Association Between Household Food Insecurity and Nutritional Status Among Children of age <5 years: A Community-based Study in a Slum of Kolkata, Eastern India.

Context: Household food insecurity (HFI) is considered one of the main risk factors of undernutrition. However, the evidence is not conclusive in our study settings. This study aimed to examine the association between HFI and nutritional status. Materials and Methods: It was a community-based cross-sectional observational study among children of age <5 years and their mothers (n = 257) conducted in a slum of Kolkata, West Bengal, carried out from March to May 2019. Data were analyzed using the Statistical Package for the Social Sciences software (version 16.0. Chicago, SPSS Inc.). Logistic regression analysis was performed to find out the association. Results: The current study found that 72.4% of participants living in food-insecure households and the proportion of underweight, wasting, and stunting among the under-five children found to be 29.9%, 17.8%, and 27.2%, respectively. Bivariate analysis showed wasting and stunting associated with HFI, whereas in multivariable regression, only stunting remained significant. Conclusion and Implications: Food insecurity (FI) remains a predictor of chronic undernutrition (wasting and stunting) highlighting the need for multisectoral strategies and policies to combat FI and multiple forms of malnutrition which will lay the foundation for sustainable and inclusive growth.

Self-care practice and its predictors amongst Type-2 Diabetes Mellitus patients in the outpatient department of a tertiary hospital of Kolkata, Eastern India - A cross-sectional study.

PURPOSE: The purpose of this study is to find out the pattern and factors associated with self-care practices among diabetic patients as self-care was considered imperative for the control of disease and enhancement of patient's quality of life. METHODS: This is a cross-sectional clinic-based observational study conducted among the type 2 diabetes mellitus patients who came for follow up to the outpatient department of a tertiary hospital of Kolkata from September to December 2019. Self-care practice assessed using questions adapted from the "Summary Diabetes Self-Care Activities Questionnaire" by face-to-face interview. Logistic regression used to find out the predictors of self-care practice. RESULTS: Self-care practice was unsatisfactory among 67.5% of the patients. Near half (56%) of the patients had mild to moderate distress and about 18% were severely distressed. Self-care practice was significantly associated with the educational level, family history, presence of hypertension, advice given regarding self-care activities, and diabetes distress levels of the participants. CONCLUSIONS: Primary care physicians should be encouraged to give practical aspects of self-care practices and counseling regarding diabetes distress. To perform self-care practices adequate, support from the family level and community level is imperative.

Out of pocket expenditure and its associated factors in neonates admitted to neonatal intensive care unit of tertiary care government hospital of Agra District, Uttar Pradesh.

BACKGROUND: Neonatal health remains a thrust area of public health, and an increased out-of-pocket expenditure (OOPE) may hamper efforts toward universal health coverage. Public spending on health remains low and insurance schemes few, thereby forcing impoverishment upon individuals already close to poverty line. OBJECTIVE: To determine catastrophic health expenditure (CHE) in neonates admitted to the government neonatal intensive care unit (NICU) and factors associated with of out-of-pocket expenditure. METHODS: This cross-sectional study was conducted in a governmental NICU at Agra from May 2017 to April 2018. A sample of 450 neonatal admissions was studied. Respondents were interviewed for required data. OOPE included costs at NICU, intervening health facilities, and transport as well. SPSS version (23.0 Trial) and Epi Info were used for analysis. RESULTS: Of the 450 neonates analyzed, the median total OOPE was Rs. 3000. CHE was found among 55.8% of cases with 22% spending more than their household monthly income. On binary logistic regression, a higher total OOPE of Rs. 3000 or more was found to be significantly associated with higher odds of residing outside Agra (adjusted odds ratio [AOR] = 1.829), delay in first cry (AOR = 1.623), referral points ≥3 (AOR = 3.449), private sector as first referral (AOR = 2.476), and when treatment was accorded during transport (AOR = 1.972). CONCLUSIONS: OOPE on neonates amounts to a substantial figure and is more than the country average. This needs to be addressed sufficiently and comprehensively through government schemes, private enterprises, and public-private partnerships.