Contrasting children and women's health and the determinants of health in a small-sized city
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Date
2005
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Abstract
Contrasts that exist in urban infrastructure and accessibility of public health and social services between suburban and urban districts of mega-cities have been well defined. There has been less research in small-sized cities (population under 500,000). This cross-sectional study was done on 1,728 ever-married reproductive-aged women living in Manisa, Turkey, in the year 2000. The probability proportion to size cluster sampling approach was used in the sample selection. Data were collected for women and 7,016 inhabitants of the interviewed households. The data were collected from the women by face to face interviews. Suburban areas (illegally occupied public land called "Gecekondu" dwellings) in Manisa differ from other urban regions (legal settlements of the city) on socioeconomic factors including household occupancy, adult literacy, social class, rates of religious marriages, unemployment, health insurance coverage, migration, cultural segregation, and social status of women. Some traditional practices were also highly prevalent in gecekondu families, where poverty is more common. Although gross fertility rate (GFR), total fertility rate (TFR), and percent decrease of the TFR were higher for gecekondu women than urban women, total wanted fertility rate (TWFR) was lower. In urban neighborhoods, prevalence of contraceptive use was higher, and the infant and child mortality rates were lower; however, when rates were adjusted for mother's age, education and number of births, the differences turned out to be nonsignificant. Women living in urban areas receive better antenatal care, child immunization services, and professional health delivery assistance and services in a health facility; these services are very scarce in gecekondu districts. Health status of gecekondu populations can be improved by social and economic support and by making health services more available and accessible, especially maternity and child health services. © The Author 2005. Published by Oxford University Press on behalf of the New York Academy of Medicine. All rights reserved.
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Keywords
Adolescent , Aged , Child , Child Welfare , Child, Preschool , Cross-Sectional Studies , Female , Health Services Accessibility , Health Surveys , Humans , Infant , Infant, Newborn , Interviews , Male , Middle Aged , Socioeconomic Factors , Suburban Population , Turkey , Women's Health , contraceptive agent , adolescent , adult , aged , article , birth rate , child , child health care , childhood mortality , city , cluster analysis , cultural factor , economic aspect , education , family , female , female fertility , health care delivery , health care facility , health insurance , health practitioner , health service , health status , household , human , immunization , infant , infant mortality , interview , male , marriage , maternal age , maternal care , migration , poverty , prenatal care , priority journal , probability , reading , religion , reproduction , sample size , social class , social status , social support , socioeconomics , turkey (bird) , unemployment , urban area