Health Need Assessment and Health Seeking Behaviour among Construction Site Workers and Homeless in South Delhi

Abstract

This observational cross sectional study is an update on the status of a marginalized community with different living conditions, health status, lifestyle, health needs and health seeking behavior in the multi-cultural metro city of Delhi. Out of 1252 screened, a total of 877 people were interviewed for self-reported illnesses, health needs and seeking behavior at four construction sites, shelters for the homeless and a slum in south Delhi. Poor hygienic conditions and inappropriate waste disposal system were observed; 24% of morbidity was recorded. In younger age group (1 month to 17 years), upper respiratory infections (34%) followed by pain in abdomen (28%) and malnutrition/anemia (20%) recorded. Other morbidities like tuberculosis, skin/UTI/ENT infections and congenital defects comprised 18% of the morbidities. Joint pains & nonspecific body aches (30%), indigestion & acidity, restlessness, irritation and anxiety (34%), vision problems (18%) visible pallor (6%) were recorded among adults. Mental problems like stress, anxiety, restlessness, irritability were present among 67% of the participants. At each of the sites, beside substance use, there was an average of 2–3 young alcoholic males (20–30 years old) who presented with severe jaundice and liver failure. Participants preferred nearby chemists, private doctors and 70% could not afford to go to government facilities due to lack of time, faith, satisfaction and loss in daily wages. Pregnant women were not even aware of the family planning/contraceptives and health facilities available nearby and that they could procure it for free. None of them had adopted contraception in spite of having more than 4–5 live children or their youngest child being 2–3 months old. A needs assessment identified need for regular mobile health services, onsite education for sanitation/nutrition/ family planning, counseling support for de-addiction, healthy living and mental health services