Health issues in a Bangalore slum: findings from a household survey using a mobile screening toolkit in Devarajeevanahalli.

Background: Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum. Methods: A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied. Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved. Results: A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted. Conclusions: Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges.