Morbidity Pattern, Availability and Utilization of Health Services: A Study among the Male Youth (15-24 Years) Living in the Slums

Background

Youth is considered as a healthy period but their health is greatly influenced by the hostile living conditions in the slums. When this is accompanied by poor health infrastructure, health risk escalates multiple times.

Objectives

The objective was (1) to study the health problems of the male youth living in the slums and (2) to study the availability and utilization of health services for the male youth living in the slums.

Subjects and Methods

Study design: Cross-sectional study. Study population: Male youth (15-24 years). Study settings: Four urban slums of Amritsar city. Study period: January 1, 2017-December 31, 2017. Sample size: One thousand male youths. Inclusion criteria: Male youth (15-24 years) with consent. Exclusion criteria: Male youth (15-24 years) not given consent, not available at home on the third repeat visit, and mentally unstable or deaf or dumb.

Results

The morbidity pattern showed that 47.5% suffered from any disease during the past 3 months and 3.3% were hospitalized in the past 1 year. Majority of the cases were due to diseases of the respiratory system and gastrointestinal system. Private health sectors including chemist shops were utilized more in case of both outpatient (88.9%) and inpatient services (57.6%) as compared to public health sector. The private health facilities were within 500 m from majority (89.6%) of households in the slums of Amritsar city.

Conclusions

Primary health care needs to be strengthened in the slums. Effective and easily accessible health-care services should be provided by the government at the doorsteps of slum households. The Information Education Communication/Behavior Change Communication activities regarding disease prevention should be strengthened to promote and protect good health.

Male Experience and Sociodemographic Characteristics of Premarital Pregnancy: Based on a Nationwide Population-Based Survey Among Urban and Rural Chinese Youths

Little is known about the male experience of premarital pregnancy (MEPP) and the sociodemographic characteristics of unmarried male youths involved in pregnancy. This study estimates the prevalence of MEPP and identifies the sociodemographic factors associated with it among Chinese unmarried youths aged 15–24 years, using data from the Survey of Youth Access to Reproductive Health in China. Descriptive analyses and χ² tests were applied to explore the number and prevalence of MEPP, and logistic regressions were used to identify the associated factors. As a result, among 2,853 sexually experienced male youths, 597 individuals reported 852 partner pregnancies caused by them during their lifetime, with a weighted prevalence rate of 20.87% (95% CI [18.85%, 22.88%]). Among these pregnancies, 78.05% ended in induced abortion. Factors like living with only the father (OR: 4.16, 95% CI [2.22, 7.8]) and the low level of education of the father (junior high school or below, OR: 1.60, 95% CI [1.04, 2.46]) were associated with MEPP among unmarried male youth. Furthermore, there is a marked difference between the rural and urban youth in factors associated with MEPP. The findings in this study highlight the importance of and need for strategies and interventions targeting male youths, in order to improve sexual education and reproductive services.

Is higher risk sex common among male or female youths?

There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries' Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel-Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15-19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.