User:Shraddhapandey2021/sandbox

My organization is called Doctors for You (DFY). It is an Indian non-profit organization that works on multiple projects throughout India. Their main mission is to provide health care to people in crisis situations, although they also work in more generally underdeveloped regions. I will be working with their Mumbai field office, working as a medical scribe (or a general outreach assistant) in Govandi, a large slum area located in Mumbai.

Article Selection

Area

Slum

• Slum
• This article is rated B-class and encourages improvements.
• I can add a section regarding slum definitions and implications when defining a slum.

Sector

• Health in India
• This article is the subject of an educational assignment at University of Utah supported by the Wikipedia Ambassador Program
• This would be a good place to talk about the role of health education and community intervention programs in battling contagious diseases and malnutrition. Under the initiatives section, I want to add a section about health awareness/educational programs that address the stigmas and lack of awareness surrounding seeking healthcare in urban populations.

Article Evaluation

"Slum"

This article is quite detailed and has gone through continuous revisions and merges with other articles. It has a B-class quality rating (Not as basic and unrevised as Start or Stub, but not quite complete enough to be an A-level article). In class, we discussed that we can look at problems with healthcare from multiple angles, depending on how we frame the issue. For example, infectious diseases can be attributed to infrastructural issues (dealing with problems of place, according to Katz). But the prevalence non-communicable diseases such as cancer and CVD can be attributed to more socioeconomic reasons like social stigmas, limited healthcare access, and lack of awareness. In addition, the language in some of the sections still sounds a bit essay-like and opinionated. I want to clean it up and make it sound more factual, as well as add in more citations and take out unnecessary bits.

Possible Scholarly Articles

• "Women’s Reproductive Health in Slum Populations in India: Evidence From NFHS-3"
• "Health and health-related indicators in slum, rural, and urban communities: a comparative analysis"
• "Differences in Child Health Across Rural, Urban, and Slum Areas: Evidence From India"
• "Lots quality coverage survey technique for assessment of immunization performance and quality in an urban slum of Mumbai"

Scholarly Sources

Area

1. "Disease: Poverty and pathogens"
   • This article starts with the sentence: "The growth of slums in the developing world's rapidly expanding cities is creating new opportunities for infectious disease to flourish and spread." It states that the population density and lack of resources in poor urban communities was a large contributor to the spread of Ebola in 2014, for example. In general, it argues that the spread of infectious diseases will continue to be a prevalent issue due to the rapid urbanization of countries around the world.
2. "The history, geography, and sociology of slums and the health problems of people who live in slums"
   • This article emphasize the health issues that impact slum populations. In India specifically, they recognize that a lot of people who live in slums are not necessarily poor, and that many destitute people live outside of the area typically defined as a slum. This dramatically impacts the distribution of healthcare and resources to the poor community, a phenomenon described by the term "neighborhood effects".
3. “Differences in Child Health Across Rural, Urban, and Slum Areas: Evidence From India
   • This article wanted to assess the association between child health and area of residence in India, using height percentiles as a measure of overall nutrition and growth. Overall, they found that slum children fared worse than their rural counterparts. They estimate that slum-specific issues (such as overcrowding and open sewers) are responsible for up to 37% of the stunting risk that children face.
4. "The burden of cholera in the slums of Kolkata, India: data from a prospective, community based study"
   • Frequent exposure to the cholera-causing bacteria, hospitalization, and patterns of healthcare utilization are all dangerous contributors to the incidence of cholera in the slums of Kolkata. This disease mainly afflicts young children, and the study correlated risk of cholera incidence with proximity to other affected family members, young age, and level of education. The study admits that these risk correlations are not easily amenable, but they believe that mass vaccination and improvements in living conditions could have a reductive effect on the rate of cholera incidence.
5. "Differences in the Prevalence of Non-Communicable Disease between Slum Dwellers and the General Population in a Large Urban Area in Brazil"
   • Public health researchers conducted a study to determine the burden of non-communicable diseases on slum communities compared to the burden on the general population. They found that across the board, slum populations showed higher prevalence of diabetes, smoking, and obesity compared to the general population of Salvador, Brazil. In their discussion section, they discuss the importance of considering the unequal impact of these public health concerns on lower-income communities, calling for targeted social interventions to facilitate access to a healthier lifestyle and more economic opportunities.
6. "Performance of a community-based health and nutrition-education intervention in the management of diarrhoea in a slum of Delhi, India"
   • This article states that diarrhea is a major health issue that affects children in slum populations around the world. This article conducted a study to figure out the effectiveness of a community-based health and nutrition program in reducing the incidence of child diarrhea. This is a study, which means that I probably cannot cite this in my Wikipedia article, but it's a good place to start when discussing the strategies and methods of community-health programs and identifying areas of improvement.
7. "The history, geography, and sociology of slums and the health problems of people who live in slums"
8. "Health in slums: understanding the unseen"
   • This article discusses a lot of the health and infrastructure problems that other previous articles have addressed. But one part I found very interesting was their discussion regarding data collection. They state that the lack of health information of nearly 1 billion people is a heavy blow for public health and development workers. They argue that the government needs to distinguish slums from other urban areas during their data collection, so that unique resources can be allocated to those groups.

