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Today we are living in urban world even India also not untouched with this phenomenon. Urban living is the keystone of modern human ecology. Generally urban attraction shows that cities provide the better opportunity in terms of better employment, education and health care facilities. But the rapid and unplanned growth is often associated with poverty, environmental degradation and demands that outstrip service capacity (Awadalla, 2013). Urbanization and economic growth are closely inter-linked. They are the source of diverse formal and informal sector employment opportunities. The rapid urbanization in conjunction with industrialization has resulted in the growth of slum. They are the hopes of millions in urban areas and the countryside. In countries like India, where the chaotic growth of population is a major hindrance to mushroom the growth of slums, slums crop up in the vicinity of urban settlement. It is a vicious circle of rural poverty leading to migration to cities in search of job, non- availability of respectable full time employment, hence, poverty leading to these migrants building temporary shelter for themselves. Later they start using the vacant public space for building shanties and settling down. This further perpetuates poverty and unhealthy urban environment. Slums manifest the worst form of deprivation that transcends income poverty. The proliferation of slums occurs due to shortage of developed land for housing, the high prices of land beyond the reach of urban poor, and a large influx of rural migrant to the cities in search of jobs. According to UN-HABITAT report slum is what that absent at least one of the following: 1) access to safe water, 2) access to sanitation, 3) safe and secure tenure, or 4) durable housing structures. “Durable” housing mean housing that is located away from natural or manmade hazards; is structurally safe, and protective against extreme weather. Crowding and economic deprivation further impairs the housing and health risks of slum dwellers (UN- Habitat, 2003). The slums are characterized by acute overcrowding, insanitary, unhealthy and dehumanizing living conditions. They do not have access to basic minimum civic services. The services means according to UN- Habitat reported include safe drinking water, sanitation, storm drainage, solid waste management, internal and approach roads, street lighting, education and health care, and quality shelter. Many of these habitations are located in environmentally fragile zone. A significant proportion of the slum dwellers also face health problems worse than their non-slum and rural counterparts (NSSO, 1993). Many civic bodies do not provide the required municipal services in slums on the pretext that these are located on ‘unauthorized’ space. Moreover, the scale of the problem is so huge that it is beyond the means of Urban Local Bodies most of whom lack a floating fiscal base and subjects to severe fiscal stress (Slums in India, 2011). As per Census 2001, 28.6 crore people live in urban areas. The urban population has increased to 37.7 crore in 2011. Urban growth has led to rapid increase in number of urban poor population, many of whom live in slums and other squatter settlements. As per Census 2001, 4.26 crore people lived in slums spreads over 640 towns/cities having population of fifty thousand or above. In the cities with population one lakh and above, the 3.73 crore slum population (in 2001) expected to reach 7.66 crore by 2011. While the Jawahar Lal Nehru Urban Renewal mission is beginning to tackle the urban infrastructure issues, urban health issues need immediate attention, especially in the context of poor (NUHM, 2013). As per Census 2011 shows approximately 13.7 million households or 17.4 percent of urban Indian households lives in slum (Census of India, 2011). Poorly planned or unplanned urbanization patterns represent a major public health challenge.

Generally high conjunction of the housing, poor building structures, high density of the population, poor environmental conditions describe the slum space. Most of the slum dwellers use traditional fuels for cooking. These traditional fuels like charcoal, coals, wood, kerosene oils, and cow dung cake release the smoke into environment. These traditional fuels led to diseases like respiratory diseases, asthma, and bronchitis.

