Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Status of Children in East Delhi: Care During Delivery, Immunization and Occurrence of Some Acute Diseases

Author(s): RK Gupta, A Pandey

Vol. 32, No. 1 (2007-01 - 2007-03)

RK Gupta, A Pandey

Care of a child from the birth itself is of great significance to ensure the growth of the same into a healthy adult. The knowledge of the extent of morbidity and its determinants is very important as it refl ects both well and ill being of the community. The information on the prevalence and about the type of illness is helpful in assessing the burden and sufferings associated with illness. Government has implemented several programmes emphasizing upon the attention by trained persons at birth to ensure safe delivery, immunization of children to prevent them from six deadly diseases and to control Diarrhoeal diseases, Acute Respiratory infections and other infections that are very common in childhood. Some studies1,3 provide information on such aspects but there is no study which provides comprehensive information on these aspects for East Delhi that may be treated as baseline information for comparison purposes in the years to come of development. Therefore, in the present paper, an attempt has been made to provide baseline information for children up to 5 years of age based on a large survey covering 20,000 households.

Material and Methods

A door-to-door survey of 20,000 households from 50 colonies/villages was carried out for collecting information on the occurrence of various diseases in East Delhi. The residential area of East Delhi was divided into six strata viz. Villages, Jhuggi Jhopri colonies, Resettlement colonies, Old Urban colonies, New Urban colonies and DDA Flats/ Government quarters in order to cater for the variation between different strata of the population, Proportional allocation of 20,000 households was made to different strata as per the population size based on 1991 Census. Information on individuals from four hundred consecutive households of each of the clusters (Colony/Village) were collected after selecting randomly a block/pocket/street etc. from the same as was applicable. During the survey 101380 individuals were enumerated including 11005 children up to 5 years of age. Information on the disease status was collected from the individuals who were found to be suffering or suffered during a period of one month preceding the day of the survey by the teams consisting of medical persons and investigators with statistical background. The most probable diagnosis was made based on the signs and symptoms. Information on attention at delivery was collected on 3691 births. Status of immunization coverage was assessed covering 2053 children of age between 1-2 years. Logistic analysis was carried to find out whether the occurrence of diarrhoeal diseases and acute respiratory infections have any association with factors like type of locality, caste, sex and age.


From (Table 1), it may be seen that the prevalence of diarrhoeal diseases and acute respiratory infections was quite high among children living in Villages, Jhuggi-Jhopri colonies and Resettlement colonies. It was comparatively less among children living in Old Urban Colonies, New Urban Colonies and DDA Flats/Govt. Qtrs. Prevalence of ARI was observed quite high in all the colonies but comparatively higher in Villages and Jhuggi – Jhopri Colonies. It was also found that the occurrences of diarrhoeal diseases declined with the increase in age of the children. Significant decline of occurrences of ARI was observed in the age group 3-5 years. Prevalence of both diarrhoeal diseases and ARI was observed higher among male children as compared to that among female children. Multiple Logistic analysis revealed that the children living in New Urban colonies were less at risk by 80% of having diarrhoeal diseases and by about 40% of having ARIs as compared to those living in Villages. The chances of occurring diarrhoeal diseases were less by 27% among female children. The children of other castes (other than SC, ST and OBC) were found to be more at risk by 40% of having ARIs. The chances of occurring Diarrhoeal diseases among children of age group 3-5 was found to decline by 52% and that of Acute Respiratory Infections by 20%.

Table 1: Prevalence (per 1000) of Diarrhoeal Diseases and Acute Respiratory Infections (ARI) Among Children.