Sector

1. "Slum Definitions in Urban India: Implications for the Measurement of Health Inequalities"
   • This article discusses how defining a slum (and the various interpretations) affect the empirical representations of healthcare and healthcare inequality. It highlights the discrepancies between local and international definitions regarding slums, and it emphasizes the importance of improving measurements by which we define/categorize urban poverty.
2. "Ensuring childhood vaccination among slums dwellers under the National Immunization Program in India - Challenges and opportunities"
3. "Improving the health and welfare of people who live in slums"
   • This article elaborates on neighborhood effects and current problems with the management and distribution of resources in the slum area.
4. "Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers"
5. "Impact of a Structured Tuberculosis Awareness Strategy on the Knowledge and Behaviour of the Families in a Slum Area in Chhattisgarh, India"
6. "Differences in Child Health Across Rural, Urban, and Slum Areas: Evidence From India"
7. "Assessment of an Integrated Nutrition Communication Approach to Educate the School Going Adolescent Girls Living In Urban Slums of Hyderabad, Telangana State, India"
8. “Patterns of illness disclosure among Indian slum dwellers: a qualitative study”
   • This article states that slum dwellers display a specific pattern when it comes to disclosing their illnesses or other health problems to healthcare professionals. Factors like fear of consequence, gender, individual agency, and overall socioeconomic environment have an effect on the ability and willingness of patients to seek healthcare resources.

Summarizing and Synthesizing

Area

• So far I am learning that the area of slum poverty and slum health is particularly hard to define in India, because the area that is officially defined as a slum does not necessarily include the totality of poor people who require resources such as healthcare. This affects how resources are managed and distributed, and the current model has the potential to exclude particular populations because they do not fit within the geographical bounds of the slum. The combined effects of neighborhood (neighborhood), international definitions/categorizations, and the political economy have vast implications on the distribution and availability of healthcare in the various inner city regions of India.
• TRY LOOKING FOR ARTICLES REGARDING UNIVERSAL HEALTH COVERAGE POLICY THAT'S TRYING TO BE ENACTED IN INDIA

Sector

• The articles I have read so far that discuss improving slum health populations through more programs emphasize the need to better categorize and document health incidences in cities like Mumbai and Dehli. This can be improved by adding infrastructure and technology that better equips doctors and other healthcare workers to maintain adequate health records. In addition, several articles emphasize the fact that organizations cannot and should not wait for major policy changes in order to implement positive change.

Drafting

Text in bold are my edits/additions. Non-bolded text is what has already been published in the article. Strikethroughs are content I wish to remove from the article.

Area

• CHANGE HEADINGS UNDER "PROBLEMS" SECTION OF "SLUM" ARTICLE
  • Current Subheadings Under Problems
    • Vulnerability to to natural and unnatural hazards
    • Unemployment and informal economy
    • Violence
    • Disease
    • Child malnutrition
    • Epidemics
  • Updated Subheadings Under Problems
    • Vulnerability to to natural and unnatural hazards
    • Unemployment and informal economy
    • Violence
    • Infectious Diseases and Epidemics
      • (due to infrastructural issues - overcrowding, water sanitation, sanitation)
    • Child Malnutrition
    • Non-Communicable Diseases
      • Including malnutrition, malaria, heart disease, etc.
      • Will focus more on issues with healthcare access and health service rather than infrastructure issues \

• Infectious Diseases and Epidemics [Under Problems Section]

Slum dwellers usually experience a high rate of disease.[183][130] Diseases that have been reported in slums include cholera,[184][185] HIV/AIDS,[186][187] measles,[188] malaria,[189] dengue,[190] typhoid,[191] drug resistant tuberculosis,[192][193] and other epidemics.[194][195] Studies focus on children's health in slums address that cholera and diarrhea are especially common among young children.[196][197] In Haiti (where a majority of the population live in poverty), after the 2010 earthquake, an outbreak of Cholera spread throughout the country, killing 8321 people. Besides children's vulnerability to diseases, many scholars also focus on high HIV/AIDS prevalence in slums among women.[198][199] In some slums, gender inequality increases women's risk of HIV/AIDS. Mutual monogamy or using condoms are two main ways to prevent HIV/AIDS, but some women might not be able to modify their behaviors due to masculine authority or violence.[200] Furthermore, Throughout slum areas in various parts of the world, infectious diseases are a significant contributor to high mortality rates. diseases can sometimes lead to high mortality in slums. According to a study in Nairobi's slums, HIV/AIDS and tuberculosis attributed to about 50% of the mortality burden.[201]

Factors that have been attributed to a higher rate of disease transmission in slums include high population densities, poor living conditions, low vaccination rates, insufficient health-related data and inadequate health service engender a higher rate of disease transmission in slums than that in non-slum areas. Overcrowding leads to faster and wider spread of diseases due to the limited space in slum housing. Poor living conditions also make slum dwellers more vulnerable to certain diseases. Poor water quality, a manifest example, is a cause of many major illnesses including malaria, diarrhea and trachoma. As Sur et al. suggest, improving living conditions such as introduction of better sanitation and access to basic facilities can ameliorate the effects of diseases, such as cholera.

