomass; whereas no relation found with ETS. CONCLUSION: Reduction of pulmonary function parameters among the study participants were related with kerosene and biomass fuel usage in the kitchen.

Determinants and Utilization of Maternal Health Care Services in Urban Slums of an Industrialized City, in Western India.

Objective: To assess the status of utilization of Maternal Health Care (MHC) services in slums of an industrialized city and elucidating the various determinants influencing the utilization. Materials and methods: A Cross-sectional study using multi stage sampling methodology was conducted in slums of an industrialized city. The study participants were the women who had given a live birth in the last one year before 4 weeks of the study starts. Total one hundred eighty families were interviewed & analysed. Results: The utilization of MHC services was poor as compared to national averages in urban slums. There was no association between age of mother, birth order, educational and occupational status of head of family with utilization of services while education and employment of mother, category and type of family, distance and time to reach health facility, were significantly associated. Conclusion: The reduction of maternal mortality and morbidity mostly depends on the utilization of MHC services. The findings of this study have important implications for improving utilization of maternal health care services.

Analysis of Out-of-Pocket Expenditure in Utilization of Maternity Care Services in Urban Slums of Rajkot City, Gujarat.

BACKGROUND: India contributes 20% global maternal deaths every year. An important reason of such maternal mortality is due to cost of maternity services which makes it in accessible to the poor. Knowledge of maternity-related expense and its determinants is useful for health authorities to focus public resources and target financial assistance or exemption guidelines toward the "neediest." METHODOLOGY: It was a cross-sectional descriptive study conducted amongst 180 women living in urban slums and who had delivered a baby within 1 year of the interview date. RESULTS: The mean cost of delivery was around Rs. 8880. The average delivery cost of private institutions was significantly higher than that of government hospitals or home delivery. Around 75% of women delivered in private institution had health expenditure of more than 10% of total annual family income - catastrophic expenditure. CONCLUSION: In spite of significantly higher maternity care-related costs in private institutes than government hospitals, majority of mothers had utilized services from private clinics and had suffered catastrophic expenditures during utilization of maternity care services. This study highlights the need for birth preparedness counseling as well as effective implementation of maternity benefit schemes to prevent families from pushing downward to the poverty line.