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The statistical field of survival analysis focuses on the examination of time-to-event data. The proportional hazards (PH) model is the most widely used in multivariate survival analysis to examine the effects of various factors on survival time. The statistics, however, do not always support the PH models assumption of constant hazards. The power of the associated statistical tests is reduced when the PH assumption is broken, which leads to incorrect interpretation of the estimation results. The accelerated failure time (AFT) models, on the other hand, do not, like the PH model, assume constant hazards in the survival data. Additionally, the AFT models can be employed in place of the PH model if the constant hazards assumption violated. This study set out to examine how well the PH model and the AFT models performed when it came to identifying the proximate variables influencing under – five mortality from National Family Health Survey data in Uttar Pradesh. Three AFT models that were based on the Weibull, exponential, and log-normal distributions were the only ones discussed in this article. The research employing a graphical technique and a statistical test revealed that the NFHS-5 data set has non-proportional hazards. The log-normal AFT model was the most acceptable model among the ones studied, according to the Akaike information criterion (AIC).
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Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey?4 was conducted. We included 770,662 individuals(112,122 men and 658,540 nonpregnant women) of 15–49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%–49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%–72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%–40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three?fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.
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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.
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Background: Men in the 25–54 year age group form the major workforce in developing countries like India. The rising trend of hypertension in this age group is a growing matter of concern. Objectives: This study analyzed secondary data analysis from the National Family Health Survey‑4. Methods: Men in the 25–54 age group (n = 76,410) from 640 districts of the country were included in the study. State and district‑wise trends in hypertension in men along with selected individual lifestyle characteristics were displayed using a geographic information system. Results: The prevalence of hypertension among men in the age group of 25–54 was found to be 35.6% for the entire country. In urban India, the prevalence of hypertension was 38.4% (uncorrected ‑ 40.2%) compared with 33.8% (uncorrected ‑ 34.9%) in rural India. Among the 27,973 hypertensives, 6984 (25%) were the known hypertensives prior to the survey. Out of these only 2403 (34.4%) were taking medicines. The prevalence of tobacco use in any form among the men in this age group was 45.7% (uncorrected ‑ 49%). Conclusion: In conclusion, the study highlights the burden of hypertension in men in the prime age group along with the alarming burden of tobacco consumption and recommends public health and policy interventions targeting both hypertension and tobacco control. It requires urgent attention and specialized strategies in tiding over this epidemic brewing in the workforce of the country
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Background: India was the first country to start family planning program in 1952. In the first 50 years there have been many changes in India. The family planning program name was changed from time to time. At the present scenario, its name is Reproductive and Child Health. In this study, authors evaluate utilization of family planning services with an objective to compare distribution of family planning services between the two regions of Uttarakhand: Garhwal and Kumaon.Methods: In this study, data mining was done using secondary database with the permission from International Institute for Population Sciences (IIPS) NFHS-4 data to carried out during 2015-2016 in Uttarakhand, India and estimate of the values for all the parameters of Family Planning was estimated. A statistical Z-score test was performed in the estimated of proportions in all study parameters of the family planning.Results: The study indicates that between the two divisions Garhwal has more utilization of family planning services as comparatively higher than Kumaon. Pithoragarh from the Kumaon division has more utilization proportion of family planning services in comparison to the other districts in the division, while Almora were recorded as the minimum use of family planning services. Uttarkashi in Garhwal region accounted for major proportion of utilization of family planning services, while Haridwar had minor proportions.Conclusions: Though overall utilization of family planning services of Uttarakhand is far better than other states in India but between the two divisions, Kumaon requires more attention in terms of utilizing services and awareness programmes. In fact, certain districts in Garhwal also require intervention from the Government to improve health quality. Both hilly and urban districts have different issues, which needs to be targeted to improve the health quality of the state.
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Anaemia is a severe public health problem amongst all vulnerable age groups in India. The National Nutritional Anaemia Prophylaxis Programme initiated in 1970, was revised and expanded to include beneficiaries from all age groups namely children aged 6-59 months, 5-10 yr, adolescents aged 10-19 yr, pregnant and lactating women and women in reproductive age group under the National Iron Plus Initiative (NIPI) programme in 2011. The dose of iron, frequency and duration of iron supplementation and roles and responsibilities of the functionaries were described. At present, the coverage of beneficiaries with iron and folic acid has been poor at the national level. The prevalence of anaemia has continued to remain high during the last 60 years, and there has been no significant change in the scenario due to various reasons. The constraints in implementation and measures to improve the NIPI programme are discussed in the current article.
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Introduction: Child’s birth weight (BW) is an important aspect not only during childhood but also affects morbidity and mortality in adulthood. The focus of this study is to examine the role of different socioeconomic factors, along with women’s decision-making autonomy on the determination of infant BW. Methods: The dataset was obtained from the National Family Health Survey, India (2005-06). The respondents were women of reproductive age (15-49 years) having at least one living child at least five years old preceding the survey. This study considered only the last single live birth child having a recorded BW at the time of delivery. Results: The results showed that 19% of the infants were born with low birth weight (LBW) with regional variations ranging from 13% to 27%. The mean BW of infants of mothers from high autonomy category was 2.90±0.645 kg, while that of mothers with low autonomy was 2.75±0.702 kg. The proportion of LBW infants was significantly higher among mothers with low education, short stature, low BMI and poor wealth index category. Percentage of LBW infants were lower among mothers with autonomy including taking care of their own health (18% versus 21% who were not), making large purchases (17% vs 22%), visiting relatives (18% vs 22%), and allowed to go to the market (18% vs 22%). Conclusion: The findings indicated that the mother’s freedom of movement and financial independence were significantly associated with infant’s BW in India. Attention should be given to improving the socio-economic conditions and empowerment of Indian women.
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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.