ABSTRACT
Introduction: In developing countries various factors lead to Under-5 Mortality and irreversible losses which can be prevented by proper measures take on factors affecting to it. Objective: This study was conducted to analyse the changing trends of Under-5 Mortality in India. The new National Family Health Survey (5th round) which was published recently came up with several new findings, which were both encouraging and disheartening and also one of the major Sustainable Development Goals.Method: A secondary data analysis was conducted of NFHS factsheets to study the U5MR in India. The indica-tors which had a correlation either positive or negative with the Under-five mortality rate were included.Result- When we look at the result, few states' performance is encouraging because they have shown some of the best declines. Correlation was found between dependant variable that is U5MR which is a dependent vari-able and several independent variables which concluded that factors like Women literacy, Men literacy, Breastfeeding, Nutritional insufficiencies, Caesarean delivery, ANC visits and IFA consumptions are negatively associated withU5MR. Conclusion: Various steps have been taken in order to improve our healthcare sector since independence, every government had their fair share of contribution, that’s the reason why we are this stage. Now it’s time to increase efforts with targeted interventions to solve this problem and complete our commitment towards the SDGs.
ABSTRACT
Background: In developing countries various childhood diseases lead the morbidity, mortality and irre-versible losses which can be prevented by proper vaccination. This study was conducted to analyse the changing trends of childhood vaccination in India and its impact on childhood diseases and mortality, the trends in coverage of each vaccine along with identification of geographical areas of concern.Materials and methods: NFHS data published by Government of India was analyzed to see the trends in vaccination coverage, female literacy, childhood diseases and under-five mortality, along with online da-tabase search for relevant literature. Results: Total vaccination coverage in India has reached to 76.4% as per NFHS- 5 data. Orissa stands at the top with 90.5% coverage while Nagaland at the bottom with 57.9% coverage. Prevalence of child-hood diseases and under-five mortality has reduced overtime accountable to increase in vaccination coverage as one of the major factors for same. Conclusion: Despite improvement in total vaccination coverage, the goal of Intensified Mission Indra Dhanush of 90% coverage still remains unachieved. There is reduction in childhood disease and mortali-ty rate, but the pandemic has adversely affected these advances. Therefore, immediate steps should be taken to gain the lost ground.
ABSTRACT
Introduction : This study was designed to find out the group mean prevalence of NCD risk factors in different administrative divisions of West Bengal (WB) and to explore the probable reasons of these differences in different indigenous habitat wise groups of districts of West Bengal. Methods : This descriptive study was conducted on available secondary data from National Family Health Survey- 5 (NFHS-5) regarding NCD risk factors. For this study, WB’s districts were divided into five administrative divisions namely Presidency, Medinipur, Burdwan, Malda and Jalpaiguri. Again WB State divided into three groups namely Jangalmahal (forest region), Pahar (Himalayan Hilly region) and “Rest of West Bengal” (ROW) on the basis of habitat of major indigenous people. Data are analyzed by Microsoft excel software in percentage and group mean. Results : Presidency (M: 20.6% versus F: 21.9%) with Medinipur (M: 20.3% versus F: 19%) divisions and Jangalmahal group of districts (M: 22.1% versus F: 16.5%) have higher group me n prevalence of high blood sugar in West Bengal. High group mean prevalence of high blood pressure was observed in Pahar (M: 26.6% versus F: 25.2%) group of districts and Jalpaiguri (M: 24.7% versus F:24%) division. The group mean prevalence of alcohol intake is very high in Jalpaiguri division (M: 25.2% versus F: 3%). The group mean prevalence of obesity (women aged 15-49 years) is increased from the last NFHS -4 survey. Conclusion : The group mean prevalence of alcohol intake and high blood pressure are very high in Pahar. The tobacco use related habit is comparatively high in Jangalmahal and Pahar group of districts. The group mean prevalence of high blood sugar is comparatively high in Jangalmahal and Presidency division areas.
ABSTRACT
Background: The sustainable development goal emphasises on reduction in mothers dying due to pregnancy. Recommended care for the pregnant mothers will help achieve this goal. Tamil Nadu is one of the best performing state in maternal and child health care. Author analysed the full antenatal care coverage of pregnant mothers of the districts of Tamil Nadu by using National Family Health Survey (NFHS)-4 data.Methods: Author did a secondary data analysis of NFHS 4 data for the districts of Tamil Nadu for understanding the MCH coverage.Results: Tamil Nadu showed 45% full AN coverage with 46.3% in urban and 43.8% in rural population, among 32 districts, Krishnagiri (65.5%) is the best performing and Virudhunagar (13.7%) is the poorest performing district of Tamil Nadu. Full AN coverage includes at least 4 AN check-up, vaccination of tetanus toxoid and consumption of 100 IFA tablets in last pregnancy. Tamil Nadu showed 81.1% of at-least 4 AN visit, 71% with vaccination for TT and 64% on consumption of 100 IFA tables. Similar coverage trend among the components of full ANC coverage is seen among all the districts of Tamil Nadu.Conclusion: Focusing on the coverage of IFA tablet consumption and also showing special interest among the rural population will increase the coverage. A detailed assessment for understanding the reasons for poor performance among the districts of Tamil Nadu is needed for better evidence-based practices.
