The Impact of Drop-In Centres on the Health of Street Children in New Delhi, India

Abstract

Objectives: To understand how and to what extent drop-in centres are associated with the physical and mental health and substance use status of street children in New Delhi. Methods: In a qualitative study, I interviewed 23 street children and two drop-in centre staff members in New Delhi. Subsequently, I conducted a cross-sectional study with 69 street children who attended centres and 65 street children who did not visit centres. I used questionnaires to assess their physical and mental health and substance use. Findings: Participants believed that because street children regularly visited drop-in centres, their health outcomes improved. Street children participated in drop-in services because staff members were nonjudgmental, they were free to be a child, their daily struggles were lessened, they received protection, they were given moral direction and they had an opportunity for a better life. However, children continued to live on the streets because street life had become normal. Quantitative findings showed that street children who visited centres had better physical and mental health outcomes and engaged in less substance use than street children who did not visit centres (p<0.01). For every month of attendance, street children experienced 2.1% (95% CI 0% to 4.1%, p=0.05) fewer ill health outcomes per month and used 4.6% (95% CI 1.3% to 8%, p=0.01) fewer substances. Street children were also less likely to have been a current substance user than a never substance user for every additional month at a center (OR: 0.79, 95% CI: 0.66 to 0.96, p=0.02). Duration of attendance was not significant in predicting mental health. Conclusion: According to participants, drop-in centres positively influence the physical and mental health and substance use status of street children by providing services in an environment tailored for them. Quantitatively, centres may improve the physical health of street children and reduce their substance use.