Perinatal care practices in home deliveries in rural Bangalore, India: A community-based, cross-sectional survey.

Background A slowing in the decline in neonatal mortality in India has hindered progress made in reducing overall child mortality. The persisting use of unsafe home deliveries and harmful neonatal care practices may contribute to this stagnation in neonatal mortality rates. Methods A community-based cross-sectional study of mothers residing in rural Bangalore, India, who had given birth within 42 days of the day of home visit was done during 2013-2014. Trained health workers interviewed women who delivered at home about perinatal care practices. The questionnaire used was adapted from previous studies assessing perinatal care practices according to World Health Organization guidelines. Descriptive analyses of perinatal practices were reported as frequencies. The association of various factors with the outcomes clean cord care, thermal care and early initiation of breastfeeding were assessed using multivariate logistic regression analyses. Results Of a total of 2230 deliveries, 945 (42.4%) took place in hospitals, while the remainder were at home (57.6%). Among home deliveries, only 30.6% were attended by a skilled worker; a safe-delivery kit was used in 40.6% and 47.1% of attendants had washed their hands before delivery. In most cases (94.6%), the umbilical cord was cut after delivery of the placenta and a non-sterile instrument was used in 26.6% of births. Harmful practices of applications on the cord stump (35.0%), bathing within 6 h (61.6%), pre-lacteal feeding (30.8%) and delayed initiation of breastfeeding (73.3%) were reported. Wrapping was usually delayed, and most (64.7%) neonates were wrapped between 10 min and 60 min after birth. Being Hindu was positively associated with good perinatal care practices, and attending antenatal care at least once was associated with clean cord care and early breastfeeding. Having a trained birth attendant at delivery was associated only with clean cord care. Having a medical doctor/nurse in attendance was associated with only early initiation of breastfeeding. Being a member of a scheduled caste/tribe was positively associated with clean cord care and thermal care. Conclusion Appropriate and culturally acceptable behaviour-change communication strategies are needed to improve delivery and neonatal care practices in Bangalore.

Physical activity and associated factors among young adults in Malaysia: an online exploratory survey.

The burden of non-communicable diseases is increasing in Malaysia. Insufficient Physical Activity, which is an important risk factor for non-communicable diseases, is less researched in Malaysia. We aimed to assess the level of physical activity and identify its correlates. An online survey was carried out during October, 2011 in the University Tunku Abdul Rahman by the opinion poll research committee. Young adults answered the Short International Physical Activity Questionnaire and a questionnaire about factors according to a socio-ecological model which was adapted from published studies. Metabolic equivalent (MET)-hours and MET-minutes were calculated. Physical activity was classified as sufficient when MET-minutes were > 840. The mean age of the 474 participants was 22.4 years (S.D. = 4.7), and 253 (53.4%) were females. Their mean and median of MET-hours of PA done during the previous seven days were 31.36 (S.D., 52.19) and 14.7 (IQR, 5.77-32.07), respectively. Physical activity done was sufficient among 242 (51.1%) participants. Using univariate analysis, being male, good self-rated health, positive intention, self-efficacy, perceived benefits, social support, and availability of facilities were associated with sufficient physical activity. Using multivariate analysis sufficient physical activity was associated with participants' intention (OR 0.75, 95% CIs 0.64, 0.88), self-efficacy (OR 0.91, 95% CIs 0.85, 0.97) and facility availability (OR 0.81, 95% CIs 0.73, 0.91). The proportion of participants with sufficient physical activity was low. Positive intention and self-efficacy associated with sufficient physical activity should be supported by availability of facilities and a safely-built environment. A nationwide survey about physical and associated socialecological factors is needed to design rational health promotion strategies.