The growth of cities had always been accompanied by the growth of slums. Ill-health due to overcrowding, poor housing and unsanitary environment, coupled with poverty were found in slum. The relative difference income and wealth was much starker in urban areas. The higher purchasing power of the rich people drives up the prices of food and healthcare goods, making them unaffordable to the poor. The rich also consume more than their proportionate share of public goods, for example, water, infrastructure, electricity, which are often subsidized by the state. Poverty and other forms of social disadvantage translate into poorer health status and outcomes for the urban poor (Madhiwalla (2007). The slum areas in urban society in Uttar Pradesh were rapidly posing serious threat to sustainable development of India. Environmental conditions of slum and its effects on their dwellers. The slum areas were characterized by complete absence of basic amenities like drinking water, toilets and bathrooms, drainage system and garbage disposal (Firdaus, 2012). Problems of urbanization and development of slum areas and outlined how the living environment of slums had impact on health of the dwellers and slum environment alienated them from the rest of the urban society. According to him the social determinants also associated with the environmental determinants (Awadalla, 2012). Scarcity of water stood as a vital problem for many people all over the world. The slum dwellers of many urban areas across countries faced serious water scarcity. The poor slum dwellers faced serious problem of scarcity of water in India as he observed (Rao, 2009). In slums, the dwellers also face variety of problems pertaining regarding water and sanitation (Prasad and Singh, 2009). Prevalence of water borne diseases among the slum dwellers is persisting. The most common diseases in the slums were found to be gastrointestinal diseases, diarrhoea, water diseases, parasitic worms/infestation and orals diseases (Singh and Dsouza, 1980) also chronic non-communicable and communicable diseases like hypertension, diabetes, intentional and unintentional injuries, tuberculosis, and rheumatic heart disease and HIV infection existed in slums (Reily et al, 2007). 

Given the context and perspective as such, we want to enquire the problems of selected slum in Prayagraj city. The city of Prayagraj is one of the million- plus populated cities in India with occupied influx of people from outside leading to the formation of slum and squatter settlements. On the basis of such observation the city of Prayagraj is also facing the squatter settlements and slum formation and this is the cause of filthy environment and many of health hazards among poor residents. Health is the major indicator of Human Development Index which determinant of the countries development. The present study is not only focus on the basic indicator of health; this is also focus on the main causes and consequences of the living environment which affect the slum dwellers health. So, the study is trying to understand the ground level problems of slums health in the city of Prayagraj. For the study we selected the slums household for the study in which we have selected the two registered slum and two unregistered slum. We have selected two slums i.e. Dharkar Bastee Slum and Harijan Bastee Rajapur for the registered slum and Haddi- Godam Jhopar Patti Slum and Chungi Parade Jhuggi- Jhopri Slum for the unregistered slum. In each Slum we have select 25 households by simple random technique and in total it is 100 households (Table-1). Hence, we select four slums purposively to studying the central part of the city and peripheral part of the city which is basically situated on the bank of river. The quantitative and qualitative both approach has been adopted for the study by following the Q-squared approach (Kanbur, 2003) and for the analysis we emphasized more on the grounded theory approach because it is necessary to find out the ground level problem which facing the slum dwellers of this city. For the study the Semi- Structured schedule has been used in which the open ended and close ended question has been used. Some FGDs and case study were also conducted tackle the objectives. We have collected data through interviews of the household’s respondents and also conduct the some disguised observation which is also called distant observation. The indicator which we have dealt in our study in general is that the identifying the living space (registered or unregistered), age structure of the respondent (head of the family member), their family size, Migration Status, Occupational Structure, Public utilities, private benefits, gender question in terms of assessing the vulnerability of health in which we dealt the time duration of the particular gender whom spent more time in that pathetic living space, accessing the health care facility, Government initiatives which taken for the benefits of slum dwellers. For the secondary data were collected from government and non-government official documents and statistics, various books, research papers, journals etc. Collected data were processed and analysed by computer based statistical software package SPSS 20 version. Finally the analysed data were integrated and presented as tables, graphs and pie diagrams.

Table-1: Coverage of the Study Area

Specific	Number	Name
State	1	Uttar Pradesh
Million-Plus City (By population size)	1	Allahabad
Types of Slum	2	1.      Registered Slum 2.      Unregistered Slum
Name of the Slum	4	1.      Registered slum- Dharkar Bastee (25 HHs), Harijan  Bastee Rajapur Slum (25 HHs) 2.      Unregistered Slum- Chungi Parade Slum (25 HHs) and Haddi- Godam Slum (25 HHs)
Total Households	100	1.      Registered Slum- 50 2.       Unregistered Slum- 50

Note: : i) Registered Slum are recognized by the Government Officials on the basis of land title; since 1980, they have been taken over by the Government for letting/ lease to slum dwellers.[1]

ii) Unregistered Slum comprises slum on the land encroaching settlements.[2]

The study is try to understand the general understanding regarding slums health condition and after that it focuses more on the women health.

