ABSTRACT
Background: Undernutrition continues to be the primary cause of ill health and premature mortality. The sustainable development goal 2 aims to end all forms of hunger by 2030 and lead towards an improvement in child health. The national data categorize the level of undernutrition as underweight, wasting and stunting. The weight for age estimates used under ICDS misses out the other forms of malnutrition. This study was conducted to assess the prevalence of undernutrition using a composite index of anthropometric failure (CIAF) and compare it with conventional indices.Methods: A community based setting and cross-sectional study design. By simple random sampling 265 under-five children residing in a marginalized community of North West district of Delhi. Interviewer administered questionnaire was used to collect information and anthropometric measurements were taken using standard operative procedures. Z scores were calculated by WHO-ANTHRO software version 3.2.2. Descriptive analysis was conducted using statistical package for social sciences version 22.Results: The prevalence of anthropometric failure by CIAF was 60.5% and based on other indices undernutrition was found as 44.5% stunting, 35.4% underweight and 26.4% wasting. MUAC detected 23.7% of undernourished. CIAF provides a better picture of undernutrition compared to other indices.Conclusions: Since CIAF is more than that estimated by any of the conventional indicators, it proves to be a better indicator in assessing the overall burden of under-nutrition in a population. Development of policies based on CIAF to reduce the burden of undernutrition may prove to be more effective.
ABSTRACT
Background: Although India’s health policy is directed toward improving adolescent reproductive health, adolescent-friendly health services are scarce. The intervention for “integrating adolescent-friendly health services into the public health system” is an effort to improve the health status of adolescents in rural areas of the Varanasi (Arajiline) and Bangalore (Hosakote) districts in India. The purpose of this article is to describe the features of the intervention and investigate the impact on improving awareness and utilization of services by adolescent, as well as quality of ARSH services in the intervention districts. Methods: Data from project monitoring, community survey (737 adolescents), exit interviews (120 adolescents), assessment of adolescent sexual and reproductive health clinics (n = 4), and health service statistics were used. Descriptive analyses and paired t-tests were used to compare the two intervention districts. Results: Overall, the percentage of adolescents who were aware of the services being offered at a health-care facility was higher in Hosakote (range: 56.2% to 74.7%) as compared to Arajiline (range: 67.3% to 96.9); 23.3% and 42.6% of adolescents in Arajiline and Hosakote typically sought multiple services at any one visit. A large percentage of clients (Arajiline: 81.7%; Hosakote: 95.0%) were satisfied with the services they received from the facility. The relative change in uptake of services from the first quarter (January to March 2009) to the last quarter (October to December 2010) was significantly higher in Arajiline (7.93, P = 0.020) than in Hosakote (0.78, P = 0.007). Conclusion: The intervention had positive results for the public health system and the services are being scaled up to different blocks of the districts, under a public–private partnership.
ABSTRACT
Adolescents among the urban and rural poor have a high incidence of chronic energy deficiency (CED) and anemia, more so in girls than in boys. Adolescent pregnancies (15-19 years) contribute to 19% of total fertility in India and record the highest maternal mortality rates. Besides maternal age, lack of education, low socio-economic status, maternal undernutrition and limited access to maternal health services are important determinants of poor pregnancy outcomes. Low birth weight is the major adverse outcome for the infant and an important determinant of increased child mortality. There is a lack of data for long term follow up of infants of adolescent mothers versus mothers 20 years and above, and more specifically, in the urban poor setting, an emerging concern.