Correlates of poor self-rated health among school-going adolescent girls in urban Varanasi, India.

BACKGROUND: The concept of self-rated health (SRH) has widely been studied among the adults and older population in developed as well as developing countries, including India. Also, studies are available in abundance examining the various concepts of SRH among adolescents. However, in India, studies on the SRH of adolescents remain scarce, especially those aiming to understand the correlates of SRH among school-going adolescent girls in an urban setting. Therefore, this study aims to determine the correlates of poor SRH among school-going adolescent girls in the urban setting of Varanasi, India. METHODS: This study is based on the primary data collected in the Varanasi district of Uttar Pradesh, India, from October 2019 to February 2020. Nearly 350 adolescent girls and their mothers were personally interviewed. Self-rated health was the primary outcome variable of this study. The exact wording of the question asked from the adolescent girls was, "In general, how would you say your health is?". RESULTS: Almost one-fifth (19.4%) of the adolescent girls reported poor SRH. Adolescent girls from Other Backward Class (OBC) [OR: 0.39; 95% CI: .18-.85] and Others caste [OR: 0.58; 95% CI: .23-0.87] were less likely to report poor SRH than their Scheduled Caste/Scheduled Tribe (SC/ST) counterparts. Girls residing in households where number of daughters were more than sons were more likely to report poor SRH [OR: 7.8; 95% CI: 1.5-39.5] than girls who belonged to the daughters only households. CONCLUSION: Composition of children was one of the important factors as outlined in this study. The role of mothers in improving the overall SRH of the girls is critical as they are involved in caring process of their daughters.

Exploring the association of lifestyle behaviors and healthy ageing among the older adults in India: evidence from LASI survey.

BACKGROUND: Understanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as "the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO)," where "functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value." People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India. METHODS: Based on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI. RESULT: The mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (ß = 2.36; 95% CI: 2.16-2.56). CONCLUSION: This study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.

How do responses vary between mothers and their daughters on measuring daughter's self-rated health (SRH): a study among school-going adolescent girls in the primary setting of Varanasi, India.

OBJECTIVE: How self-rated health (SRH) varies when the response on SRH is recorded from the respondent herself (adolescent girl) and her mother on her behalf. This study examines the prevalence of SRH among adolescent girls from her point of view as well as from her mother's point of view. This insight could help us interpret the differences in opinion of girls and their mothers while measuring the girls' self-rated health. RESULTS: Almost one-fifth (19.4%) of the girls reported poor SRH. In contrast, only one in eight mothers (12.3%) could report their daughters under the category of poor SRH. Nearly one-third (76.5%) of the mothers reported their daughter's SRH as good when daughters themselves rated poorly on SRH and another one-tenth (9.6%) reported their daughter's SRH as poor when daughters themselves categorized in the good SRH category [χ2 = 9.900; p < 0.002]. More than 90 percent of the Rich and Middle wealth index women, women in the household with only daughters and no son, women whose husbands had higher education, women with higher secondary education, and non-working women visualized their daughter's SRH as good when daughters themselves reported poor SRH.

Prevalence and factors associated with triple burden of malnutrition among mother-child pairs in India: a study based on National Family Health Survey 2015-16.

BACKGROUND: Malnutrition in mothers as well as in children is a significant public health challenge in most of the developing countries. The triple burden of malnutrition is a relatively new issue on the horizon of health debate and is less explored among scholars widely. The present study examines the prevalence of the triple burden of malnutrition (TBM) and explored various factors associated with the TBM among mother-child pairs in India. METHODS: Data used in this study were drawn from the fourth round of the National Family Health Survey (NFHS-IV) conducted in 2015-16 (N = 168,784). Bivariate and binary logistic regression analysis was used to quantify the results. About 5.7% of mother-child pairs were suffering from TBM. RESULTS: Age of mother, educational status of the mother, cesarean section delivery, birth size of baby, wealth status of a household, and place of residence were the most important correlates for the triple burden of malnutrition among mother-child pairs in India. Further, it was noted that mothers with secondary education level (AOR: 1.15, CI 1.08-1.23) were having a higher probability of suffering from TBM, and interestingly the probability shattered down for mothers having a higher educational level (AOR: 0.90, CI 0.84-0.95). Additionally, mother-child pairs from rich wealth status (AOR: 1.93, CI 1.8-2.07) had a higher probability of suffering from TBM. CONCLUSION: From the policy perspective, it is important to promote public health programs to create awareness about the harmful effects of sedentary lifestyles. At the same time, this study recommends an effective implementation of nutrition programs targeting undernutrition and anemia among children and obesity among women.

Multiple morbidities and health conditions of waste-loaders in Mumbai: A study of the burden of disease and health expenditure.

Study assesses the effects of solid-waste loading on workers, the resultant development of occupational morbidities, and economic burden of these morbidities. A cross-sectional survey was conducted with 360 municipal workers from six of 24 municipal wards in Mumbai. The nearest neighborhood method of Propensity Score Matching (PSM) examined the impact of waste-loading on the development of morbidities and to identify the risk factors - multiple logistic regression analysis was performed. The prevalence of musculoskeletal disorders (MSDs), injury, eye and skin infections found significantly higher for waste-loaders compared to comparison group. The PSM method revealed that the occupation of waste-loading significantly raised the risk of injury (34%), MSDs (23%), eye (19%), skin infection (15%) and disability (15%), compared to comparison group. Significantly higher health expenditure is observed among waste-loaders who have sought treatment in private health facility than public. The study recommends to offer assistance the medical insurance for reducing the financial burden on waste-loaders.

Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey.

BACKGROUND: Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. METHODS: The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15-49. The study variables include the mother's age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. RESULTS: We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15-19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. CONCLUSIONS: Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

Assessing musculoskeletal disorders among municipal waste loaders of Mumbai, India.

OBJECTIVES: The study aims to assess the impact of municipal waste loading occupation upon developing musculoskeletal disorders (MSDs) and thereby disabilities among waste loaders. Additionally, the study has identified the potential risk factors raising MSDs and disabilities. MATERIAL AND METHODS: A cross-sectional case-control design survey was conducted in 6 out of 24 municipal wards of Mumbai during March-September 2015. The study population consisted of municipal waste loaders (N = 180) and a control group (N = 180). The Standardized Modified Nordic questionnaire was adopted to measures the MSDs and thereby disabilities in the past 12 months. A Propensity Score Matching (PSM) method was applied to assess the impact of waste loading occupation on developing MSDs and disabilities. RESULTS: Waste loaders had a significantly higher risk of developing MSDs as well as disabilities than the control group particularly for low back, hip/ thigh upper back and shoulder. Propensity Score Matching results revealed that the MSDs were significantly higher among waste loaders for hip/thigh (22%), low back (19%), shoulder (18%), and upper back (15%) than matched control group. Likewise, MSDs-related disabilities were found to be significantly higher among waste loaders for low back (20%), hip/ thigh (18%) upper back (13%) and shoulder (8%) than the control group. Duration of work, substance use and mental health were found to be the potential psychosocial factors for developing the risk of MSDs and disabilities. CONCLUSIONS: The municipal waste loading occupation raised the risk of MSDs and related disabilities among waste loaders compared to the control group. The preventive and curative measures are strongly recommended to minimize the burden of MSDs and disabilities. Int J Occup Med Environ Health 2017;30(6):875-886.