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Primary and Reproductive Health in the Slums of
Trivandrum City
I. Introduction
1.1
India is the first country to initiate a national
family planning programme, integrated in the Primary Health Care
system, to contain the rate of population growth. It started as family
planning program, expanded into family welfare, covering both maternal
and child health (MCH) care and family planning. After the
International conference on Population and Development (ICPD)of 1994 in
Cairo, it became reproductive and child health, which included services
of reproductive tract infection, sexually transmitted diseases and
HIV/AIDS. Besides the expansion of services in the post-ICPD era, the
basic strategy of the Indian programme changed from target-orientation
to a need- based approach, focusing on meeting the needs of the members
of the community rather than achievements of certain national
demographic goals. In other words, the philosophy of its implementation
has undergone a change; it has become a two-step process of assessment
of the community needs (CNA) as the first step, and meeting those
needs, as the second.
1.1.1 Mainly a rural country, India has 72 per
cent of its population living in rural areas (Census 2001a). It was
therefore natural that all developmental efforts including those
related to health and family welfare focused on rural areas right from
the beginning. Successive Five Year Developmental Plans expanded the
infrastructure and activities. Today, a reasonable network of health
infrastructure has been created in rural areas, providing both
reproductive and primary health care services. Focus on rural areas and
constraints of resources in the programme led to a slow progress of
reproductive and primary health care services in urban areas. It was
presumed that better economic status and greater awareness of the urban
population and better accessibility of services there will help them to
take care of their own health including reproductive health goals. This
expectation, fell far short for the slum population groups living in
urban areas. This group forms about 40 percent of the large
metropolitan areas. It is therefore important that reproductive and
primary health care services in the slums receive adequate emphasis.
With this backdrop it is felt necessary to undertake a well-designed
study on reproductive and primary health care services in urban slums,
covering both dimensions of the service needs of people and how they
are being met or unmet.. The emphasis of the study should be on
policies, programmes and their implementation, and acceptance or
non-acceptance by the people. It should ultimately help in
strengthening the reproductive and primary health care services in
urban areas for meeting the needs for the slum population groups in
India. This study was conducted in the city of Trivandrum (also spelt
Thiruvananthapuram), the capital of the state of Kerala in India.
1.1.2 India, with a population of one billion,
has 28 States administered by their own elected governments and seven
Union Territories administered by the Centre. Kerala in the southwest
corner of the country is a small state, which takes up 1.27 per cent of
the land area and 3.1 percent of the population. The state was formed
in 1956 when the states of the country were re-organised on linguistic
lines. Till then the state was in three distinct regions. The
southernmost region was called Travancore and was ruled by the Maharaja
of Travancore till 1947 when the country gained independence from the
British. The middle region called Cochin (Kochi) was ruled by another
Maharaja. Both these monarchs owed their allegiance to the British
monarch who had suzerainty over the whole of India. But the
northernmost region called Malabar was directly ruled by the British as
part of the Presidency of Madras.
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1.1.3 The state has many features
that make it different from the other states of the country. The most
striking is the settlement pattern of the people. They live in small
homesteads from one end of the state to the other without much of a
difference between rural and urban areas. The population density is 819
per Sq. Km. against 324 of India. It has a coastal line of about 600
Kms. along the Arabian Sea and a width of about 60 Kms., bounded by the
mountain range of Western Ghats. It has been called a rural-urban
continuum where the villages are only administrative boundaries and the
towns, a thicker concentration of houses. Most of the villages (85.3
per cent) are well connected by motorable roads against 36.8 per cent
in the country. Similarly nearly 95per cent of the Kerala villages have
a bus stop within 5 Kms. and a Post Office within 2 Kms. against 64.5
and 70.2 per cent respectively for the country. The difference is even
more striking when it comes to telephones. More than 85per cent of
Kerala villages have telephone facility within two Kms. whereas only
51per cent of the villages in the country have it (Shariff, 1999). The
development of the rural areas has been so good that the urban
population has actually declined from 26.39 per cent in 1991 to 25.97
in 2001 (Census 2001a)
1.1.4 The next feature that strikes a casual
visitor to the state is the mix of religions. While India’s population
is a mixture of 12 per cent Muslims and 2 per cent Christians, most of
the others being Hindus, in Kerala Muslims are 21per cent and
Christians 20 per cent according to the Census of 1991. On the
political front the state is reported to be the first in the world to
have an elected communist government. The origins of communism can be
traced to the spread of literacy among a people who suffered from the
yoke of feudal tyranny in the agrarian sector. Literacy itself owes its
origin to the liberal policies of the Monarchs of Travancore and Cochin
and the efforts of Christian missionaries. The World Bank’s World
Development Report of 1991 cites the Royal Rescript of the Maharani of
Travancore in 1817 that commits the state to “defray the entire cost of
the education of its people in order that there may be no backwardness
in the spread of enlightenment among them”. Initially education was the
prerogative of the upper caste Hindus. But social reform movements that
started as a protest against the institutionalisation of social
exclusion by the upper casts, began demanding education for the
backward communities (Vijayachandran 2001). Spread of education has
been the prime mover of the development of the state, leading to a
literacy level of 91per cent and a female literacy level of 88per cent
against the all India figures of 65.4 and 54.2 per cent respectively in
2001.
1.1.5 However, job opportunities in the State
are very meagre and large segments of the workforce go outside the
state and the country seeking employment. The remittances from these
non-resident Keralites are a great source of income for their families
at home and keep the economy afloat. In spite of this, it remains one
of the poorer states of the country, with a per capita income less than
the national average. The Government estimate of per capita income for
1999-2000 is Rs.19461, which works out to about US$ 423 at the current
exchange rate (GOK 2000a).
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1.1.6 According to the estimates
of poverty by the Planning Commission of Government of India for
1999-2000, the poverty in the state is concentrated in the urban areas
with 20.27 per cent of the population living below the poverty line.
This means that they do not have the required financial capacity to
purchase food, which will fetch 2100 calories for an individual in a
day. It is noteworthy that the figure of poverty in the rural areas of
Kerala is very low at 9.38 per cent. But for the country as a whole the
situation is just the reverse with 27.09 per cent in the rural areas
and 23.62 per cent in the urban areas (Narayana 2001). This is a
telling example of the quality of life in the rural areas of Kerala.
1.1.7 Though the State is poor, it leads all the
other states in every indicator of health. It has often been compared
with many advanced countries of the world in its health status. Table
1.1 below gives a picture of the quality of life in the state in
comparison with the rest of the country and some other countries of
Asia.
Table 1.1 Selected Indicators of Development for
Kerala and Some Asian Countries
| Country / State |
Population (million) 1994 |
GDP Per Capita PPS $ 1994 |
HPI value (%)
1996 |
Population below International Poverty line
1985 (one PPS $ /day) |
Female Literacy Rate (%) 1994 |
Gross enrolment ratio (1995) in Secondary
Schools |
Life Expectancy Year 1994 |
Total Fertility Rate |
IMR 1994 |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Kerala |
30.5 |
1618 |
15.0 |
NA |
86.3 |
103 |
71.7 |
108 |
13* |
| India |
918.6 |
1348 |
36.7 |
52.0 |
39.0 |
49 |
61.3 |
3.0 |
74 |
| Sri Lanka |
18.1 |
3277 |
20.7 |
4.0 |
86.9 |
75 |
72.2 |
1.7 |
16 |
| Thailand |
58.2 |
7104 |
11.7 |
0.1 |
90.7 |
55 |
69.5 |
1.8 |
29 |
| Malaysia |
19.7 |
8865 |
NA |
5.6 |
77.5 |
57 |
71.2 |
3.4 |
12 |
| Indonesia |
194.6 |
3740 |
20.8 |
14.5 |
77.1 |
48 |
63.5 |
2.5 |
53 |
| China |
1208.8 |
2604 |
17.5 |
29.4 |
70.9 |
67 |
68.9 |
1.8 |
43 |
* According to National Family Health Survey for
1998-99, the IMR for Kerala is 16.3.
Notes: HPI: Human Poverty Index. This takes into account (i) the
survival deprivation in terms of people not expected to survive to age
40, (ii) a composite index of deprivation in economic provisioning
indicated by (a) population without access to safe water, (b)
population without access to health services, and (c) underweight
children under the age of five.
Source: Kannan, 1999.
1.1.8 As can be seen in this table, Kerala with
less than a fifth of the income of Malaysia, has achieved about the
same levels of life expectancy and infant mortality. In fact in total
fertility and female literacy Kerala is much ahead. Only Thailand has a
lower Human Poverty Index than Kerala. The annual growth rate of
population in Kerala has come down from 2.33 per cent in 1951-71 to 0.9
in 1991-2001 (Census 2001b). With all these statistics UNDP put the
human development index for Kerala at 62.79, 20 notches above that for
India. Even for China and Egypt, two countries known for their high
physical quality of life, the figures are only 60.9 and 61.1
respectively (Srinivasan & Shariff 1997)
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1.1.9 The State has a fairly good
health infrastructure in the public sector. The All India pattern of
one sub-centre with an Auxiliary Nurse Midwife for 5000 population, one
Primary Health Centre (PHC) for 25,000-30,000, and a Community Health
Centre for 100,000 dots the Kerala landscape with these institutions. A
woman of Kerala has to travel typically only 1.5 Kms. to reach a sub
centre for antenatal care or for immunising her child, whereas in the
rest of the country the radial distance to a sub centre is 2.7 Kms. A
typical PHC in the country covers an area of 143.08 Sq. Kms. with a
radial distance of 6.8 Kms. and in Kerala 37 Sq. Kms. with a radial
distance of 3.4 Kms. All put together the Government runs 1317
institutions manned by 4367 doctors trained in the modern system of
medicine with 45684 beds (GOK 2000). If the institutions and beds in
the other systems of medicine (mainly Homeopathy and the Indian System
of Medicine called Ayurveda) are added it comes to 2672 institutions
and 48258 beds. That is about one bed for 650 persons in the public
sector alone. But if we add the facilities in the private sector for
all the three systems of medicine there are altogether 1529
institutions and 120182 beds for a population of 31 million which is
one bed for every 258 persons, something that not even many developed
countries can dream of (Vijayachandran 2001).
