Science Journal of Public Health
Volume 4, Issue 1-1, January 2016, Pages: 1-5

An Assessment of Health Status of Street Children in Tangail, Bangladesh

Md. Abdul Hakim*, Md. Jalal Talukder

Department of Food Technology and Nutritional Science, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Santosh, Tangail, Bangladesh

Email address:

(M. A. Hakim)
(M. J. Talukder).

To cite this article:

Md. Abdul Hakim, Md. Jalal Talukder. An Assessment of Health Status of Street Children in Tangail, Bangladesh. Science Journal of Public Health. Special Issue: Childhood Malnutrition in Developing Countries. Vol. 4, No. 1-1, 2016, pp. 1-5. doi: 10.11648/j.sjph.s.2016040101.11


Abstract: The study was conducted in a regional city Tangail, which is located in the central part of Bangladesh and well connected with the capital city Dhaka. There were 10% gamines and 90% street boys selected for the study from the twelve different upazilas in Tangail applying the simple random sampling method. Results divulged to contribute 66.67% underweight and 33.33% normal weight street children. According to the study, 34.97% children were different works doers and also about 65% were absolute work abstainers. The mainstream (85.5%) children were the three times and another 14.5% were two times daily meal eaters. Most children (85.3%) washed their hand before taking meal, 57.5% taken bath daily and 59.8% of them were diseases sufferers in the last 3 months prior to conducting study.

Keywords: Health status, street children, malnutrition, Tangail district, Bangladesh


1. Introduction

The street children are the girls and boys coming to fight to adorn the streets for their habitual abode and livelihood drifted into a nomadic life [1].  Child is a young up to 18 years age according to the section 4 of in vogue Bangladeshi Child Act 2013. Street children is a term to denote the homeless children regarding to live on the streets of different cities and urban areas worldwide and the homeless youth are often termed as street kids and street youths. The definition of street children is contradictory, but most of the practitioners and policymakers adopt the UNICEF given concept of homeless, care free and unprotected boys and girls aged less than 18 years to dwell on the streets are the street children [2]. The street children are considered as a part of thrown away (forced to leave home) children in many developed nations who are more likely to come from single-parent homes [3], or due to the consequence of polygamy in different societies across the world. These fellow children are often subject to abuse, neglect, exploitation, or extreme cases, murder by clean-up squad hired by businessmen, criminal gang and very often the police to retain great business benefit [4]. They are often involving in different illegal activities such as drug dealing, crime, theft, swindling and gang activities on the spur of their deprivation on culture, moral, tradition, shelter, income, social networking, health, nutrition, hygiene cares and religious rights owing to living away from families since the childhood [5] and however, a greater bulk of them is legal life sustaining works doers such as parking car washing, baggage loading, show polishing and others in different countries on the basis of cultural variation across the globe.

The UNICEF defines 3 groups of street children as (a) Street Living Children (children ran away from their families and live alone on the street), (b) Street Working Children (children to spend most of their day time on the streets fending for themselves, but returns home on a regular basis) and (c) Street Family Children (children living on the streets with their families) [6].

Children leave the home and heading to the streets in view of poverty, intra-family feud and alluring the modernity getting obstacles in continuation on these tend in their family structures and consequently broken families and child abuse [7,8].

The bulk of street children are on the rise day by day and they may reach 800 million if apt initiatives delayed to overcome the faced problems in this regard [9]. There are 63% of them going to bed hungry and 53% are chronic malnutrition sufferers, 27 million are severely underweight and 33million are not in school entry at all [1]. In 1990, the government assumed that there are about 1.8 million children on the streets in Bangladesh, about 215, 000 children including 1, 00000 girls are thought to be in Dhaka City alone and 12 years later, there are probably 7 million children on Bangladeshi streets, most of them work as car cleaners, beggars, vendors, newspaper sellers, garages helpers, rag pickers and in other informal areas in different hazardous works [10].

According to a report from Consortium for Street Children, a United Kingdom based consortium of related Non Government Organizations, UNICEF estimated that 100 million children were growing up on urban streets around the world. Fourteen years later, in 2002, UNICEF similarly reported, "The latest estimates put the numbers of these children as high as 100 million [11].