All surveyed slum situated with densely populated, where all the dwellers were do not have any private space for bathing. Inside the slum we observed the narrow lanes, cramped houses and heaps of garbage. A pungent smell spread all around the slum. Due to the dense population of the slum and congested construction of houses, darkness appeared even during day time. The waste materials were scattered here and there. There was no fixed zone for animals like pig and other animals. Material used in housing construction is basically bricks, clay, bamboo, plastics, tin, sag and ragged cloths. There is no privacy in the house among families. The cottages had height approximately 3 to 4 feet. The families were visibly poor. The present paper is tried to describe the living conditions of the slum dwellers because the nature of their living arrangements creates so many diseases. According World Health Organization (WHO) substandard housing condition perpetuates the many of the infectious diseases which is associated with their surrounding environments[3]. This living arrangement associated with women’s health also because in Indian society women were supposed to live inside the door. Perhaps poverty break all the boundary of gender stereotype in slums study but the burden of work became double on women’s. They work inside as well as outside both. In this perspective the present study dealing with following survey results.   

1. Demographic and Socio-economic Profile of Slums Households

1.1. Sex Composition of the Slum Households

The sample table consisted of 55.0 per cent female respondents and the rest male (Table-2). The respondent slum dwellers were in working age group.

Table 2: Sex Compositions of Slums Households Respondents

Gender	Registered		Unregistered		Total
	No.	%	No.	%	No.	%
Male (Adult)	22	44.0	23	46.0	45	45.0
Female (Adult)	28	56.0	27	54.0	55	55.0
Total	50	100.0	50	100.0	100	100.0

Source: Field Survey, 2020.

1.2. Caste Category of the Slums Households

75.0 per cent of the respondent belonged to SCs and the rest General castes. In registered slum all were SCs and in unregistered slum 25.0 per cent were General castes or Muslim and rest from the SCs (Table-3). All the landless poor who were basically low in social category by birth live in slums.

Table-3: Distributions of Slums Households by Castes

Castes	Registered		Unregistered		Total
	No.	%	No.	%	No.	%
SCs	50	100.0	25	50.0	75	75.0
General Castes	0	0.0	25	50.0	25	25.0
Total	50	100.0	50	100.0	50	100.0

Source: Field Survey, 2020.

1.3. Family Types

52.0 per cent of the households in slums constituted joint family. The percentage is high in this category because most of the Muslim family living in a join family.

1.4. Population Size and Dependency

Registered slum by religion covered 328 persons in 50 households in Hindu religion and in unregistered slum 141 persons belonged to Hindu Religion and 167 persons belonged to the Muslim Religion which covered 25 households. In general 73.74 per cent of the total households were Hindus and the rest Muslim (Table-4).

Table-4: Size and Dependency of Population from Sample

Total Population	Religion	Registered		Unregistered		Total
		No.	%	No.	%	No.	%
	Hindu	328	100.0	141	45.77	469	73.74
	Muslim	0	0.0	167	54.23	167	26.25
	Total	328	100.0	308	100.0	636	100.0
Total earning members	Hindu	137	100.0	66	42.58	203	69.52
	Muslim	0	0.0	89	57.42	89	30.48
	Total	137	100.0	155	100.0	292	100.0

Source: Field Survey, 2020.
1.5. Average of the Households
Average household size was six. In registered slum, it was six while in unregistered slum it was seven.
1.6. Migration Status
Most of the households migrated twenty to forty years back.
1.7. Educational Status

Most of the respondents were Illiterate 74.0 per cent. Only 11.0 per cent of the respondents were attained primary education. And 14.0 per cent were taken informal education (Table-5). Most of the people in the slums were illiterate. They were not even aware of the necessity of education. Male literacy rate in the slum was higher than that of female. Most of the female were illiterate. Most of the literate people attained education up to the primary level. They were not interested to send their children to school. This was reinforced by the financial constraint. Their children were working hands to earn money. Most of the children used to go to cost-free government schools. Most of the people in the slum were engaged as manual labour so there is no relation between the educations and their job opportunity so most of them dropout by completing their primary education.

Table-5: Educational attainment of the Respondent of the Households

Educational Level	Registered Slum		Unregistered Slum		Total
	No.	%	No.	%	No.	%
Illiterate	41	82.0	33	66.0	74	74.0
Informal Education	3	06.0	11	22.0	14	14.0
Upto Primary Level	5	10.0	6	12	11	11.0
Upto High school	1	2.0	0	0.0	1.0	1.0
Total	50	100	50	100.0	100	100.0

Source: Field Survey, 2020.

The additional information is that the female education is very less significant in numbers. Most of the women 65.0 per cent were illiterate. Only 17.86 per cent were complete their primary education.

1.8. Private benefits of the Slums Households

Table shows that most of the housing character is basically semi- kutcha in nature i.e. 44.0 per cent. Most of the 85.0 per cent slum respondents were living in single room. A very high percentage 75.0 was used to go for defecation in open space. A very significant 65.0 per cent were cooking outside from the house and rest were cooking inside because of non- availability of any other option because they have not a proper space for cooking. 100 per cent slums household facing the problem of open drain. Due to this various types of diseases arises. Most of the slums households 75.0 per cent were generally use tap for drinking water and rest of the households use bore well situated in cluster of the slum. 100.0 per cent households dispose their garbage by their own in back side of the house (Table -6).

Table-6: Housing and Environmental Conditions of Slums Household

Private Utilities of Households		Registered		Unregistered		Total
		No.	%	No.	%	No.	%
Types of House	Kutcha	33	66.0	10	20.0	43	43.0
	Semi-pucca	13	26.0	31	62.0	44	44.0
	Pucca	4	8.0	9	18.0	13	13.0
Living space	Single Room	39	78.0	46	92.0	85	85.0
	More than one room	11	22.0	4	8.0	15	15.0
Toilet Facility	Absent	50	100.0	25	50.0	75	75.0
	Community Toilet	00	00.0	25	50.0	25	25.0
Specific space for cooking	Outside	46	92.0	19	38.0	65	65.0
	Inside	4	8.0	31	62.0	35	35.0
Drainage System	Open Drain	50	100	50	100	100	100
Drinking water	Tap	50	100.0	25	50.0	75	75.0
	Bore well	0	0.0	25	50.0	25	25.0
Garbage Disposal	Self	50	100.0	50	100.0	100	100.0
Total Households		50	100.0	50	100.0	100	100.0

Source: Field Survey, 2020.

Table-7: Fuel Used for cooking in Slums Households

Types of Fuel	Registered Slum		Unregistered Slum		Total
	No.	%	No.	%	No.	%
LPG Gas	1	2	6	12	7	7
Wood/Cow dung	22	44	15	30	37	37
Kerosene stove	6	12	7	14	13	13
Coal	0	0	2	4	2	2
Multiple Response	21	42	20	40	41	41
Total	50	100.0	50	100.0	100	100.0

Source: Field Survey, 2020.
Most of the households were using wood and cow dung for the cooking i.e. 37 per cent. Along with this they use vehicle tyres, plastic cracked bottles etc. (Table 10) A very less number were using LPG gas for cooking. The dwellers of the surveyed slum used wood for cooking that they used to purchase it at Rs. 10/ Kg. So sometimes it is out of their pocket expenditure. In that case they used to burn some waste material which creates household air pollution from cooking. Another pollutions creates by heating and lighting, particularly rudimentary biomass and coal cooking which affect more and more women’s health because women were directly linked with kitchen.
1.9. Occupation
The slums households generally involve in the labour intensive work like manual labourers, domestic work (32 per cent), rickshaw pulling (14 per cent), rag pickers (18 per cent), street hawkers, and shop workers etc. (Fig. 1) 
Figure 1: Occupational Pattern of Slums Households

Source: Field Survey, 2020.
Most of the individuals in this slum were drop outs at primary level for poverty, lack of awareness, practice of child labour. Most of the children were picking rags.
Youngsters of this slum entered into job market of rag picking early to financially assist households. The dwellers generally engaged in menial kind of job which affects their health physically, mentally both.
 1.10. Intoxication
According to figure the most of the slums households involves in different kind of intoxication. The percentage is approximately similar in tobacco consumption both male and female. Apart from that male percentage is higher in other intoxication like bidi, liquior, gutkha consumption (fig.2).
Figure 2: Intoxication among Slums Households

Source: Field Survey, 2020.

1.11. Prevalence diseases

Most of the respondents 52 per cent were reported that their households suffered from jaundice. Most of the respondents households 53.0 per cent basically women were facing low BP problem. Other diseases like tuberculosis, diarrhoea, and asthma, typhoid skin diseases etc. prevalence in the study area (fig. 3).