ABSTRACT
Background: Breastfeeding is one of the most important determinants of child survival, birth spacing, and prevention of childhood infections. The beneficial effects of breastfeeding depend on breastfeeding initiation, its duration, and the age at which the breast-fed child is weaned. Data from NFHS-4 suggest that in India, in Gujarat where only 56% of infants are exclusively breastfed and 50% of infants are initiated with breastfeeding within one hour of birth. This study was planned to identify the gaps in breastfeeding practices so that necessary interventions can be designed and thereby implemented. The objective is to study the breastfeeding practices of mothers having children below 2 years of age in the field practice areas of the medical college and to associate the findings of these practices with the socio-demographic characteristics of the population.Methods: The study conducted was a community based cross-sectional one in the six villages of RHTC of PIMSR. The study was conducted by surveying a total of 204 mothers to study their breastfeeding practices which were categorized into ‘good’ and “not so good’ practices. From this the total score was calculated and associated with socio-demographic variables.Results: Majority of the mothers were in the age group 18-22 and educated up to ‘primary’ and most of them were from social class IV and V. Only 23% of the mothers had adequate knowledge of exclusive breastfeeding. About 70% practiced both early initiation of breastfeeding and feeding colostrum whereas nearly 80% practiced exclusive breastfeeding.Conclusions: It is concluded from the study that even though the practice of breastfeeding was found quite good, the gaps in the knowledge and practice must be addressed through health education and support through peer and health groups. Documenting the success stories will go a long way for community education and behavioral change in communication at the community level for adequate breastfeeding practices.
ABSTRACT
Background: India, which accounts for world's 17.5 percent population, is the second most populous country in the world next only to China (19.4%). The major objective of the NFHS surveys has been to strengthen India’s demographic and health database, to anticipate and meet the country’s needs for data on emerging health and family welfare issues. The objectives of the study were to study the different background characteristics of women adopting different family planning methods and to analyze the associated socio-demographic factors..Methods: Secondary data analysis of NFHS 4 datasets obtained from DHS program portal. Appropriate statistical testing of associated socio-demographic variables done and interpreted accordingly.Results: Out of total 63696 couples, 99.2% women and 98.6% men knew modern method of contraception, 48.6% were currently using modern method of contraception and 7.4% traditional method. The majority (34%) women adopted female sterilization as current method of contraception. There is interstate variation in the contraceptive prevalence rate highest (80.60%) in Chandigarh compared to least (26.64%) in Goa. There is significant association observed between place of residence, religion, wealth index, women education, education of husband towards current contraceptive use.Conclusions: About 45% of population increase is contributed by births above two children per family. The adoption of appropriate method of contraception by couples made available through quality family planning services and empowering women by proper behavior change communication will help improve the present contraceptive prevalence rate especially among the vulnerable groups.
ABSTRACT
Assessment of the status of health and nutrition of a population is imperative to design and implement sound public health policies and programmes. The various extensive national health and nutrition surveys provide national-level information on different domains of health. These provide vital information and statistics for the country, and the data generated are used to identify the prevalence and risk factors for the diseases and health challenges faced by a country. This review describes the various national health and nutrition surveys conducted in India and also compares the information generated by each of these surveys. These include the National Family Health Survey, District Level Household Survey, Annual Health Survey, National Nutrition Monitoring Bureau Survey, Rapid Survey on Children and Comprehensive National Nutrition Survey.
