ABSTRACT
Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under?five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health?care facilities. A community?based cross?sectional study was carried out among 380 under?five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under?five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru?Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.
ABSTRACT
Background: Nutritional status of under?5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house?to?house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.
ABSTRACT
Objectives: To generate evidence on engaging girls' collectives to address anemia and social norms in self-contained, privately-managed tea plantations in India. Methods: In 2006, UNICEF India partnered with a federation of tea companies in Assam's Dibrugarh district, and Twinning Corporate Social Responsibility to establish 158 girls' collectives across 117 of 273 tea gardens. These collectives meet weekly to discuss and address social issues such as child marriage, child labor, school dropout, and life skills. In 2012, supervised weekly iron folic acid (IFA) supplementation, biannual deworming and nutrition education were weaved in these peer interactions and implemented in 15 tea estates through 45 girls' collectives comprising 7097 adolescent girls, with the objective to address anemia. Visual aids, recipe demonstrations, and home gardening were used to make sessions interesting. Government positioned adequate supplies at tea estate hospitals/outposts. Two peer monitors per tea estate supervised the activities of the collectives. The follow up of this cohort included a baseline (2011) and an end line (2013) survey. Results: Compliance with weekly IFA supplementation (4 tablets per month) increased from 25% (2012) to 82% (2013). Home gardens were introduced in 1,002 homes and 55 community patches. Provisional end line data shows a 1.25 g/dl improvement in mean hemoglobin levels (9.77 to 11.2 g/dl). There is also evidence of increased girls' re-enrollment in high school and a reduction in the proportion of child marriages. Conclusions: Lessons from this public-private partnership can be adapted to similar programming environments that aim at reaching out to adolescent girls with anemia control interventions.