In addition to poor living conditions, low vaccination rates cause excess cases of disease in slums as well. Slum children are less likely to be vaccinated mainly because some slum dwellers refuse vaccinations without understanding its importance or no one at home is able to take the child to health sectors for vaccinations. Lack of reliable data also has a negative impact on slum dwellers' health. A number of slum families do not report cases or seek professional medical care, which results in insufficient data. This might prevent appropriate allocation of health care resources in slum areas since many countries base their health care plans on data from clinic, hospital, or national mortality registry. Moreover, health service does not exist in most of the world's slums. Emergency ambulance service and urgent care is typically unavailable in slums. Health service providers avoid servicing slums. A study shows that more than half of slum dwellers are prone to visit private practitioners or seek self-medicationwith medicines available in the home. Private practitioners in slums are usually those who are unlicensed or poorly trained and they run clinics and pharmacies mainly for the sake of money. A recent study has shown that there has been substantial improvement in the health awareness of the slum dwellers of Mumbai with regards to HIV/AIDS and diabetes.

Slums have been historically linked to epidemics, and this trend has continued in modern times. For example, the slums of West African nations such as Liberia were crippled by as well as contributed to the outbreak and spread of Ebola in 2014. Slums are considered a major public health concern and potential breeding grounds of drug resistant diseases for the entire city, the nation, as well as the global community. [Taken from "Epidemics" section]

• Non-communicable Diseases [Under Problems Section]

A multitude of non-contagious diseases also impact health for slum residents. Examples of prevalent non-infectious diseases include: cardiovascular disease, diabetes, chronic respiratory disease, neurological disorders, and mental illness. In some slum areas of India, diarrhea is a significant health program among children. Factors like poor sanitation, low literacy rates, and low awareness make diarrhea and other diseases extremely prevalent and burdensome on the community.

Lack of reliable data also has a negative impact on slum dwellers' health. A number of slum families do not report cases or seek professional medical care, which results in insufficient data. This might prevent appropriate allocation of health care resources in slum areas since many countries base their health care plans on data from clinic, hospital, or national mortality registry. Moreover, health service does not exist in most of the world's slums. Emergency ambulance service and urgent care is typically unavailable in slums. Health service providers avoid servicing slums. A study shows that more than half of slum dwellers are prone to visit private practitioners or seek self-medication with medicines available in the home. Private practitioners in slums are usually those who are unlicensed or poorly trained and they run clinics and pharmacies mainly for the sake of money. [Taken from "Disease" section] The categorization of slum health by the government and census data also has an affect on the distribution and allocation of health resources in inner city areas. A significant portion of city populations face challenges with access to health care but do not live in locations that are described as within the "slum" area.

Overall, a complex network of physical, social, and environmental factors contribute to the health threats faced by slum residents.

Sector

Health Education Programs [New section under "Initiatives"]

The Indian government has implemented several initiatives over the past few decades to boost healthcare opportunities and access in both rural areas and urban slums. International researchers and organizations have cited the need to implement more long-term solutions to permanently improve slum health; they argue that government-funded programs like the National Rural Health Mission (NRHM) or the National Urban Health Mission (NUHM) have a short-lived impact. The National Immunization Programme, a notable example, prioritized providing vaccinations to slum-dwellers to reduce spread of infectious disease, but research suggests that the efficacy of this program was limited because slum residents remain unaware of the significance of being immunized. This finding demonstrated the need to implement health education programs to work towards long-term solutions to the slum health crisis . Non-profit organizations have approached this problem in a multitude of different ways.

While some organizations continue to provide service through opening medical facilities in inner city areas or advocating for infrastructural change (e.g. improving water sanitation), other newer organizations are increasingly focusing on educating the population on health care resources through community-based health education programs. Factors like fear of consequence, gender, individual agency, and overall socioeconomic environment have an effect on the ability and willingness of patients to seek healthcare resources . Implementing health awareness programs and focusing on improving the population's knowledge of healthcare resources has a significant effect on their ability to access affordable care, prevent illness, and prevent job loss. For example, in parts of India, public facilities offer free treatment for tuberculosis, yet many slum residents choose to visit expensive private healthcare facilities due to lack of awareness of this program. After an initiative involving conversations between health experts and slum households, a significant number of residents turned to public facilities rather than private hospitals to receive effective treatment at no cost.

Organizations have implemented a similar method of health education within urban schools to combat nutritional deficiency and malnutrition among children . Through use of informational videos and posters and curriculum changes, all implemented within a school setting, adolescents had an increased awareness of their nutritional needs and the resources they could utilize.