ABSTRACT
Introduction: It is believed that empowered women can contribute to the health, productivity and benefit of the whole family and community and improved prospects for the next generation. The empowerment of women is a fundamental prerequisite for their health. With better reproductive health practices, women can go safely through pregnancy, child birth and fertility regulations. Objective: The main objective of this study is to investigate whether women empowerment in two study groups i.e., Northern states and Southern states of India is linked with their reproductive health practices. Data and Methodology: The data from the 2015-16 National Family Health Survey (NFHS-4) was used in the study. Women who were currently married or living with a partner were included in the analysis. Logistic regression analyses were conducted to examine the association between the reproductive health outcomes with the domains of women empowerment and other socio-economic and demographic variables. Results: Women‘s participation in household decision making having slightly higher percentage for a visit to family/ relatives in northern region under study, whereas the decision making in own health care as well as major and small household purchases were found higher in southern region. It can be surprisingly seen that women who justified refusing sexual intercourse to husband were significantly less likely to be assisted by a skilled person in delivery if overall Indian data is concerned, but no effect has been seen in northern and southern regions after the adjustment with socio-economic and demographic characteristics. The women who didn‘t support wife beating were more likely to use modern method of contraception in northern region.
ABSTRACT
Background: In 2014, approximately 462 million adults worldwide were underweight; while 1.9 billion were either overweight or obese. Hence, a study was carried out first time using the NFHS Standard of Living Index to assess the association between socioeconomic status and underweight & overweight among likely to conceive women.Material & Methods: In Determinants of Birth Weight (DBW): a community based prospective cohort study; household characteristic information was collected from 1293 likely to conceive women. Nutritional status of women was graded based on WHO international BMI categories. Chi-square test and multinomial logistic regression were applied to assess the association between standard of living and underweight & overweight with the 95% confidence level and p values less than 0.05.Results: The prevalence of underweight, normal weight, overweight and obesity was found 35.1%, 52.4%, 9.7% and 2.7%, respectively, with mean±SD BMI 20.4 kg/m2±3.876 kg/m2. The low standard of living was significantly associated with underweight whereas high standard of living was associated with overweight among likely to conceive women in a rural North Karnataka with a p value less than 0.05.Conclusion: Among likely to conceive women, there is an inverse association between standard of living and underweight whereas positive association with overweight in a rural North Karnataka.
ABSTRACT
Universal Health coverage (UHC) is required for fulfilment of Health for All. Currently World Health Organization has proposed indicators for tracing coverage of UHC. This study aimed to find the current status of the UHC in India and Indian States. Material and Methods: Data were collected from the national data portals, national surveys and annual reports of ministry. In case of non-availability, numerator and denominator were used from different sources. Data were entered in to Microsoft excel and analysed using Stata-12. Results: Coverage indicators for Non Communicable diseases and cataract surgery were not available in any national survey or national report of ministry. Coverage of none of the health system indicators were found to be 100%. Few indicators like Skilled attendance at birth, TB cure rate, Preventive chemotherapy against filariasis, access to improved water source had a coverage of 80%. Across the states and union territories the coverage was variable but no significant difference was observed between the EAG and Non EAG states. Very few states have achieved the minimum coverage of 80% in various coverage indicators. Conclusion: There is non-availability of some data and some data were collected in duplication. Because of the lack of data, it is not yet possible to compare the UHC service coverage index across key dimensions of inequality. Until these data gaps are overcome, inequalities in service coverage cannot be assessed.
ABSTRACT
The third National Family Health Survey (NFHS-3) is a large dataset on indicators of family welfare, maternal and child health, and nutrition in India. This article using NFHS-3 data is an attempt to bring out the impact of economic status, i.e., the wealth index on maternal health. The study was based on an analysis of the NFHS-3 data. Independent variables taken were the wealth index, literacy, and age at first child birth. Effects of these variables on the maternal health care services were investigated. Out of the total 124,385 women aged 15-49 years included in the NFHS-3 dataset, 36,850 (29.6%) had one or more childbirth during the past 5 years. The number of antenatal care (ANC) visits increased as the wealth index increased and there was a pattern for choice of place of delivery (for all deliveries during the last 5 years) according to the wealth index. Logistic regression analysis of the abovementioned variables were sought to find out the independent role of key determinants of the different aspects of maternal health care. It showed that the wealth index is the leading key independent determinant for three or more ANC received: Tetanus toxoid (TT) received before delivery, iron tablet/syrup taken for more than 100 days, and institutional delivery. Mother's literacy was the leading independent key determinant for early antenatal registration. The study suggested that along with the mother's literacy, the wealth index that is an important predictor of maternal health care can be added for categorization of the districts for providing differential approach for maternal health care services.
