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Other Documents
Kamla Gupta, Fred Arnold and H. Lhungdim
Publication Date
August 2009
Publication ID


This report analyzes health and living conditions in eight large Indian cities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur). The report is based on data from India's 2005-06 National Family Health Survey (NFHS-3). A special feature of NFHS-3 is that the sample was designed to allow separate estimates of population, health, and nutrition indicators to be generated for each of these eight cities, as well as for the residents of slum and non-slum areas in these cities. In addition, a wealth index was constructed for households in urban India as a whole, using NFHS-3 data on household assets and housing characteristics. For the purposes of this report, the urban poor population is defined as those persons belonging to the lowest quartile on this wealth index. The study examines the living environment, socioeconomic characteristics of households and the population, children's living arrangements, children's work, the health and nutrition of children and adults, fertility and family planning, utilization of maternal health services, knowledge of HIV/AIDS, attitudes of adults toward schools providing family life education for children, and other important aspects of urban life for the eight cities by slum/non-slum residence and for the urban poor The analysis shows that more than half of the population in Mumbai lives in slums, whereas the slum population varies widely in the other seven cities. Major differences in the estimation of the size of the slum population are found depending on how slum areas are defined (according to the 2001 Census designation or observation of the area by the NFHS-3 team supervisor at the time of the fieldwork). The poor population in these cities varies within a narrower range, from 7 percent in Mumbai to 20 percent in Nagpur. The analysis finds that a substantial proportion of the poor population does not live in slums and that a substantial proportion of slum dwellers are not poor (that is, they do not fall into the bottom quartile on the NFHS-3 wealth index). In some cities, the poor are mostly concentrated in slum areas, whereas the reverse is true in other cities. Although slum dwellers are generally worse off than non-slum dwellers, this pattern is not consistently true for all indicators in every city, and the differentials are quite small in some cases. However, there are large disparities in health and living conditions between the poor and the non-poor in these cities. Although there is an obvious need to improve living conditions and the health of slum dwellers, it is equally apparent that programs that focus solely on slum areas will not be able to address the urgent needs of the large poor population not living in slums.