Growth status of homeless Nepali boys: Do they differ from rural and urban controls?

The rapid increase in numbers of homeless children in cities of the developed and developing world is a matter of grave concern. A multi-disciplinary study was undertaken to examine the health and lifestyles of the homeless in Nepal in comparison to other local children. Few studies have quantified the health of street-children in the developing world using anthropometric indicators, and to our knowledge this is the first to systematically compare the homeless with appropriate controls from both rural and urban areas. Heights and weights were measured for 307 six to fourteen year-old boys (111 homeless, 62 squatter, 82 privileged school and 52 village boys). Height for age (HAz), weight for age (WAz) and weight for height (WHz) z-scores relative to reference data from the National Center for Health Statistics (NCHS) were used as indicators of growth status. Stunting characterized all but the school-boys, but wasting was not observed. The homeless were less stunted than either poor squatter or village boys. On arrival on the streets, they were taller than village boys, and duration of homelessness had no effect on their growth status. Thus in terms of physical growth, and despite frequent health complaints, homeless boys in Nepal fare relatively better than control groups of poor urban and rural boys. Comparative studies which reveal some successful aspects of street-life show that urban homelessness may represent an appropriate response to circumstances of poverty.