ABSTRACT
Background: Obesity is a multifaceted problem with wide-reaching medical, social and economic consequences. While health consequences are much known, but due to paucity of data, economic consequences are less known in India. The prevalence for excessive weight particularly among women population has been increasing dramatically in India in the last decades. We examined the economic burden on individual and households due to overweight and obesity among women in the national capital territory of India, Delhi. We particularly examined the health expenditure pattern in absolute amount as well as a proportion to their household expenditure among women according to their level of body mass index (BMI). Methods: A population based follow-up survey of 325 ever-married women aged 20-54 years residing in the national capital territory of Delhi in India, systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) samples who were re-interviewed after four years in 2003. Women’s expenditure on health has been seen as a gross and as a ratio of total household expenditure. Anthropometric measurements were obtained from women to compute their current body mass index. Multiple logistic regression analysis was used to estimate the odds ratios adjusting for various socio demographic confounders. Results: A significantly (p<0.0001) higher monthly gross health expenditure as well as proportion of total household expenditure was found according to the women’s level of BMI. Average monthly health expenditure was Rs. 132 among overweight women, Rs 143 among obese women which further increased to Rs. 224 among morbidly obese women compared to only Rs 68 among normal weight women. Almost, 15% overweight, 16% obese and 21% morbidly obese women (p<0.0001) had economic burden which accounts for more than 5% of their total household expenditure on their health compared to only 10% normal weight women. Significantly, obese and morbidly obese women were more than two times more likely to spend higher amount on their health (OR 2.29 95% CI: 1.07-4.90; p=0.033) than normal weight women. Also overweight women were significantly two times more likely to spend high proportion on their health with respect to total household expenditure (OR 2.11; 95% CI: 1.03-4.35; p=0.042) than normal weight women. Conclusions: There is substantial economic burden of obesity for individuals as well as for the households which calls for urgent intervention in the obesity awareness and health promotion among Indian women who faced the greatest burden of increasing body weight in the last decade. Prevention is obviously more cost effective than treatment, both in terms of healthcare and personal costs. Health care providers and policy makers need to critically understand the issue of obesity and develop effective policies and programs for its prevention among Indian women.
ABSTRACT
Background & objectives: the level of infant and child mortality is high among Scheduled Tribes particularly those living in rural areas. This study examines levels, trends and socio-demographic factors associated with infant and child mortality among scheduled tribes in rural areas. Methods: Data from the three rounds of the National Family Health Survey (NFHS) of India from 1992 to 2006 were analysed to assess the levels and trends of infant and child mortality. Univariate and multivariate Cox proportional hazard model were used to understand the socio-economic and demographic factors associated with mortality during 1992–2006. Results: Significant change was observed in infant and child mortality over the time period from 1992-2006 among Scheduled Tribes in rural areas. After controlling for other factors, birth interval, household wealth, and region were found to be significantly associated with infant and child mortality. Hazard of infant mortality was highest among births to mothers aged 30 yr or more (HR=1.3, 95% CI=1.1-1.7) as compared with births to the mother’s aged 20-29 yr. Hazard of under-five mortality was 42 per cent (95% CI=1.3-1.6) higher among four or more birth order compared with the first birth order. The risk of infant dying was higher among male children (HR = 1.2, 95% CI=1.1-1.4) than among female children while male children were at 30 per cent (HR=0.7, 95% CI=0.6-0.7) less hazard of child mortality than female children. Literate women were at 40 per cent (HR=0.6, 95% CI=0.50-0.76) less hazard of child death than illiterate women. Interpretation & conclusions: Mortality differentials by socio-demographic and economic factors were observed over the time period (1992-2006) among Scheduled Tribes (STs) in rural India. Findings support the need to focus on age at first birth and spacing between two births.
ABSTRACT
Objective: To examine the pattern of growth faltering in preschool children, using World Health Organization (WHO) growth standards 2006 from the available datasets of first and third National Family Health Survey (NFHS 1 and 3). Design: Data-analysis of two large-scale cross-sectional surveys done at a gap of 15 years. Setting: General community. Subjects: Preschool children included in NFHS 1 (n = 37,768) and NFHS 3 (n = 41,306). Main outcome measures: Weight for age Z-scores (WAZ), height for age Z scores (HAZ) and weight for height Z scores (WHZ) based on WHO growth standards for the first four years of life. Results: Mean WAZ score at ‘0’ month during first and third surveys were -1.15 (n=268) and -0.76 (n=184), respectively. Of the total growth faltering in weight for age Z (WAZ) score by the end of third year, 55% and 44% of the growth faltering was already present at birth for the first and third survey, respectively. There was no change in weight for height Z (WHZ) score for the first three years during both the surveys. Conclusions: A good part of the total growth faltering in India has already taken place at birth. Much of the growth faltering in early life can be attributed to faltering in HAZ scores or stunting. Understanding the causal role of stunting and its prevention as well as improving birth weight appears to be the key for better efficacy of public health programs in preventing under-5 malnutrition in India.