1.1.10 However health planners have long been
aware of the fact that in this state of high social development there
are pockets untouched by all these improvements where malnutrition,
poverty and low health status still prevail. Three such islands are
mentioned by writers, namely the hilly areas inhabited by tribes, the
coastal areas occupied by the fishing community and the slums of the
cities. (Ramachandran 1996) this study will explore whether this is
true of the slums of the city of Trivandrum.
1.1.11 The city of Trivandrum is situated in the
southern tip of the State. The city has a long history behind it. Some
historians say that it is mentioned in some literature of the 8th
century as the seat of a University. However the modern history of the
city starts in the 12th century when the King of Travancore took an
interest in the City. Even before that Sree Padmanabha Swami Temple,
which was the center of the City, was attracting attention of many
travelers. The city was elevated to the status of the official capital
of Travancore dynasty in the 18th century. Ever since then it has been
the capital of Travancore. When the state of Kerala was formed in 1956
it became its capital.
1.1.12 It has a population of 750,000 spread
over 142 sq. kms. The total literacy level for the city is 92.5 percent
and for the women 90 per cent. About 12,000 of its people live in 36
identified slums, making up 1.6 per cent of the population. The
literacy level in the slums is only 78 per cent. (Census 2001a&b)
In October 2000, five rural areas surrounding the city were added on to
its administrative limits. These areas, being rural, did not have
designated slums; but many slum like settlements.
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1.2 Health Infrastructure
1.2.1 The city is well served by
health facilities both by government and private enterprises. There are
25 hospitals in the public sector, the largest being the Trivandrum
Medical College, a teaching institution. With 1542 beds and 23
specialties it caters to the education of under graduates and
postgraduates in medicine, dentistry, nursing, pharmacy, medical
laboratory technology and public health. The women and children section
is a separate hospital with 732 beds. Likewise the ophthalmic hospital
and mental hospital are separate units. While this is meant for
teaching, there is a general hospital meant for clinical services with
747 beds. It has also 12 specialties. On the non-teaching side there is
also a separate women and children hospital with 422 beds. Together
with other hospitals run by government there are 5246 beds in the
public sector in the allopathic system of medicine (GOK 2000). There
are about 400 beds each in Homeopathy and Ayurveda. The private sector
also provides big and small hospitals in the city, their number being
35, in addition to 41 clinics. Some of these hospitals have specialties
of a rare nature and serve in effect as referral hospital to many other
institutions. However it may be mentioned here that these hospitals
cater not only to the city population but also for patients coming from
the rest of the district and the neighbouring districts. The Medical
College Hospital serves as a referral hospital for at least three
districts of Kerala with a combined population of 7 million. The people
from at least two districts of the neighboring state of Tamil Nadu also
use this as their referral hospital. Thus it serves about 10 million
people.
1.3. Studies on Health in Urban Slums
1.3.1 Some studies are available
on the slums of India, which cover several aspects of health care also.
The proceedings of a conference on `Health Care of the Villages and
Urban Slums’ held on Jan 22-24 1990 in Calcutta, India noted the
alarming growth of urban population, which was 3.78 percent per annum
between 1971 and 1981 against 2.19 percent of the general population.
As much as 47 per cent of the urban growth was constituted by transfer
from rural areas. It is the people who come to the city in search of
livelihood that squat in the land and create slums. That conference
noted that the size of the slum population is directly related to the
size of the city. The town with less than 50,000 people had only 10.04
per cent in slums, and as the size of the town went up it steadily
increased to 30.78 per cent in the cities over 1 million in 1981 (Sahni
& Xirasagar, 1990)
1.3.2 WHO and UNICEF had an interregional
consultation on `Primary Health Care in Urban Areas’ in July 1986 in
Manila. (UNICEF & EAPRO, 1986) That conference noted that a third
of the urban people in Asia lives on slums. It brought out five
constraints in dealing with Primary Health Care in slums, namely, (i)
the true facts about urban poor are hidden in the aggregated data, (ii)
lack of understanding of primary health care among the medical
profession, (iii) the policy and the planning capability at the city
level is weak, (iv) lack of appropriate community Organisation among
urban poor settlements, and (v) lack of resources.
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1.4 Objectives
1.4.1 No study specific to the
health care of the slums of Trivandrum could be located. This is
probably the fist attempt to study the various aspects of primary and
reproductive health care of the slums of Trivandrum city. The major
objectives of the study are as follows:
1. To determine what percentage of population in urban slums and
non-slum areas are able to meet their various reproductive and primary
health care needs and through what sources - public, voluntary and / or
private.
2. To understand reasons for preferring one or more of these sources;
more particularly, to know why free public sector program services are
not utilised.
3. To understand the quality of care they receive, particularly from
the public sector program.
4. To determine why reproductive and primary health care needs for
certain percentage for population remain unmet, and
5. To relate public sector program policies, programmes and its
implementation with its access, acceptance and quality of services and
identify gaps at different levels.
1.5 The Plan
1.5.1 The next chapter describes
the methodology followed in the survey explaining the sampling
procedure, the grouping of the questionnaire, the plan for interviews
and the data processing. The third chapter is about the household
characteristics of the slums, the non-slums and the suburban areas as
captured in the survey. It describes the age, sex distribution and
marital status of the sample and goes on to cover their religious
affiliation, educational level and occupation. It goes on to present
the housing conditions, the possession of durable goods and the basic
amenities in the house. An attempt is also made in the chapter to
classify the sample by the expenditure and income data, including
remittances from migrants.
1.5.2 In Chapter IV the prevalence, incidence
and pattern of morbidity are presented, covering also the type of
treatment and the expenses involved. An attempt is then made to
highlight the financial burden caused by the disease by describing the
source of money spent for treatment how it was raised and the loss of
wages due to illness. In the same chapter the mortality in the sample
population is described, finding out the age and cause of death. The
fifth chapter is about reproductive health of women, starting from
their menarche, going through marriage, conception, antenatal care,
delivery and contraception. While the women in the reproductive age
group are the main respondents in this chapter, it also captures some
aspects of reproductive health of adolescence girls. Chapter VI is
about Child Health. The aspects described are breast-feeding, birth
weight, immunisation and nutritional supplements. The story of
reproductive health continues in Chapter VII, which focuses on the
awareness of HIV/AIDS, sexually transmitted diseases and infections of
the reproductive tract. The awareness of mode of transmission, the
source of information and misconception about the diseases are covered.
Three groups of respondents are involved in this chapter, namely women
and men in the reproductive age group and adolescent girls.
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1.5.3 Chapter VIII is about the
utilisation of public facilities and the assessment of the quality of
service there. Responses on the choice of treatment facility and the
reasons for the choice given by various groups are put together in this
chapter and the determinants of client satisfaction are explained. In
Chapter IX the result of the in-depth interviews with community leaders
service providers, programme managers, NGOs, health activists and
policy planners are put together. Their suggestions for improvements
are grouped under various headings. The last chapter is a brief
description of the summary and conclusion.
II. Data and Methodology
2.1 Introduction
2.1.1 This is a two pronged study;
the first being a sample survey of residents of the study area and the
second, an in-depth enquiry with community leaders, service providers,
programme managers, NGOs in the field, health activists and planners
and policy makers. We felt that such a two level structure will enable
the study to meet our objective more meaningfully and policy
recommendations will emerge with better quality.
2.2 Sampling Procedure
2.2.1 The city of Trivandrum
consisted of 50 wards covering an area of 74.93 square kilometers till
October 2000. The areas outside the city consists of villages divided
into administrative units called Panchayats, which have an elected
local governments, like the city. Five such Panchayats surrounding the
city were added to the city in October 2000. These five Panchayats
(details in Annexure 1) were added as 31 wards to the city making the
total number of wards 81 and the area 141.74 sq km. The five added
Panchayats brought in an additional population of 350,091. The current
population of the city is 744,739 (Census 2001a). The old city area had
36 properly designated slums. The newly added areas, being rural in
nature till October 2000, did not have such a list. We went through the
development plans of these five Panchayats and found that there were
really poor areas with slum like conditions in terms of socio-economic
status and environmental conditions, some being worse off than the
slums of the city. These poor areas were found to be a distinct group,
different from the slums and non-slum areas of the old city. We thus
decided to treat them as a separate unit, and call them, for want of a
better expression, `Suburbs’.
2.2.2 In view of the constraints on resources
and the possibility of coming to commonly applicable findings we
decided to have a convenient sample of 1000 households from the three
areas viz., slums, non-slum areas and suburbs. As our main focus was on
the slums, we decided to select one half of the total sample i.e. 500
from there, 250 from the suburbs and for comparison, 250 from the
non-slum areas. A uniform sampling procedure was adopted in all the
areas. The 36 slums in the old city were divided into 6 groups based on
the size of the land area since the sizes of the slums are not uniform.
The formulation of the six groups is as follows.
| Group I |
Area <0.2 hectare |
| Group II |
0.2 - 0.49 hectare |
| Group III |
0.5 - 0.9 hectare |
| Group IV |
1.0 - 1.49 hectare |
| Group V |
1.5 – 4.99 hectares |
| Group VI |
5 hectares and above |
2.2.3 From each group, two slums were selected
using simple random sampling technique, making a total of 12. The total
population of each slum was available (given in Annexure I) and the
average household size was taken as 5 as this the household size in the
district of Thiruvananthapuram according to the Census of 1991. Using
this information, we estimated the number of households in each
selected slum. The sample size of each slum was determined by the
technique of probability proportional to size (PPS). [(Number of HH in
the index slum/ total HH) * 500]. The sample households were then
selected by systematic sampling method with random start.
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2.2.4 In the five `suburbs’, we
found 47 slum-like locations for our study. From each suburb, two
localities were selected randomly, making a total of ten. Twenty-five
households from each were selected using the same procedure as
mentioned earlier. Thus the sample size for the suburban area is 250
households.
2.2.5 Again, 250 non-slum households from the
study area were also selected. The corporation area consists of 81
wards currently (see Annexure I). From these wards, 10 were selected
randomly and each ward was divided into four segments using topographic
maps showing roads, by lanes etc. From these four segments, one was
selected randomly. From the selected 10 segments, 25 households were
taken using the same sampling procedure followed in the other cases.
2.2.6 As the second major component of our
study, apart from the sample of respondents from households, a
representative sample of 56 functionaries consisting of community
leaders, service providers, programme managers and planners and policy
makers were also interviewed for understanding their perceptions,
attitudes and suggestions for improving primary health care in slums.
(The list of those interviewed in Annexure II) This was done in a
hierarchical way. First, the data on qualitative aspects reported by
the household respondents were taken up with community leaders to
obtain their reactions. The opinions and perceptions of the leaders of
the community, NGOs, health activists and the service providers were
collected to discuss with the policy makers and programme managers how
to formulate and implement strategies for the improvement of health
care systems in the slums.
2.3 Questionnaire
2.3.1 The first phase of the
survey was intended to collect a variety of information about the
households and individuals to study the level of health status in
general and the Reproductive and Child Health (RCH) in particular along
with the utilisation of public health care system. The field survey
used 106 questions grouped into four: on the household, on the burden
of disease, on Reproductive and Child Health and on the quality of
Public health care service. The questionnaire was prepared in the local
language of Malayalam (English translation in Annexure III) and its
pretest was carried out in the study area.
2.3.2 The household questionnaire consisted of
four sections. In section 1, all usual residents, as reported by the
head or an elderly member of household in each sample were listed. For
each person, the survey collected information on age, sex, marital
status, religion, education, occupation, and relationship with the head
of the household. Section 2 collected information on the ownership of
the house, materials used for the house construction, electrification
of the house and the type of cooking fuel used. Section 3 covered the
environmental condition, asking about the toilet facility, the source
of drinking water and water for other needs and the provision for
wastewater disposal. In order to understand the overall economic status
of the sample, possession of household durables, the monthly
expenditure on food and other items in the family were elicited in
section 4. These points were covered in the first seventeen questions
and the 105th and 106th questions, which were the last, tried to obtain
information on income of the households including income from
remittances from members working outside the state and country.
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2.3.3 The next group of questions
was intended to assess the health status of the sample, the pattern of
morbidity and mortality and the burden of disease. The questionnaire
collected information on the prevalence of disease with a recall period
of one month prior to the survey date, the treatment taken, expenditure
on the treatment, source of money for that and the income loss due to
the disease for each member of the household. Then the questionnaire
gathered information on the death of any member in the household within
three years of the survey date. The information on age, sex and marital
status of the females of the household was used to identify the
respondents for administering the women's questionnaire.
2.3.4 The questionnaire on Reproductive and
Child Health which was the third group consisted of four sections. The
first section collected information from all ever-married women in the
reproductive age of 15-49 years. In order to understand the demographic
and health behaviour of the sample women, a series of questions (from
numbers 35 to 66) were included in this section. The background
characteristics such as age, education, occupation, religion etc. of
the couples were collected. The details of each pregnancy such as the
date of delivery, outcome of pregnancy, sex and survival status of each
child, date of death if not living, and details of miscarriages were
included in the questionnaire. Questions were also asked about the
onset of menstruation, present menstrual status, problems related to
menstruation and treatment taken. Details regarding last pregnancy
including its outcome, problems, antenatal, natal and postnatal care,
place of delivery and breast-feeding behaviour were also gathered. In
addition to this all currently married women were asked about their
current pregnancy status, use of contraceptives, problems related to
the use of a specific method and treatment taken and the reasons for
nonuse.
2.3.5 The second section in this group covered
Child Health, collecting the details of immunisation against six
vaccine preventable diseases and child care of the last child aged two
years or less at the time of survey. The age at the administration of
each vaccine, the number of doses, the date and place of administration
and the reasons for non-immunisation were asked. The details of Vitamin
A drops, Iron and Folic acid and Pulse Polio immunisation taken were
also collected through this interview schedule.
2.3.6 In the third section, questions were
included to assess the awareness of Reproductive Tract Infections
(RTI), Sexually Transmitted Infections (STI) and Acquired Immuno
Deficiency Syndrome (AIDS) among all ever married women of the selected
households and their knowledge about the curability of these diseases.
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2.3.7 The fourth section consisted
of questions on adolescent health of the females aged 13-18 years. They
were asked about their age at menarche, menstrual cycle, problems
related to menstruation, treatment taken, prevalence of white discharge
and the treatment for that, awareness of RTI/STI and HIV/AIDS and the
prevalence and treatment of RTI.
2.3.8 The fifth was about sexual health of males
between 13 and 54 years. Questions related to age, education, marital
status, total number of sons and daughters born and living were asked.
Then it went on to any problems of sexual health they had before or
after marriage, the treatment taken for these problems, reason for not
taking the treatment, the effectiveness of the treatment, knowledge
about STI and HIV/AIDS, transmission of the diseases and their
prevalence.
2.3.9 The last group of questions was about the
quality of government health services and client satisfaction.
Information on the visit of all ever-married women on any government
health facility for the last three months was collected. This
questionnaire gathered details of the presence of health staff in the
hospital at the time of respondent’s visit, their behaviour towards the
clients, availability of medicines, satisfaction about the treatment
received etc. Some questions related to client satisfaction of public
facilities were put to other respondents also in the context of the
burden of disease. But these were taken along with the data gathered in
this group for analysis.
2.4 Training and Fieldwork
2.4.1 In order to maintain uniform
survey procedure in all the selected areas, a 'Manual of Survey
Procedure' dealing with different aspects of the survey was prepared.
It consisted of instructions to the interviewers regarding interview
techniques, field procedure, method of asking questions and recording
answers. It also contained instructions to the editors and supervisors
of the survey. The methods for house listing and mapping were also
provided in the manual. Most of the interviewers were post-graduates in
Social Sciences with some prior experience in household data collection
although the minimum educational qualification fixed was a graduate
degree in social sciences. All field staff were given two weeks
training on the questionnaire, techniques of interviewing, mapping,
editing and other aspects of the study by the senior staff of the
Population Research Centre, University of Kerala, Thiruvananthapuram.
During the training, mock interviews were conducted between
participants and the pretest results were also evaluated. The field
survey was conducted during February - May 2001.
2.5 In-depth interviews
2.5.1 The second stage of the
study began by collecting information about the needs of the community
through in depth interview of the leaders of the community. Two
Research Assistants, one a Ph.D. in Social Demography and the other a
postgraduate in sociology and mass communication, both with several
years of experience in conducting such studies, interviewed the local
leaders and chiefs of nongovernmental organizations. They enquired with
the leaders about their assessment of the health problem of the
community, their expectations from the government programmes and what
role they played to alleviate these problems. Some of the NGOs
interviewed were also providers of some services. After getting a
picture of the health and reproductive health needs of the people, the
next stage was interviewing the providers of services. These were
Government functionaries in health at the cutting edge level, doctors
and paramedics of public and private hospitals both non-profit and for
profit. In the next stage the programme managers were interviewed with
the information collected from the first three groups. These were
government functionaries in the city health department and the Health
Services of the state who provided the services in the city area. This
was to understand program characteristics, program quality, program
management and policies and factors that affect them. The next group of
informants was health activists who had several ideas about cost
effective provisioning of services. All this information was used in
interviewing the planners and decision makers like the Mayor of the
City Corporation, District Medical Officer, Director of Health services
and the Principal Secretary to Government in the Health Department. The
information collected from these interviews is used in the appropriate
places in the study.
To Top
2.6 Data Processing
2.6.1 All completed questions were
edited in the field by the field editor and it was re-edited by the
field supervisor. The supervisor checked all skip sequences and
responses for consistency. Random checks were conducted by the Research
Assistant independently in the field. The data were coded after
assigning appropriate codes for open-ended questions. The coded data
were entered in computer and analyses was performed using the
Statistical Package for Social Sciences (SPSS).
