Health-Seeking Behaviors, Health Information, and Health Awareness in Bangalore City Slums

According to the National Family Health Survey conducted by the Ministry of Health and Family Welfare in India, the urban population in India should exceed 550 million by the year 2030. As cities are becoming more concentrated, so are low-income slum settlements, areas typically inhabited by people of low socio-economic status with limited access to education and public health services. And as the country undergoes rapid urbanization and more and more people begin to migrate towards cities, considerable time and resources must be spent on assessing the quality and responsiveness of the urban healthcare system.

Over the past few decades, public health initiatives in India have been focused largely in rural areas, as most of the country’s poor live on farmlands where healthcare resources and infrastructure are sparse and spread out over considerable distances. Community health centers and hospitals are often understaffed, lacking supplies and measures to diagnose and treat disease, and are generally limited in their ability to provide valuable health information to the rural poor. If the rural poor are struggling to access essential health information and services, then how do the urban poor cope with ill-health in comparison?

Studies have shown that people living in urban spaces generally make more income, and are also closer in proximity to health providers and resources. However, despite what seems to be an abundance of resources in cities, there are still major disparities in health indicators amongst individuals living in the same urban area. For example, according to the NFHS-3, the under-five mortality rate was 73 for every 1,000 births amongst the urban poor, compared to just 48 for every 1,000 births when considering the average of all city dwellers in India. While the resources and infrastructure may seem to be there, public health facilities and outreach measures simply haven’t been able to keep up with the explosion of urban population growth, and as a result, many slum-dwellers are being left behind or outright neglected with regards to healthcare.

This study is particularly focused on understanding how urban slum-dwellers negotiate the urban health system in its current state, and how health information flows across individuals of different settlements and socioeconomic backgrounds. The study intends to address two main research objectives/questions:

1. Understand the health-seeking behaviors of the urban poor, and how health-seeking behaviors differ across individuals and settlements. What are the main factors that affect health-seeking behaviors?
2. What are the main sources of health information for people living in urban slums, and how do these sources of information differ across individuals?

By understanding the health-seeking behaviors of an individual, the main sources of health information an individual relies on, and their overall level of health literacy, we can better understand the relationships between these variables and how they affect attitudes towards healthcare.