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  • Title: Child mortality in new industrial localities and opportunities for change: a survey in an Indian steel town.
    Author: Crook N, Malaker CR.
    Journal: Health Transit Rev; 1992 Oct; 2(2):165-76. PubMed ID: 10148656.
    Abstract:
    As Asia becomes increasingly urbanized the effect of new industrial development on child mortality becomes of increasing interest. In India, considerable investment has been made in the social infrastructure of industrial new towns. This survey of Durgapur steel town in West Bengal shows that although the average level of child mortality in the working class population is favourable in comparison with other Indian cities, considerable differentials, that can be related to social, economic and environmental differences within the population, have arisen since the creation of the city in the late 1950s. The paper argues that the undertaking of selective sanitary interventions to improve access to drinking water (in particular) would be administratively feasible in these industrial new towns, of immediate impact, and indeed necessary if the differentials in mortality are to be eliminated. 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.
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