Research reveal that different form of malnutrition is associated poor growth, cognitive developments, educational performances and income in later life [12-18]. The children are the different diseases sufferers [19-21] on the basis of seasonal variation and some are chronic health disorders sufferers according to their dwelling topographic variation. About 73% of street children in Dhaka city suffer from chronic malnutrition while mortality and morbidity status among street dwellers has reached an alarming level for lack of basic health and nutritional care services [22]. A range of social, demographic and community factors have significant impacts on childhood malnutrition [23-26].

The study explores the health status situation of the street children in Tangail district, the central body of Bangladesh, which may help to form relevant programs on their issues. The study aim was to assess the nutritional status in association with their socio-demographic condition.

2. Methodology

2.1. Study Nature

The study was a cross-sectional study.

2.2. Study Areas

The villages at Tangail Sadar, Sakhipur, Basail, Madhupur, Ghatail, Kalihati, Nagarpur, Mirzapur, Gopalpur, Delduar, Bhuapur and Dhanbari upazilas of Tangail district on Dhaka division in Bangladesh were the areas to conduct the study.

2.3. Data Collecting Assay

A planned questionnaire was developed containing both the closed and open ended query to collect data through face-to-face interview with the respondents. The questionnaire was pretested in areas far away from the sample areas and revised according to the feedback gained in the field level. The questionnaire was formed to obtain the relevant information considering personal, household, social and economic details, dietary patterns, general behaviors, leisure period activities, drug addiction and abuse, anthropometric assessments and interrelation between different variables.

2.4. Anthropometric Data Collection

The anthropometric data were collected using the procedures listed below:

2.5. Body Weight Measurement

The body weight was recorded using the standard weighing machine keeping the respondent bare footed with minimal cloths.

2.6. Body Height Measurement

The height was recorded using modified tape keeping the respondent stranded on a platform, bare footed with their head upright, looking straight forward.

2.8. Nutritional Status Assessment

The nutritional statuses of the respondents were assessed using measured BMI.

2.9. Data Verification

The questionnaire was checked per day taking the interview and again these were carefully rechecked after collecting all the data and coaded prior the entrancing into computer technology. The   data was edited in case of sighting discrepancy (doubt entry, wrong entry etc.).

2.10. Statistical Analysis

The data were processed to undergo statistical analysis using SPSS 16 windows program. Microsoft Word, Microsoft Excel were used to represent the tabular, charts and graphical representation.

3. Results

Table 1. Socio-demographic contour of street children.

Grouping Frequency Percentage
Gender
Gamines 12 10
Boys 108 90
Ages (Years)    
6 to 10 35 29.17
11 to 15 85 70.83
Siblings    
< 3 22 18.33
3 to 5 57 47.5
6 to 8 41 34.17

Table 1 showed age distribution of respondent where 70.83% within 11 to 15 and 29.17% within 6 to 10 age ranging and it's also observed that 47.5% respondent had 3 to 5 and 18.33% had <3 siblings respectively.

Table 2. Monthly income and daily meal eaten frequency.

Grouping Respondents (%)
Monthly income (BDT)
>2000 35.5
1501 to 2000 28.5
1000 to 1500 31.8
<1000 4.2
Daily meal eaten frequency
4 0
3 85.5
2 14.5
1 0

Table 2 showed that 35.5% respondent earned >2000 BDT (highest) and 4.2% were <1000 BDT (lowest) earners. The highest (85.5%) children were the three times, 14.5% two times and 0% was four and single time meal takers per day.

Table 3. Hygiene practices and diseases experience.

Patterns Respondents (%)
Hand washing before eating
Yes 85.3
No 14.7
Daily bath taken
Yes 57.5
No 42.5
Suffering from diseases in last 3 months
Yes 59.8
No 40.2

According to table 3 information, 57.5% respondent took bath daily, 59.8% suffered from diseases in last 3 months and 85.3% washed their hand before eating as a common hygiene practices.

Figure 1. Summary of Nutritional status on the BMI basis.

Figure 1 presented to have 33.33% normal weight and 66.67% underweight respondent measured using the BMI standard. The greater portion of respondent was found in underweight meaning a galore gape on the track to attain nutritional soundness.

Table 4. Crosstab between nutritional status and age.

Ages (Years) Nutritional status
Underweight (n) Normal weight (n)
6 to 10 23 12
11 to 15 57 28
φ=-0.013

Table 4 proved that maximum respondent were in underweight and the gained phi coefficient (φ=-0.013) indicated that age of the respondent tends no difference in their nutritional status.

