Child mortality in new industrial localities and opportunities for change: a survey in an Indian steel town
Crook, N.; Malaker, C.R.
Health Transition Review the Cultural Social and Behavioural Determinants of Health 2(2): 165-176
1992
ISSN/ISBN: 1036-4005 PMID: 10148656 DOI: 10.2307/40651982Document Number: 323244
The hypothesis of this study of infant mortality in an Indian steel town is that the government can intervene, by providing clean water and sanitation, clean air, and decent housing, and reduce mortality. The objectives were to estimate mortality for a nonmetropolitan city with a heavy industrial base and to identify mortality differentials and their social or environmental influences. 1500 households were sampled in Durgapur, which is reported to have lower than the national average mortality (6.7/1000 in 1980-82 for the crude urban death rate and 48/1000 live births for infant mortality in 1983). Households were stratified into official low grade housing in the steel township and into bustees, or huts, in spontaneous housing. A detailed description of the sample and the housing types is provided. The Brass method was used to estimate infant mortality rate (IMR) and child mortality. Life table measures were generated using the West model of the Coale-Demeny life tables. IMR was estimated at 46/1000 for townships and 70/1000 for bustee areas. The weighted sample of IMR for the working class population within the city was estimated at 54/1000, which is similar to IMR in Calcutta. This infant mortality was the lowest among Durgapur's urban population. Occupation-differentiated IMR was the greatest; i.e., 30.4/1000 for skilled workers and 83/1000 for lower occupations. Literacy differences were also apparent, with literate mothers showing an IMR of 83/1000, and with the completion of primary school, showing an IMR of 43.1/1000. Those with an inside toilet had an IMR of 67.5/1000 and those with an outside toilet an IMR of 96.5/1000. Access to drinking water showed a similar pattern. Construction features of housing also showed slight differences; floor construction was considered important as an indicator of dampness, but was not measured. Occupation, access to safe drinking water, and maternal education were the most important, statistically independent variables in the child survival model in the bustee or township areas. The policy should thus be directed to providing safe drinking water and sanitation in unplanned areas as a cost-effective strategy having a substantial impact on child survival. Other interventions are desirable if funding is available.