Area Diarrhoeal
Village 19.7 73.5 1266
Jhuggi-Jhopri Colonies 25.2 70.4 1704
Resettlement Colonies 16.8 56.8 2078
Old Urban Colonies 12.1 58.1 4529
New Urban Colonies 3.2 53.6 616
DDA Flats/Govt. Qtrs. 13.5 67.7 812
All 15.5 62.0 11005

N = Sample Size

Table 2: Status of Deliveries Conducted and Immunization Coverage (%)

Area Status of Deliveries Immunization status
Place of Delivery Type of Attention at
Institutional Domiciliary Trained Untrained N BCG DPT POLIO MEASLES N
Villages 55.0 45.0 83.2 16.8 405 94.3 86.2 88.2 81.7 246
Jhuggi/Jhopri colonies 29.0 71.0 61.1 38.9 579 80.1 69.1 72.7 64.3 311
Resettlement colonies 52.0 48.0 82.2 17.8 680 95.0 87.6 89.5 71.8 380
Old Urban colonies 89.3 20.7 91.8 8.2 1545 97.8 93.3 93.3 82.7 851
New Urban colonies 97.0 3.0 99.0 1.0 201 99.0 94.2 94.2 90.3 103
DDA Flats/Govt. Qts. 92.2 7.8 97.8 2.2 281 98.9 98.2 98.2 93.2 162
All 65.7 34.3 85.2 14.8 3691 94.3 88.2 89.3 79.0 2053

N = Sample Size

It is evident from (Table 2) that more of the mothers living in Villages, Resettlement colonies, Old Urban colonies and DDA Flats/ Govt. Qtrs got their deliveries conducted in government institutions whereas more of the mothers living in New Urban colonies got conducted in private institutions. Quite a large number of deliveries were conducted in homes particularly in Villages, Jhuggi-Jhopri Colonies and Resettlement colonies. Every third delivery in East Delhi was found to be conducted in homes. Most of the deliveries were found to be conducted either by qualified trained professionals like doctors, nurses and ANMs or by trained dais in all the areas except in Jhuggi- Jhopri colonies where about two – fifth of the deliveries were conducted by untrained persons.

It may also be observed from (Table 2) that more than 94% of the children received BCG vaccination except in J.J. colonies, however, the coverage was quite good of the order of 80% in the same. More than 88% of the children received three doses of DPT vaccine and more than 89% received three doses of Polio vaccine. A decline in coverage was observed of the order of 4-5% from first dose to third dose both of DPT and Polio. Almost all the children living in New Urban colonies and DDA Flats/Govt. Qtrs. received BCG, DPT and Polio vaccines. Coverage of children for vaccination against Measles was of the order of 80% maximum being in DDA Flats/Govt. Qtrs. and minimum in J.J. colonies.


The study revealed that occurrence of diarrhoeal diseases was the highest among children living in JJ colonies and that of ARIs among children living in Villages. The children living in JJ colonies are more at risk of having diarrhoeal diseases due to poor and unhygienic living conditions. The occurrence of these diseases among children was found to decline with the increase in age. The prevalence of these diseases was observed less among female children. The advanced statistical analysis of data using Multiple Logistic analysis revealed similar findings validating these empirical findings.

The present study also revealed that about 66% of the deliveries were conducted in institutions and trained persons conducted 85% of the deliveries. NFHS-II2 carried out in 1998-99 reported about 59% institutional deliveries and about 85% of the deliveries conducted by trained persons in whole of Delhi. The results are not comparable due to difference in covered areas.

The complete doses of immunization were received by about 80% of the children. The coverage levels in East Delhi were, BCG (94.1%), DPT (88.2%), Polio (89.3%) and of Measles (79%) as against reported by NFHS-II(2) for whole of Delhi, BCG (92.0%), DPT (79.9%), Polio (80.7%) and Measles (77.5%). The coverage levels for BCG and Measles as reported by this study seems to be quite close to as reported for Delhi by NFHS-II2.


The authors are sincerely thankful to the Directorate of Health Services, Government of National Capital Territory of Delhi who sponsored the study.


  1. Gupta RK, Singh P. Communicable diseases among children in same slum areas of Delhi Hospital Administration, Official Journal of the Indian Hospital Association 1997;34:19-25.
  2. National Family Health Survey-II (1998-99), IIPS, MOHFW, Mumbai.
  3. Bhatnagar S, Dosajh U. Diarrhoeal disease morbidity in children below 5 years in urban slums of Delhi. Indian J. Med. Res. 1986;84:53-8.

Deptt. of Community Medicine, Institute for Research in Medical Statistics (ICMR), Ansari Nagar, New Delhi-110029, INDIA.
E-mail: [email protected]
Received: 02.06.05

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica