Health Seeking Behavior Of Street Children In Jaipur City

Presented by :
Achint Kumar Ashish Tripathi Dikshita khanduja Himanshi choudhary Jaidev khatri Manisha Narang

Content
Introduction Problem statement Review of literature Rationale Research questions Research objectives Research methodology Tool and techniques Activity plan Budget Ethical consideration Limitations

Introduction
In India there are 11 million street children ,which are the 10% of worlds total population of street children.
(UNICEF2007)

Despite efforts by the government and many NGOs, the number does not diminish and it is growing continuously.
Jaipur city is selected for the study as it forms the focal point of massive in-migration(within Rajasthan) leading to the swelling population of street children.

Who are street children ?

Any boy or girl who has not reached adulthood, for whom the street has become his or her habitual abode or livelihood and who is inadequately protected , supervised or directed by responsible adults -By UNICEF

Street children can be put under three categories: Street children

Children on the street

Children of the street

Abandoned children

65.9% of the street children lived with their families on the streets.

31% 52% 17%

on footpath in night shelters other places

other places includes under flyovers and bridges, railway platforms, bus stops, parks, market places.
Source:UNICEF 2007

Problem statement
Careless attitude of street children towards their health and lack of motivation to avail health care services.

Review of Literature:
Study by Zena Amury and Anitha Komba This study was carried out in the three districts of Dares salam , Tanzania. It briefs about the poor utilization of health services by the street children. The study discusses Tanzania's National Health Policy with a focus on access to health care and also vulnerability of street children to diseases. Findings of the study reveal that street children frequently experience illnesses, injuries ,headaches etc. In addition, they also complained about the unfriendly behavior in public health care centers.

Assess to healthcare by street children in the urban context of N'djamena By- K.Wyss,L.Nodjadjim This study tells about the frequent illness episodes that street children are confronted with and also identifies the association of their illness with their living conditions and behaviors adopted by them. As per the study, the consumption of unsanitary water, hygienic condition, food , violence, alcohol and drugs have disastrous consequences on the health status of the children

STI profile and treatment seeking behavior of Street children in Surat. By-Asst Professor, Professor and head of Dept of community medicine, Surat Municipal Institute of Medical education and Research. This study focuses on STI infected children and those who are at risk. Its a cross sectional study conducted among 326 children. Findings reveals that almost half of the children had a history of having sex and were the victims of STI.All of them had the history of seeking Treatment irregularly and incompletely. Moreover the majority seeks treatment at public facilities where though the cost of treatment is less, the behavior of the staff is often unsatisfactory and the children feel stigmatized and ashamed. Al these factors compel them to seek treatment either from chemist ,quakes or unqualified allopathic doctor

Health-Seeking Challenges Among Homeless Youth. by Angela L. Hudson et al (Hudson A.L, Nyamathi A, Greengold B, Slagle A, Griffin DK, Khalilifard F). Study reveals that root cause for not availing health facilities among homeless youth was scarcity of service sites and long waiting time for the service. Beside that some other factor are also playing important role like discrimination by the service provider and a pervasive sense of stigma.

Psychological help-seeking in homeless adolescents. By-Collins P, Barker C A study conducted by Collins and Barker on homeless adolescents shows that perceived betrayal by their families made many participant reluctant to seek help from others. But many of them also shows that they are ready to take help from others if they are perceived to be genuine, caring, trustworthy, empathic and capable of containing their distress.

Illness incidence and health seeking behaviour among street children in Rawalpindi and Islamabad, Pakistan (- a qualitative study. Child Care Health Development) Ali M, de Muynck A. Another study conducted in Rawalpindi, Pakistan shows that the main cause of not using health services are long waiting time, monetary problem, negative attitude of service providers and their inferior status.

Rationale:
Population of street children in India is very high, that is 11 million.(UNICEF report 2007) They have careless attitude towards their health. They are not motivated enough to seek health care services. Not enough data is available on their health status. Not any specific National program is available to cater their health needs.

Research Questions: What are the factors/constraints that prevent street children to use health care services?

Research Objective:
To explore the perceptions of street children of Jaipur regarding their illness ,their health care seeking behavior.

To identify the obstacles in accessing the health care services by street children.

Methodology:
Research Study Design: Descriptive, cross-sectional

Study Place in Jaipur: Jawahar Nagar slum areas Mansarovar slum areas

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Sampling: Sampling Technique:

Multistage Sampling procedure Cluster sampling Systematic sampling Selected Sample : We will try to make sample size as large as possible within the time frame or we will continue the study till we get the point of redundancy,ie no new data comes up any more.

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Tools and Techniques

Data collection methods :Tools: Interview and FGDs guideline Techniques: In-depth Interviews Focus Group Discussions

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Variables
Economic

Migration Health Seeking Behaviour Abuse

Literacy

Attitude

Parental Negligence
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Action Plan
Week Activity
Discussion Review Litrature Selection of Area point Formulate Tool Pre-Testing Finalization of tools Field Movement Plan Selection of Investigators Training of Investigators Data Collection Analysis Plan Data Entry and Cleaning Data Analysis Report Writing 1 2 3 4 5 6 7 8 9 10 11 12

Budget
Office Administration Cost
Quantity Furnished Office Monthly expense ( Rs ) 7,000 Total ( Rs ) 21,000

Computer
Phone/Internet Stationary Travel allowance TOTAL COST

2
-

20,000
3,000 1,000 3,000

40,000
9,000 3,000 9,000 82,000

Personnel Project coordinator Research Officer Statistical analyst Field Supervisor Investigators Data entry operator Class IV TOTAL COST

Number 1 1 1

No of Months 3 3 1

Salary/mo nth 30,000 20,000 15,000

Total (Rs) 90,000 60,000 15,000

1
3 1 2 -

1
1 1 3 -

13,000
10,000 8,000 3,000

13,000
30,000 8,000 18,000 2,34,000

Activity Training cost Miscellaneous TOTAL

Total cost 10,000 5,000 15,000

Activities

Total

Human Resource Office administrative cost Other direct cost Sum Total

2,34,000 82,000
15,000 3,31,000

Ethical Consideration
The information gathered will be kept confidential and will not be released to anyone. The information about the key informants shall not be disclosed Data provided shall be used only for the purpose of research in Public Health Sector.

06 March 2012

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Limitations of study:
Some children might be scared to be interviewed by strangers(researchers). At times, children can be reluctant to discuss their experiences. Participation will be voluntary for children they can withdraw from participation at any time.

Refrences:
Hudson A.L, Nyamathi A, Greengold B, Slagle A, Griffin DK, Khalilifard F. Health Seeking Challenges Among Homeless Youth.Nurs Res. 2010 ; 59(3): 212218 Collins P, Barker C. Psychological help-seeking in homeless adolescents. Int J Soc Psychiatry. 2009 July;55(4):372-84 Ali M, de Muynck A. Illness incidence and health seeking behaviour among street children in Rawalpindi and Islamabad, Pakistan - a qualitative study. Child Care Health Dev. 2005 Sep;31(5):525-32 Patel N.B,Bansal R.K. STI Profile and treatment seeking behaviour of street children in Surat. National Journal of Community Medicine 2010, 1(1):12-16 Amury Z,Komba A.Coping strateties used by street children in the event of illness. REPOPA, Research Report 10/1. K. Wyss, L. Nodjadjim. Access to health care by street children in the urban context of N'DJAMNA, CHAD. UNICEF report 2007