III. Household Characteristics
3.1
This Chapter presents the major characteristics of
the sample household population such as age, sex composition, marital
status, income, expenditure, household conditions, possession of
durable goods, basic amenities and the socio-economic characteristics
of the usual residents. The main purpose of this Chapter is to describe
the environment in which the study population lives.
3.2 Age and Sex Composition
3.2.1 First we wanted to know the
age composition of our sample. The distribution of household population
by age and sex composition as recorded in the survey is shown in Table
3.1.
Table 3.1 Age and Sex Distribution of Household
Population
| Age Group |
Urban |
Suburban |
Total |
| Slums |
Non Slums |
| M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
| <1 |
1.1 |
0.9 |
1.0 |
0.6 |
1.3 |
1.0 |
0.8 |
1.3 |
1.0 |
0.9 |
1.1 |
1.0 |
| 1-4 |
8.8 |
5.8 |
7.2 |
3.8 |
4.6 |
4.2 |
7.4 |
7.4 |
7.4 |
7.2 |
5.9 |
6.5 |
| 5-9 |
9.2 |
9.1 |
9.2 |
7.6 |
7.1 |
7.3 |
7.6 |
6.8 |
7.2 |
8.4 |
8.1 |
8.2 |
| 10-14 |
8.2 |
8.1 |
8.2 |
10.4 |
6.3 |
8.3 |
8.0 |
9.4 |
8.7 |
8.7 |
8.0 |
8.3 |
| 15-19 |
7.6 |
10.8 |
9.3 |
8.6 |
8.2 |
8.4 |
10.3 |
8.5 |
9.4 |
8.5 |
9.6 |
9.1 |
| 20-24 |
9.8 |
9.8 |
9.8 |
7.4 |
8.8 |
8.1 |
10.5 |
11.1 |
10.8 |
9.4 |
9.9 |
9.6 |
| 25-29 |
7.9 |
9.4 |
8.7 |
7.2 |
7.9 |
7.5 |
10.5 |
7.0 |
8.7 |
8.4 |
8.5 |
8.4 |
| 30-34 |
5.9 |
7.5 |
6.8 |
7.0 |
8.8 |
7.9 |
8.7 |
9.2 |
9.0 |
6.9 |
8.2 |
7.6 |
| 35-39 |
9.2 |
9.4 |
9.3 |
8.2 |
8.8 |
8.5 |
7.2 |
7.4 |
7.3 |
8.5 |
8.8 |
8.6 |
| 40-44 |
6.7 |
5.5 |
6.1 |
6.6 |
5.7 |
6.2 |
6.3 |
6.3 |
6.3 |
6.6 |
5.7 |
6.1 |
| 45-49 |
6.7 |
5.1 |
5.9 |
5.0 |
5.6 |
5.3 |
5.3 |
5.5 |
5.4 |
5.9 |
5.3 |
5.6 |
| 50-54 |
5.8 |
5.8 |
5.8 |
3.2 |
9.2 |
6.3 |
2.7 |
7.7 |
5.2 |
4.4 |
7.1 |
5.7 |
| 55-59 |
4.3 |
4.4 |
4.4 |
9.4 |
6.5 |
7.9 |
7.6 |
5.0 |
6.3 |
6.4 |
5.0 |
5.7 |
| 60-64 |
2.5 |
3.2 |
2.9 |
4.4 |
4.4 |
4.4 |
2.9 |
2.8 |
2.8 |
3.1 |
3.4 |
3.2 |
| 65-69 |
3.1 |
2.0 |
2.5 |
4.8 |
3.3 |
4.0 |
2.3 |
1.7 |
2.0 |
3.3 |
2.2 |
2.7 |
| 70-74 |
1.6 |
1.9 |
1.8 |
3.0 |
1.9 |
2.4 |
1.5 |
1.1 |
1.3 |
1.9 |
1.7 |
1.8 |
| 75-79 |
0.8 |
1.0 |
0.9 |
2.4 |
0.2 |
1.3 |
0.4 |
0.6 |
0.5 |
1.1 |
0.7 |
0.9 |
| 80+ |
0.6 |
0.3 |
0.5 |
0.6 |
1.3 |
1.0 |
0.2 |
1.3 |
0.7 |
0.5 |
0.8 |
0.7 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
1060 |
1146 |
2206 |
501 |
522 |
1023 |
526 |
542 |
1068 |
2087 |
2210 |
4297 |
Median
age |
27.8 |
27.5 |
27.5 |
32.7 |
32.8 |
32.7 |
27.1 |
28.3 |
27.7 |
28.6 |
28.9 |
28.7 |
To Top
3.2.2 The total population
surveyed is 4297 distributed in 1000 households. The slum population of
the city is 11,667 (Census 2001a). The survey covered 2206 people in
the slum, making 18.9 per cent of the total slum population. There are
2087 males and 2210 females, making up a sex ratio of 1059 females for
every 1000 males. In a country with a sex ratio of 933, this is indeed
remarkable. But the State of Kerala has shown a sex ratio favourable to
females in the recent decades, the last being 1036 in 1991 and 1058 in
2001 (Census 2001b). It is significant that in the slums, this ratio is
even higher at 1081.
3.2.3 It can also be found that on the whole
children below one year comes to 0.9 percent per cent, 1.1 per cent and
1 per cent respectively among the male, female and the total
population. Also there is a smaller proportion of children under age
five than age five to nine (except suburban) which is in agreement with
the ongoing demographic transition in the state from high growth to low
growth, as we saw in chapter one. Children in the age group of 1-4 are
around 7 per cent in the slums and in the suburbs while they are only
4.2 per cent in the urban areas. The fact that there is no such
difference in the 0-1 age group in the three areas indicates that the
fertility decline took place earlier in the urban areas and the poorer
people in the slums and in the suburbs are only catching up.
3.2.4 Young population (0-14 years) constitutes
nearly one fourth (24 percent) of the total for both sexes. One has to
view this in the context of India and Kerala where the corresponding
figures are 36.1 per cent and 27.6.per cent respectively as revealed in
NFHS –2 (IIPS and ORC Macro 2001) . In the non-slum areas, the young
population constitutes 20.8 per cent, while it is much higher in the
suburbs at 24.3 per cent and slums at 25.6at 25.6 per cent. This adds
one more piece of evidence to the observation in the previous paragraph
that fertility decline has been delayed in the slums and suburban
areas. There is a larger number of the population in the younger age
group than in the older age groups of each sex in all the study areas.
Among the total population 55 per cent are in 15-49 age group. The
highest proportion (56.9 per cent) of this age group is in the suburban
area followed by slum (55.9 per cent) and non-slum (51.9 per cent).
Moreover women outnumber men at the oldest ages (80+) except with a
slight difference in the slum. Women are generally believed to be more
likely to survive to older ages leading to a higher expectation of life
for them. Though the difference appears negligible at present, it is
quite likely that the gap will widen in course of time when demographic
transition becomes universal.
3.2.5 The median age of the population shows the
youthful character of the population of the study area. For the total
population it is 28.9 years. The median age for females is higher by
0.3 years. This, again, is in tune with a higher expectation of life at
birth for females.
To Top
3.2.6 In order to find the dependency ratio in the
sample we extracted the data from Table 3.1 and put it in Table 3.2.
Table 3.2 Households by Age
| Age Group |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| < 15 |
25.5 |
20.8 |
24.3 |
24.1 |
| 15-64 |
68.9 |
70.5 |
71.2 |
69.8 |
| 65+ |
5.6 |
8.7 |
4.5 |
6.1 |
| Total |
100 |
100 |
100 |
100 |
| Dependary Ratio (%) |
45.1 |
41.8 |
40.4 |
43.3 |
3.2.7 The distribution of population by broad age
groups shows that the largest share of nearly 70 per cent is in the age
category of 15-64 years and the lowest share of 6 per cent is in the
age group 65 years and above. The age distribution of population in
suburban and slum are quite similar. The dependency ratio indicates
that for every person in the productive age group there are 0.4 persons
under age 15 or age 65 and above. The dependency ratio in the slums at
45.1 is higher than in the other areas.
3.3 Marital Status
3.3.1 Table 3.3 describes Marital Status of
household population at the time of the survey.
Table 3.3 Marital Status by Household Population
Marital
Status |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
| Single |
52.1 |
43.3 |
47.5 |
46.1 |
38.5 |
42.2 |
51.4 |
42.1 |
46.6 |
50.5 |
41.8 |
46.0 |
| Married |
44.7 |
40.9 |
42.7 |
49.3 |
45.2 |
47.2 |
44.9 |
42.8 |
43.8 |
45.8 |
42.4 |
44.0 |
| Widow |
1.8 |
11.9 |
7.0 |
3.2 |
10.7 |
7.0 |
2.8 |
10.7 |
6.5 |
2.4 |
11.3 |
7.0 |
| Divorced |
0.3 |
0.3 |
0.3 |
0.0 |
0.2 |
1.0 |
0.0 |
0.2 |
0.1 |
0.1 |
0.2 |
0.2 |
| Separated |
1.1 |
3.7 |
2.4 |
1.4 |
5.4 |
3.4 |
0.9 |
4.2 |
2.6 |
1.1 |
4.2 |
2.8 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
500 |
250 |
250 |
1000 |
3.3.2 It is observed that overall 44 per cent of
the population is currently married, 7 per cent widowed and another 3
per cent per cent divorced or separated. In all the three areas, males
outnumber females both in the never married and married categories.
However, in widowhood women outnumber men in all the three areas. In
the suburbs and slum areas, the proportion of never married was more
than married. But this trend was reversed in the non-slum area.
To Top
3.4 Household Composition
3.4.1 Table 3.4 provides the percent distribution
of households by sex of head of households and other members, size and
relationship structure.
Table 3.4 Household Composition
| Details |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
|
Household Headship
|
| Male |
76.6 |
83.6 |
78.4 |
78.8 |
| Female |
23.4 |
16.4 |
21.6 |
21.2 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
| Relationship |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
| Head |
36.1 |
10.2 |
22.7 |
41.7 |
7.8 |
24.4 |
37.3 |
9.9 |
23.4 |
37.7 |
9.6 |
23.3 |
| Wife |
0.0 |
31.6 |
16.4 |
0.0 |
37.0 |
18.9 |
0.0 |
33.7 |
17.1 |
0.0 |
33.4 |
17.2 |
| Husband |
0.4 |
0.0 |
0.2 |
0.4 |
0.0 |
0.2 |
0.9 |
0.0 |
0.5 |
0.5 |
0.0 |
2.5 |
| Son |
49.9 |
0.0 |
24.0 |
46.5 |
0.0 |
22.8 |
49.8 |
0.0 |
24.5 |
49.1 |
0.0 |
23.8 |
| Daughter |
0.0 |
34.2 |
17.8 |
0.0 |
39.3 |
20.0 |
0.0 |
35.2 |
3.6 |
0.0 |
35.7 |
18.3 |
| Grandchildren |
16.6 |
10.8 |
8.8 |
5.0 |
5.4 |
5.1 |
7.2 |
5.4 |
4.4 |
6.4 |
8.2 |
7.3 |
| Son-in-law |
4.3 |
0.0 |
2.1 |
4.6 |
0.0 |
2.2 |
3.4 |
0.0 |
2.7 |
4.2 |
0.0 |
2.0 |
| Daughter-in-law |
0.0 |
7.9 |
4.0 |
0.0 |
3.8 |
1.9 |
0.0 |
5.4 |
2.7 |
0.0 |
6.3 |
3.2 |
| Parent |
0.5 |
1.8 |
1.1 |
0.8 |
2.1 |
1.5 |
0.0 |
2.8 |
1.4 |
0.4 |
2.1 |
1.3 |
| Other |
2.2 |
3.4 |
6.6 |
1.0 |
4.6 |
2.9 |
1.4 |
7.6 |
4.7 |
1.6 |
4.6 |
3.3 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
1060 |
1146 |
2206 |
501 |
522 |
1023 |
526 |
542 |
1068 |
2087 |
2210 |
4297 |
3.4.2 As one would expect in a
typical household group in India, the large majority of households
(78.8 per cent) is headed by males. The proportion of female-headed
households is more in slums (23.4 per cent) compared to the suburbs
(21.6 per cent) and non-slum areas (16.4 per cent) areas. Female-headed
households would have limited resources, which would be one
contributory factor for the relative poverty of these areas. About 24
per cent of the population is sons and 18.3 per cent daughters of the
head of household. Grandchildren constitute 7.3 per cent.
3.4.3 On an average, there are 4.3 persons in a
household in our sample; 4.1 persons in non-slum households, 4.3 in the
suburbs and 4.4 in the slums. This compares with 5.1in Kerala State and
5.4 in India (NFHS -2).
To Top
3.5 Religion
3.5.1 India is predominantly a
Hindu country with 82 per cent of the population professing this faith,
12 per cent Islam, 2 per cent Christianity and 4 per cent others in
1991. Kerala throws up a different picture with 57 per cent Hindus, 21
per cent Muslims and 20 per cent Christians (Census, 1991). Our sample
shows yet another mix. Table 3.5 gives the distribution of households
by major religious groups.
Table 3.5 Distribution of Households by
Religious Affiliation (%)
| Religion |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| Hindu |
46.6 |
70.4 |
82.0 |
61.4 |
| Muslim |
9.0 |
14.4 |
18.4 |
10.2 |
| Christian |
44.4 |
15.2 |
9.6 |
28.4 |
| Total |
100 |
100 |
100 |
100 |
| Number |
500 |
250 |
250 |
1000 |
3.5.2 Hindus are even higher than
in the state. But what is interesting is that the Christians constitute
the second largest religious community with 28.4 per cent. Muslims with
10.2 per cent are only about half the average of the state. Though
Hindus are the predominant group in all the three areas, the slums
present a different picture. There, Hindus and Christians are more or
less equally represented. One could venture an explanation in the fact
that many slums in our sample are inhabited by the fishing community
(not necessarily engaged in fishing) and there is a higher proportion
of Christians among them.
3.6 Education
3.6.1 Education has been
identified as the cornerstone of development as it affects almost all
aspects of human life and leads, among other things, to better health
outcomes. In a country with a total literacy rate of 54.16 per cent
(Census 2001b) Kerala flaunts itself as a 100 per cent literate state
and many writers attribute its high health outcomes and demographic
achievements to an early attainment of literacy especially among the
females.
3.6.2 The information on educational attainment
was collected for every member of the household. Since basic education
is starting at age six, only those above six have been considered here.
Table 3.6 provides the distribution of male and female household
members by the level of education obtained.
To Top
Table 3.6 Distribution of Population by
Education Level (%)
| Level of Education |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
| No Formal Education |
20.7 |
21.4 |
21.1 |
11.5 |
16.3 |
13.9 |
16.8 |
23.0 |
19.9 |
17.5 |
20.60 |
19.10 |
Primary
(Standards 1-4) |
18.3 |
18.0 |
18.1 |
8.9 |
8.1 |
8.5 |
14.8 |
18.1 |
16.5 |
15.2 |
15.60 |
15.30 |
Middle
(Standards 5-7) |
21.0 |
21.2 |
21.2 |
9.2 |
9.0 |
9.0 |
17.6 |
19.2 |
18.4 |
17.2 |
17.70 |
17.40 |
Secondary
(Standards 8 & 9)
|
21.9 |
27.7 |
24.8 |
11.6 |
12.5 |
12.1 |
26.7 |
27.6 |
27.2 |
20.5 |
24.00 |
22.30 |
| Matriculation |
12.9 |
8.1 |
10.4 |
23.3 |
18.8 |
21.0 |
15.2 |
6.0 |
10.5 |
16.0 |
10.20 |
13.00 |
| Under Graduate |
3.9 |
2.5 |
3.2 |
10.8 |
13.1 |
12.0 |
3.2 |
3.0 |
3.1 |
5.4 |
5.20 |
5.40 |
| Degree |
0.6 |
0.6 |
0.6 |
12.3 |
13.3 |
12.8 |
1.1 |
3.0 |
2.1 |
3.6 |
4.30 |
4.00 |
| PG and above |
0.7 |
0.4 |
0.6 |
12.3 |
8.9 |
10.6 |
4.6 |
0.0 |
2.3 |
4.6 |
2.40 |
3.50 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
945 |
1039 |
1984 |
471 |
480 |
951 |
475 |
496 |
971 |
1891 |
2015 |
3906 |
3.6.3 It shows that 19 per cent of the sample
did not have any formal education, 17.5 per cent males and 20.6 per
cent females. This does not mean that all of them are illiterate. Some
would have become literate as a result of the literacy mission, which
was a big movement in Kerala in the Nineties. Various reports of the
mission have shown that it had its impact in Trivandrum district also.
However the state figure for formal education is 92.8 percent for males
and 85.1 per cent for females. This figure is bettered in the urban
area with 88.5 per cent males and 83.7 per cent females (I-2). But when
it comes to our sample it is worse with 82.5 per cent for males and
79.4 per cent for females.
3.6.4 The overall level of education attained is
generally low among slum dwellers. On the whole a very small proportion
(7.5 per cent) of males and females have received higher education
leading to a university degree and above. Moreover, there is a notable
difference in educational attainment between the groups. People living
in non-slum areas have considerably more education than those living in
other areas. While 21 per cent of the non-slum areas have completed the
school education only 10.5 per cent in the suburbs and 10.4 per cent in
the slums have reached that stage. When it comes to women it is still
lower with 8 per cent in the slums and 6 per cent in the suburbs. Thus
one could say generally that the people in the slums are less educated
than their counterparts in the non-slum areas.
To Top
3.7 Occupation
3.7.1 After age, religion and
education, we probed into the nature of the occupation of the sample
population. Table 3.7 shows the distribution of occupational profile of
the sample household members.
Table 3.7 Distribution of Population by
Occupation (%)
Occupational
Status |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
M |
F |
Total |
| No Job |
19.4 |
17.6 |
18.5 |
23.9 |
16.6 |
20.1 |
10.2 |
18.4 |
14.4 |
18.2 |
17.6 |
17.9 |
| Govt. employee |
4.0 |
3.1 |
3.5 |
16.2 |
7.4 |
11.6 |
4.5 |
2.2 |
3.3 |
7.1 |
3.9 |
5.5 |
| Coolie |
6.4 |
5.0 |
5.7 |
2.3 |
0.7 |
1.5 |
12.5 |
11.5 |
12.0 |
6.9 |
5.5 |
6.2 |
Business
|
24.4 |
5.0 |
14.1 |
10.5 |
0.9 |
5.6 |
46.1 |
1.2 |
23.5 |
26.5 |
3.1 |
14.3 |
| Pensioner |
16.5 |
1.0 |
8.3 |
9.0 |
5.0 |
6.9 |
15.5 |
1.0 |
8.2 |
14.4 |
2.0 |
7.9 |
| Student |
5.1 |
19.5 |
12.7 |
21.9 |
17.1 |
19.4 |
3.0 |
17.7 |
10.4 |
8.7 |
18.5 |
13.8 |
| Housewife |
0.0 |
40.8 |
21.7 |
0.0 |
48.7 |
25.3 |
0.0 |
43.7 |
22.0 |
0.0 |
43.5 |
22.7 |
| Driver |
5.3 |
0.3 |
2.7 |
1.3 |
0.0 |
0.6 |
3.2 |
0.0 |
1.6 |
3.8 |
0.2 |
1.9 |
| Skilled |
5.5 |
4.0 |
4.6 |
5.4 |
1.9 |
3.6 |
4.0 |
2.9 |
3.5 |
5.1 |
3.2 |
4.1 |
| Non-skilled |
2.2 |
2.8 |
2.6 |
1.3 |
1.2 |
1.2 |
0.7 |
1.2 |
1.0 |
1.6 |
2.1 |
1.8 |
| Fishing |
11.2 |
0.7 |
5.6 |
8.2 |
0.5 |
4.2 |
0.2 |
0.0 |
0.1 |
7.6 |
0.4 |
3.9 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
770 |
873 |
1643 |
389 |
421 |
810 |
401 |
407 |
808 |
1560 |
1701 |
3261 |
To Top
3.7.2 Only those who were 15 years
and above were considered here. Of the total respondents nearly 18 per
cent reported that they have no work. Among non-slum population, this
is 20.1 per cent. Nearly 27 per cent of the male respondents are
engaged in business, much more (46 per cent) in the suburbs. Next to
business, the largest proportion of males (14.4%) is pensioners.
Government employees constitute 7.1 per cent of males. Nearly 8 per
cent are engaged in fishing. Around 7 per cent are coolies. We can
attempt to find the daily wage earners by adding three categories,
namely, coolies, non-skilled workers and those engaged in fishing. On
the whole 11.9 per cent of the people are daily wage earners, the slums
leading the pack with 13.9 per cent and the suburbs with 13.1 and
non-slums with 6.9 following.
3.7.3 Regarding female respondents, the largest
proportion (61.1 per cent) is either housewives or unemployed. 18.5 per
cent are students. Of the remaining, coolies came to 5.5 per cent,
government employees 3.9 per cent, business (petty vendors or running
small shops) 3.1 per cent and pensioners 2 per cent.
3.8 Condition of Housing
3.8.1 The household questionnaire
obtained the information on housing conditions and household
possessions. The data are helpful in assessing the standard of living,
the socio-economic status of the household and environmental conditions
in which the respondents live. Table 3.8 presents the distribution of
households by housing conditions like type of roof, wall, flooring and
the number of rooms apart from the details of ownership of the house.
Table 3.8 Distribution of Households by Housing
Characteristics (%)
| Characteristics |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
|
I. Ownership
|
|
| Ownership |
88.2 |
84.8 |
78.0 |
83.7 |
| Rent |
11.8 |
15.2 |
22.0 |
16.3 |
|
II. Roof
|
| Concrete |
24.4 |
59.6 |
21.2 |
32.4 |
| Tiled |
17.8 |
32.4 |
46.0 |
28.5 |
| Thatched |
45.4 |
4.8 |
25.6 |
30.3 |
| Sheet |
12.4 |
3.2 |
7.2 |
8.8 |
|
III. Wall
|
| Coconut leaves |
21.0 |
0.8 |
4.8 |
11.9 |
| Mud |
8.6 |
3.2 |
10.4 |
7.7 |
| Exposed Brick |
9.6 |
4.4 |
18.0 |
10.4 |
| Brick with Cement Plaster |
60.4 |
91.6 |
66.8 |
69.8 |
| Sack |
0.4 |
0.0 |
0.0 |
0.2 |
|
IV. Flooring
|
| Marble |
0.4 |
4.0 |
0.0 |
1.2 |
| Ceramic Tiles |
1.2 |
3.6 |
1.2 |
1.8 |
| Mosaic Tiles |
2.0 |
26.0 |
7.6 |
9.4 |
| Cement |
79.0 |
62.0 |
68.4 |
72.1 |
| Mud plastered with Cowdung |
13.4 |
4.0 |
20.4 |
12.8 |
| Exposed mud |
4.0 |
0.4 |
2.4 |
2.7 |
|
V. Number of Rooms
|
| One Room |
5.6 |
3.2 |
6.0 |
5.1 |
| Two Rooms |
23.0 |
1.6 |
6.4 |
13.5 |
| Three Rooms |
31.8 |
8.4 |
30.0 |
25.5 |
| Four or Five Rooms |
34.6 |
48.4 |
46.0 |
40.9 |
| Six and above |
5.0 |
38.4 |
11.6 |
15.0 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
500 |
250 |
250 |
1000 |
To Top
3.8.2 For the purpose of this
survey, the owner of a house is the person living in the house without
paying rent. Data indicate that among the total households 83.7 per
cent own their houses and the remaining 16.3 per cent pay rent. In the
urban area there were 15.2 per cent households who were paying rent for
their houses compared to 7.6 per cent in suburban and 11.8 per cent in
the slums. It may be noted here that there were instances where some
slum dwellers complained that they do not have title over the land they
occupy. But urban squatting, which is the major source of the creation
of slums, does not appear to be a major problem here unlike in the big
cities of India and the rest of the third world.
3.8.3 Coming to roofing, two materials, which
give permanent nature to it, are reinforced cement concrete and tiles.
By this standard 58.8 per cent of the houses in the sample have
permanent roofing, 32.4 per cent with concrete and 28.5 per cent with
tiles. 30.3 per cent had roofs thatched with cadjan coconut leaves,
which is a common roofing material for the poor in Kerala. Nearly 9 per
cent of the houses were roofed with sheets of various materials like
asbestos, aluminium and PVC. Only people with a reasonable means of
livelihood can afford to put concrete on top of their houses. Only 21.2
per cent in the suburban areas and 24.4 per cent in the slums could do
this while 60 per cent in the non-slums could afford it. Next in status
and cost would come tiled roofing. Transformation of roofing from tiles
to concrete is also an indication of the urbanization of the
households. This impression is borne out by the fact that 46 per cent
of houses in the suburbs have tiled roof while it is only 32.4 per cent
in the non-slums. But when it comes to the slums, the most popular
roofing material is coconut leaf thatch, covering 45.4 per cent of
houses as against 25.6 per cent in the suburbs and 4.8 per cent in the
non-slum areas. Houses that have sheet roof constitute 12.4 per cent in
the slums, 7.2 per cent in the suburbs and 3.2 per cent in the non-slum
areas. These two types of roofing are of a temporary nature and are
used by those who cannot afford the other two. Thus, 57.8 per cent of
the houses in the slums and about 33 per cent in the suburbs are of a
temporary nature, going by the roofing material. This can be taken as
an indicator of their access to resources.
3.8.4 Overall, the walls of a large proportion
of households are made up of bricks plastered with cement (69.8 per
cent). One out of ten houses have their walls made of bricks without
plastering. These two types of walls can be considered of a permanent
nature. Coconut palm leaves provide the walls of 12 per cent of the
houses and mud of 7.7 per cent. Sack is the wall material of 0.2 per
cent of the houses, all of which are in the slums. Thus 19.8 per cent
of the houses have temporary walls. While this constitutes only 4 per
cent of the houses in the non-slum area and 15.2 per cent in the
suburbs, it makes up a substantial 30 per cent of the houses in the
slums. It is safe to assume that the walls of a temporary nature with
materials like leaves, mud and sack do not have permanent roofing, as
it will not be supported by the walls. Thus out of the 57.8 per cent of
the houses in the slums with temporary roofing 30 per cent have
temporary walls also, making them insecure for living and liable to
perish in the heavy monsoons of the state. This also points to the
prevalence of poverty in the slums.
3.8.5 The type flooring used is another
indicator of the economic status of the occupant. Of the six types,
marble is the most expensive. No house in the slums has it. But 4 per
cent of the houses in the non-slum areas have it, while only a
negligible number (0.4 per cent) in the suburbs use it. The next
high-cost item is ceramic tiles, which is used by 3.6 per cent of the
houses in the non-slum area and only 1.8 per cent in the slums and
suburbs. The most commonly used flooring material is cement, covering
72 per cent of the houses. While nearly 92 per cent of the houses in
the non-slum areas are of this type, only 66.8 percent in the suburbs
and 60.4 per cent of the slums belong to this group. The traditional
flooring in the state is beaten earth covered with cow dung, which has
to be re-applied every now and then. This prevails to some extent in
the rural areas of the state. It is therefore not surprising that more
than 20 per cent of the houses in the suburbs have this kind of
flooring. This decreases to 13.4 per cent as we go to the slums and to
4 per cent in the non-slum areas of the city. But there are some people
who are too poor to afford even the cow dung covering for the mud
floor. They have just the beaten mud as their floor. Four per cent of
the houses in the slums and 2.4 per cent of the suburbs are of this
type. It is negligible in the non-slum areas.
3.8.6 The information on the number of rooms
that a household has, gives a measure of crowding. While most of the
respondents in urban areas (86.8 per cent) live in fairly adequate
space with four or more rooms, 53.2 per cent in the suburban areas and
much less (39.6 per cent) in the slums live with such convenience. On
the other hand, an overwhelming proportion of respondents in slums
(44.1 per cent) and in the suburban areas (42.4 per cent) live in
limited space with three rooms or less, against only 13.2 per cent in
the non-slum areas. The proportion of households that live in single
room and two-room tenements in the slums are 5.6 and 23 per cent
respectively, giving a picture of their overcrowding. With all these
features, it would not be far off the mark to infer that about 30 per
cent of the people in the slums are too poor to afford houses that keep
the minimum standards.
To Top
3.9 Household Durable Goods
3.9.1 In order to obtain
additional information on the economic status of households, the
respondents were asked about the possession of certain domestic items.
Table 3.9 shows the percentage of households having certain durable
goods.
Table 3.9 Distribution of Households by
Possession of Durable Goods (%)
| Possession |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| Telephone |
14.4 |
56.8 |
16.4 |
25.5 |
| Refrigerator |
11.4 |
52.0 |
10.0 |
21.2 |
| Washing Machine |
2.0 |
26.0 |
0.0 |
7.5 |
| Television |
56.8 |
89.2 |
51.2 |
63.5 |
| VCR/VCP |
5.0 |
29.6 |
2.4 |
10.5 |
| Water pump |
3.6 |
11.2 |
1.6 |
5.2 |
| Grinder |
7.6 |
51.2 |
4.0 |
17.6 |
| Fan |
60.2 |
94.0 |
45.6 |
67.7 |
| Radio |
37.4 |
61.6 |
24.0 |
41.9 |
| Sewing Machine |
15.0 |
21.6 |
6.8 |
15.2 |
| Tape Recorder |
3.8 |
5.6 |
1.2 |
0.3 |
| Electric Mixer |
26.3 |
25.9 |
15.0 |
23.5 |
| Computer |
0.0 |
2.8 |
0.0 |
0.2 |
| Number |
500 |
250 |
250 |
1000 |
3.9.2 The data indicate that
almost 68 per cent of the households have fans (94 per cent in urban,
46 per cent in suburban and 60 per cent in slum) and 64 per cent own a
television (89 per cent in urban 51 per cent in suburban and 57 per
cent in slum). A little more than one fourth of the households have a
telephone. The proportion is high in the non-slum area (56.8 per cent)
than the suburbs (16.4 per cent) and slums (14.4 per cent). About one
fifth of the households also possess a refrigerator. The distribution
is more than half in the non-slum areas (52 per cent) followed by 11.4
per cent in the slums and 10 per cent in the suburbs. On the contrary,
it was observed that the percentage of households possessing electric
mixer is more in the slums (26.3 per cent) than in the other two areas.
But it may be noted that 51.2 per cent of the houses in the non-slum
areas have grinders. Probably the function of electric mixer is also
carried out by the grinders. Only 2.8 per cent of the households
possess a computer, none in the slums or suburbs. Ownership of
household durables varies tremendously between the areas. A comparison
of the extent of material possessions reveals that its degree is higher
in the non-slums than in the other two areas. The non-slum differential
is particularly strong for telephones, refrigerators, television,
VCR/VCP, fan and radio.
To Top
3.10. Ownership of Vehicles
3.10.1 Table 3.10 provides the
percentage of households owning certain vehicles.
Table 3.10 Distribution of Households by
Ownership of vehicles (%)
| Vehicle |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| Car |
0.2 |
12.4 |
0.4 |
3.3 |
| Scooter |
9.2 |
33.2 |
16.4 |
17.0 |
| Auto rickshaw |
0.2 |
0.8 |
2.8 |
0.2 |
| Cycle |
22.2 |
24.4 |
13.6 |
21.5 |
| Boat with Engine |
1.0 |
0.0 |
0.0 |
0.1 |
| Number |
500 |
250 |
250 |
1000 |
3.10.2 Those who have one type of
vehicle or the other are less than half. More than a fifth of the
households own a bicycle (24.4 per cent in urban, 13.6 per cent in
suburban and 22.2 per cent in slums). Next to bicycle, scooter is the
most commonly owned mode of transport. On the whole 17 per cent of the
households possess a scooter. The proportion is 33.2 per cent in the
urban area, 16.4 per cent in the suburbs and 9.2 per cent in slums).
Overall only 3.3 per cent of households possess a car. Only one
household in the slum possesses a boat with engine, which is used for
the purpose of fishing.
3.11 Basic Amenities
3.11.1 Besides the nature of
houses, living conditions are influenced by the basic amenities
available. The presence of certain facilities affects the health as
well as the quality of life of the people. Here an attempt is made to
find out the availability of these amenities, which include
electricity, fuel, drinking water, water for other needs, toilet
facility, drainage facility etc. These physical characteristics of the
household have an important bearing on exposure to environmental
pollution as well as reflecting household economic condition. Table
3.11 provides information regarding the household amenities available.
To Top
Table 3.11 Households by Basic Amenities (%)
| Basic Amenities |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
|
I. Electricity
|
| Yes |
74.8 |
97.2 |
85.6 |
85.9 |
| No |
25.2 |
2.8 |
14.4 |
14.1 |
|
II. Fuel
|
| Wood |
75.4 |
32.0 |
84.0 |
66.7 |
| Kerosene |
9.0 |
2.0 |
1.6 |
5.4 |
| Gas (LPG) |
15.6 |
66.0 |
14.4 |
27.9 |
|
III. Drinking Water
|
| Tap at Home |
24.2 |
68.0 |
12.0 |
32.1 |
| Public Tap |
66.2 |
8.8 |
39.2 |
45.1 |
| Own Well |
8.6 |
23.2 |
30.0 |
17.6 |
| Public Well |
1.0 |
0.0 |
18.0 |
5.2 |
|
IV. Water for other needs
|
| Tap at Home |
22.0 |
66.0 |
11.2 |
30.3 |
| Public Tap |
51.8 |
9.2 |
26.0 |
34.7 |
| Own Well |
24.8 |
24.4 |
39.6 |
28.4 |
| Public well |
0.8 |
0.4 |
20.4 |
5.6 |
| Pond |
0.4 |
0.0 |
0.0 |
0.2 |
| Stream/River |
0.0 |
0.0 |
2.8 |
0.7 |
| Bore well |
0.2 |
0.0 |
0.0 |
0.1 |
|
V. Drainage Facility
|
| Without Cover |
20.0 |
4.4 |
2.4 |
11.7 |
| With Cover |
14.0 |
34.4 |
0.0 |
15.6 |
| Pit |
0.4 |
2.0 |
0.0 |
0.7 |
| No Facility |
65.6 |
59.2 |
97.6 |
72.0 |
|
VI. Stagnation of Water
|
| Yes |
23.6 |
7.6 |
23.2 |
19.3 |
| No |
76.4 |
92.4 |
76.8 |
80.7 |
|
VII. Toilet Facility
|
| No Facility |
34.6 |
1.6 |
24 |
23.6 |
| With Flush |
6.7 |
45.5 |
8.9 |
19.8 |
| Without Flush |
78.4 |
50.4 |
72.7 |
67.9 |
| Pit |
14.9 |
4.1 |
18.4 |
12.3 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
500 |
250 |
250 |
1000 |
|
No Facility
|
| Public Toilet |
46.2 |
0.0 |
10.0 |
36.3 |
| Open Ground |
53.8 |
100.0 |
90.0 |
63.7 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
173 |
4 |
16 |
237 |
3.11.2 Electricity is widely
available in the study area. Overall 85.9 per cent of the households
have this facility. Electricity is much more common in non-slums, 97.2
per cent of households having it, compared to 85.6 per cent in the
suburbs and 74.8 per cent in the slums. It is observed that about one
fourth of the households in the slums is deprived of electricity while
in the non slums it is less than 3 per cent.
3.11.3 Wood is the main source of fuel for
cooking. Overall 66.7 per cent of the households use this fuel, 27.9
per cent use LPG and 5.4 per cent kerosene. While two thirds of the
households in the non-slums have LPG as their fuel, wood is the fuel
for three fourths of the households in the suburbs and slums.
To Top
3.11.4 Access to water and
sanitation is an important determinant of disease free living. Water is
generally supplied to all by the Government. But only some have
plumbing in their homes. Others depend for drinking water on the public
tap in the street or on wells, some their own and some public. The
majority (45 per cent) depends on street tap, only a third (32.1 per
cent) having taps in their homes. But the position changes grossly when
we disaggregate this data. Sixty eight per cent of the non-slum people
have piped water in their homes while only 24 per cent of the slum
dwellers and 12 per cent of the suburbans have this luxury. As one
would expect in a rural like setting, 48 per cent of the households in
the suburbs depend on well water, 30 per cent on their own wells and 18
per cent on public wells. But even within the non-slum areas of the
city, 23.2 per cent of the households depend on wells for drinking
water. It is noteworthy that only 9.6 per cent of slum dwellers depend
on well water for drinking.
3.11.5 Availability of water for other needs is
also important. A variety of sources of water are available in the
study area. We have seen that 45 per cent of the people take their
drinking water from public taps. While this is the source of water for
other purposes also, the proportion is only 34.7 per cent. This is
probably because of the difficulty in fetching the water from the
street tap, or due to their reluctance to use unprotected water for
drinking. Only a negligible proportion of households is dependent on
other sources like public well, river, pond and bore well.
3.11.6 Another facility that has an equal
bearing on health and disease- free living is the drainage system for
wastewater. Table 3.11 provides information regarding the type of
drainage system in the study area. A majority of the households (72 per
cent) has no drainage system operating in their locality. It was found
that most of the of households (97.2 per cent) in the suburbs have no
drainage facility, followed by 65.6 per cent in the slums and 59.2 per
cent in the rest of the urban area.
3.11.7 The respondents were asked whether there
was any stagnation of water around their houses. On the whole, more
than 80 per cent said that there was no stagnation of water within the
premises of their houses and hence it was not a problem for them. This
is surprising in the face of the fact that 72 per cent of the houses do
not have drainage facility. The lack of stagnation is probably because
of the undulating terrain of the city. Trivandrum is fortunate enough
to have been built on a complex of hills. Most of the remaining 20 per
cent of the households which have the problem of water stagnation are
in the slums and suburbs. The proportion is almost similar in both
areas. Another factor that reduces the stagnation of water in the slums
is that many of the slums are close to the sea where the sandy soil
percolates the water down quickly. Only 7.6 per cent of the households
in urban area have the problem of water stagnation.
To Top
3.11.8 Table 3.11 also provides
the information on the kind of toilet facilities used by the sample
households. It is found that 76.4 per cent of the households have
toilet facility. It is to be noted that in the slums only 65.4 per cent
of the households have this, while 76 per cent have this in the suburbs
and nearly all in the urban area.
3.11.9 Nearly 88 per cent of households have
modern facility. Out of this only19.8 percent have flushing facility.
It is quite disturbing that in the slums and suburbs 14.9 per cent and
18.4 per cent of the households respectively use pit latrines. In the
crowded settlements of the slums where 10 per cent of the houses use
well water for drinking, 15 per cent using pit latrines is not a
healthy sign. A similar health hazard is posed by those who use the
open ground as toilets. The two surveys carried out by Kerala Sastra
Sahitya Parishat (KSSP) had revealed that the open defecation in the
state had come down from 51.1 per cent in 1987 to 27. 6 per cent in
1996 (Kunhikannan and Aravindan, 2000) But one would have expected this
to be nil in a city like Trivandrum which is known for its cleanliness.
Therefore it is surprising that more than 63 per cent of those who do
not have toilets use open ground as toilets. This is a whopping 15 per
cent of the households in the sample area where 22.8 per cent of the
people take drinking water from wells. However the use of open ground
is negligible in the urban area where the dependence on open wells for
drinking water is substantial (23.2 per cent). Fortunately only 48
households (9.6 per cent) in the slums use drinking water from the
wells where the use of open ground for toilet is by 93 houses (53.8 per
cent of houses with no facility), which makes 18.6 per cent of the slum
population. In the suburbs 21.6 per cent use open ground for toilet and
48 per cent depends on wells for drinking water.
3.11.10 The reluctance to use public toilets was
probed informally by the enumerators and covered in the interview with
community leaders. The common complaint is that the number of public
toilets is not adequate and their maintenance is also poor. The doors
of some of them are broken or missing. In the absence of Corporation
sweepers, they are not cleaned frequently. In some cases, slum dwellers
have employed their own sweepers and tried to keep the toilets clean.
Inadequate facilities for latrines and their overuse in the absence of
cleaning have made them not only unserviceable but also extremely
unhygienic. The practice of pay-and-use toilets adopted in some other
cities in India and abroad is worth trying here.
3.12 Monthly Household Expenditure
3.12.1Information has been
elicited on expenditure for measuring the economic status of the
household population.
3.12.2Table 3.12 shows the distribution of the
sample households according to monthly expenditure.
Table 3.12 Monthly Expenditure of Households
| Monthly Expenditure (in Rs.) |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
| <500 |
13.6 |
0.8 |
6.4 |
8.6 |
| 500-999 |
24.6 |
5.2 |
30.0 |
21.1 |
| 1000-1499 |
23.0 |
12.0 |
27.2 |
21.3 |
| 1500-1999 |
22.0 |
18.4 |
16.4 |
19.7 |
| 2000-2499 |
9.2 |
14.8 |
7.6 |
10.2 |
| 2500-2999 |
4.4 |
16.4 |
5.6 |
7.7 |
| 3000-3499 |
1.8 |
11.6 |
4.0 |
4.8 |
| 3500-3999 |
0.8 |
7.6 |
1.6 |
2.7 |
| 4000-4499 |
0.4 |
6.0 |
0.0 |
1.7 |
| 4500-4999 |
0.0 |
2.0 |
0.4 |
0.6 |
| 5000+ |
0.2 |
5.2 |
0.8 |
1.6 |
| Total |
100.0 |
100.0 |
100.0 |
100.0 |
| Number |
500 |
250 |
250 |
1000 |
| Median |
1257 |
2459 |
1250 |
1477 |
To Top
3.12.3 On the whole, the average
monthly expenditure of more than half of the households (51 per cent)
in the sample was below Rs.1500. Poverty line in the urban area is
defined as having enough to consume to get 2100 calories per day. The
amount required for that at current prices is Rs. 372 per capita per
month (Oommen, 1999). For the family size of 4.3, the expenditure
required to cross the poverty line is Rs.1600. However our data is in
intervals of Rs500 and we can take Rs1500 as the cut off expenditure.
If we follow this criterion we can see that as high as 61.2 per cent in
the slums and 63.6 per cent in the suburbs are below the poverty line,
while only 18 per cent in the non-slum area come in this category.
However we recognize that this data is only a quick measure of poverty,
which has other dimensions. Households with monthly expenditure above
Rs.1500 and below Rs.5000/- constitute about 47.4 per cent. The number
of households with expenditure more than Rs.5000 was extremely low
at1.6 per cent.. It can also be seen that the largest group of 18.4 per
cent in the non-slum areas spends in the range of Rs.1500 to Rs.2000,
whereas in the suburbs and slums it is 16.4 and 22 per cent
respectively. . If we take the expenditure below Rs500 as a rough and
ready measure of people living in abject poverty, there are 13.6
percent of the people absolutely poor in the slums and 6.4 per cent in
the suburbs whereas in the non-slums it is only less than one per cent.
The median expenditure for the sample is Rs.1477. For the slums it is
Rs.1257, for the suburbs Rs.1250 and for the non-slum area Rs.2459.
3.12.4 The questions on total expenditure were
not asked straight away. Item wise expenditure was asked and then added
to get the total. This gave more reliability to the data. The item wise
break up is given in Table 3.15.It reveals that the largest proportion
of the people in the slums (29.4 per cent) and in the suburbs (28 per
cent) spend in the range of Rs.1500 to Rs. 2000 on food. In the other
parts of the city the largest group (20.8 per cent) spent in the range
of Rs.3000 to Rs.3500 on food.
3.12.5 Coming to utilities, while all spent some
amount on fuel, nearly 63 per cent did not spend anything on water and
nearly 20 per cent did not spend on electricity. Most of the others in
all the three areas spent less than Rs.50 on water and less than Rs.150
on electricity. The expenditure on fuel also came to less than Rs.50
for most people.
3.12.6 But huge differential is noticed in the
expenditure towards rent. It is noteworthy that most of the people
(88.6 per cent) did not have to pay any rent. Ownership of houses seems
to be the ruling pattern across the three areas. The majority of those
who stay in rented buildings in the slums and in the suburbs pay less
than Rs.350 a month, while in the non-slum areas the majority pays more
than Rs.1050 per month. It is interesting that at least 2 families in
the slums also pay more than Rs.1050.
3.12.7 When it came to education more than half
the people did not have to spend anything. This could be due to a
variety of reasons like having no school-going children at the time of
the survey, getting the benefit of free education from the government
which is available for large sections of the population, support from
service organizations for books etc. Nearly a fifth of the households
in the slums and suburbs spent less than Rs.150 a month, while 22.8 per
cent in the non-slum areas spent up to Rs.350.
3.12.8 The next item queried was clothing. More
than a quarter of the households in the slums and suburbs spent only
less than Rs.50 a month on this item. More than half in these areas
spent up to Rs.150, whereas in the urban areas more than half spent up
to Rs.750 on clothing.
3.12.9 As far as expenditure on treatment is
concerned, 54.6 per cent of the total reported no expenditure. It is to
be noted that more than three fourth of the households in the non-slum
area did not have to spend anything on this. Nearly 30 per cent in the
slums and a fourth of the people in the suburbs spent less than Rs.150
a month on treatment. The expenditure on treatment for the episodes of
illness in the previous month is dealt with separately in Chapter IV.
3.12.10Thirty seven per cent in the slums and
40.4 per cent in the suburbs spent up to Rs.150 a month on travel,
while more than a third in the non-slum areas spent up to Rs.350. When
it came to entertainment, the picture changed. The vast majority (83
per cent) answered that they do not spend anything on entertainment.
Nearly 13 per cent spent below Rs.150 a month with some slight
variations across the areas. Probably they watch Television, nearly two
thirds having it at home (see Table 3.9). The expenditure on TV being
of a capital nature would not figure in the monthly expenditure. The
items grouped as miscellaneous include donations, gifts, charity etc.
Half the people do not have any expenditure on this and more than a
third spent less than Rs. 150 a month with some variations in the
areas.
To Top
Table 3.13 Distribution of Households by Item
wise Expenditure (%)
| Item wise Expenditure (in Rs.) |
Urban |
Suburban |
Total |
| Slum |
Non-slum |
|
Food
|
| <500 |
2.8 |
2.0 |
2.4 |
|