Table 5. Crosstab between nutritional status and education level.

Education level Illiterate Upto  the PSC
Underweight (n) 55 25
Normal weight (n) 12 28
φ=+0.367

The phi coefficient (φ=+0.367) from table 5 indicated that there were weak positive association of nutritional status with the education level of respondents.

Table 6. Crosstab between nutritional status and drinking water sources.

Water sources Underweight (n) Normal weight (n)
Tube well 29 57
Others 11 23
φ=+0.013

Table 6 represented that most respondents were tube well water drinker and the phi coefficient (φ=+0.013) achieved from the table indicated that the drinking water sources make difference in nutritional status.

Table 7. Working patterns of the respondents.

Patterns Percentage
Street hawker 10
Garbage picker 5.8
Buss helper 12.5
Others 6.67

Table 7 showed that 34.97% respondents were involved in different patterns of working status (Street hawker, garbage picker, buss helper etc.) and on the other hand the rest 65% of them were not involved in any type of works.

4. Discussion

The study was steered at Tangail district, the central landscape in Bangladesh of some 3.6 million populations with 1,100/ km2 population density on 3414.35 km2 surface area [27] in order to make the coverage of nutritional status of Tangail district street children as a central body of the state to support the ultimate nutritional assessment of Bangladeshi street children as a whole to aid taking intervention to upgrade their prevailing nutritional status assisting different socio- economic and demographic contour [28,29]. The government should take solvable action to reduce the malnutrition degree in association with the social status upgrading bid as the government is obliged to ensure the right to adequate healthcare and nutritional soundness to all the rural and urban population irrespective of cast, creed, income, gender and religion across the country as per the section 18 (A) of Bangladeshi Constitution lowering the prevailing malnutrition intensity. The education level of the children is desired to improve, using safe drinking water in obligatory in accordance with the achieved phi coefficient (φ=+0.367) from table 5 and phi coefficient (φ=+0.013) from table 6 orderly to improve their nutritional status and social living standard. The huge percentage of street children was found to be the malnutrition gainers by dint of lacked access to safe drinking water, inadequate nutritious foods, lack of hygiene practices and shelter. There were observed 66.67% underweight and 33.33% normal weigh in support of the conducted study which is comparable to findings of various studies conducted in various time frames in various countries [30,31].  Nutritional status reflects possible option to assure physiological needs driving away multidimensional existing horror in the target population to form malnourishment as big headache in the societies. With nutrients consuming in adequate proportion sorting various foods maintaining food guide pyramid, the standard nutritional status can gained through proper metabolism  [32-34] in the body to support growth and development, health and nutritional care and physical and mental activities and help to prevent diseases [35-37]. Lack of nutrition and homelessness related stress can be also contributing to early smoking behaviours of these children and smoking a significant social burden [38]. If their (nutrients) deficiency (often) and excess (rare) condition exists for long time, they result in interference with body functioning and increasing the occurrence of diseases [39]. The government should speed up national child protection system monitoring the children's rights violation keeping them from going back to the streets through various programs like education, drug detoxification programs and providing a safe family-like environment. A new type of socioeconomic modelling and policy analysis tools such as spatial microsimulation models [40-44] can be useful in this case to design effective policies and see any governments and non-governments organisations, environmental and spatial effects across different countries [45-48]. The International Day for Street Children is commemorates on April 12 each year with different gala themes as a formal advertisement fighting shy of the concerned children's rights but the day's importance and purposes are to be make clear to all the street children and the prompt measures proceed with as usual with the purposes to curb their life to lead astray.

5. Conclusion

Malnutrition is one of the premier public health problems in developing countries, the gravest single threat to global public health and the foremost child mortality contributor across the globe also.  The current study findings revealed that malnutrition problem is in multi-dimensional helm pointing different linkages to social, economic and demographic factors. The street life is in alarming magnitude of supreme vulnerability to feel into the destitute ditch making their hang heavy hard up life. The street children are in physical, mental, social and spiritual health perils and they are at bay of different violence, abuse and so on. The state patronization, different local and international Non Government Organizations are in galore need to come up with health, nutrition, hygiene and education programs to upgrade their condition on behalf of attaining their secured childhood.


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