Figure 3: Prevalence Diseases in Slum Households

Source: Field Survey, 2020.

If we look for the reasons of the prevalence diseases the main reason is seen open drain 76.0 per cent, most of the households respond that the always water logged in h drain which born the diseases. Other reason for the causing diseases is water logging, dumping site, open defecation etc.  The dwellers of this slum generally ate low quality food due to financial constraint. All the dwellers were non-vegetarians who used to eat the residue part of chicken and mutton. They used to purchase rotten fruits and vegetables at low price.

Figure 3.1: Reasons of Causing Diseases

Source: Field Survey, 2020.

1.12. Access of Health Facility and related Health Problem

Most of the slums households 42.0 per cent were used to go in the Government hospital. 32.0 per cent were used to go private hospitals for medication. 14.0 per cent were used to take tradition health care in which they used generally Ayurveda kind of thing like leaf and stem of some plants etc.  The dwellers of these slums generally used to go in government hospital in case of illness (fig. 4). But they did not access the proper health care facility. The major challenges that they face is that the education less poor dweller did not know that where to go for meet health need and the reason is that they do not know the clear norms for urban health facilities. The slum dwellers did not get any health benefits provided by Government free of cost facility.

Figure 4: Access of Health Facility among Slums Households

Source: Field Survey, 2020.

1.12.1 Menstrual Hygiene among Women

Most of the female respondents reported that approximately 74.0 per cent were using clothe during their periods. Only 8.0 per cents were using sanitary napkins in their periods. 18.0 per cent were use both of the thing in their periods. Females were more vulnerable in terms of their health (fig. 5). Because of their poverty they were not able to purchase the sanitary napkins for their hygiene. They mostly use the cloth which is also not proper clean and it affects their health. So they were facing some vaginal infection due to this. Women do not know from where to access the free napkin facility or by purchase in minimum cost.  

Figure 5: Menstrual Hygiene among Female in Slums Households

Source: Field Survey, 2020.

1.12.2 Delivery Services   

Figure shows that the most of the women 42.0 per cent in the slums access the Private hospital at the time of their delivery. 32 per cent of women’s were access government hospital at the time delivery. And a significant percentage 26 per cent were deliver their child in the presence of trained female (Daai) (fig 6). Women in the Slum face difficulty to get delivery service in government hospital because they were ill-treated in the government hospital. Sometimes because of fear they do not go for their delivery in the Government hospital.

Figure 6: Delivery Services Utilized by Slums Women

Source: Field Survey, 2020

1. Awadlla, H. I. (2013). Health Effect of Slum: A consequence of urbanization. Scholarly Journal of Medicine , 7-14. 2. (2003). The Challenges of Slums. Earthscan Publicatioan Ltd., London and Sterling. 3. (1993). Slum in India. National Sample Survey Organization (NSSO). 4. (2001, 2011). Census Report. Office of the Ragistrar and Census Commissioner, Census of India. 5. Firdaus, G. (2012). Urbanization, Emerging Slums and Increasing Health Problems; A challenge before the nation: An emperical study with reference to state of Uttar Pradesh in India. E3 Journal of Environment Research and Management , 146-152. 6. Madhiwalla, N. (2007). Healthcare in Urban Slums in India. The National Medical Journal of India , 20 (3), 113-114. 7. Rao, S. C. (2009). Sociology of Indian Society. New Delhi: S Chand & Company. 8. Singh M & A DeSouza. (1980). The Urban Poor Slum and Pavement Dwellers in the Major Cities of India. New Delhi: Manohar Publication. 9. Prasad R & M N Singh. (2009). Living Condition and Life Style of Mankhurd Slum Dwellers. International Institute for Population Sciences, Mumbai. 10. Riley. (2007). Slum Health Diseases of Neglected Populations. Retrieved October 28, 2016, from BMC International Health and Human Rights: http://www.biomedcentral.com/1472698X/7/2 12. Kanbur, R. (2003). Q- Squared Qualitative and Quantitative Methods of Poverty Appraisal. Delhi: Permanent Black.

1. United Nation (2003), The Challenges of Slums, pp. 13.
2. Ibid.
3. https://www.who.int/sustainable-development/housing/health-risks/en/