Nurturing Care Interventions for Realizing the Development Potential of Every Child: From Pilot to Scale Up in Maharashtra.

The WHO-UNICEF nurturing care framework (NCF) for early childhood development provides a roadmap for action, focusing on pregnancy and the first three years of life. It emphasizes the need to invest in capacity building and empowerment of service providers, families and communities to create a conducive environment that promotes child development. We describe our experience of implementing nurturing care interventions, beginning with a pilot project in Maharashtra covering a population of 10000 to and scaling it up to a model called Aarambh (the beginning), catering to a population of 1,500,000. Opportunities available within the existing services across multiple sectors were used; Integrated Child Development Services (ICDS) scheme, the health sector, and others. It utilized multiple approaches for promoting NCF within families; home visits by frontline workers (FLWs), mothers' meetings, growth monitoring and promotion sessions, and community-based events as key opportunities. Joint training for FLWs, establishing supervisors of FLWs as their trainers, and an interactive training curriculum were critical elements identified for the success of the model. An environment of appreciation for the FLWs and their supervisors helped build their confidence and helped them own the interventions.

Maternal depression and its association with responsive feeding and nutritional status of infants: A cross-sectional study from a rural medical college in central India.

Context: Globally, around half of all under-5 deaths are attributable to undernutrition. The magnitude of child undernutrition in India is one of the highest in the world. Responsive feeding that has the potential to optimize nutrition and development depends on a "healthy mother". Objectives: The objective of this study was to find out the magnitude and determinants of maternal depression among mothers of infants who attended immunization clinic in a rural medical college in central India and observe its association with infant-feeding practices and nutritional status of infants. Study Design: This was an analytical cross-sectional study. Materials and Methods: Study was conducted among consecutively chosen 300 mothers and their infants who visited the immunization clinic of hospital during May-September, 2016. Data were collected individually by interviewing each mother, and anthropometry of her infant was done. The mothers with depression were diagnosed according to the 10-item Edinburgh Postnatal Depression Scale. Magnitude of depression has been reported using frequency and percentage, whereas association has been studied using prevalence odds ratio with 95% confidence interval (CI) and logistic regression at 0.05 significance level. Results: The magnitude of maternal depression was 19% (95% CI 14.4-23.5). Mothers with depression had significantly higher odds for not indulging in responsive feeding. Maternal education had significant association with maternal depression after adjusting for other variables. Conclusions: Burden of maternal depression is high among mothers of infants who attended immunization clinic in a rural medical college in central India and is significantly associated with nonresponsive feeding practices.

Validating the MUAC (Mid-upper arm circumference) Cut-off for Detection of Severe Acute Malnutrition in Children Aged 6-59 Months in Rural Maharashtra.

OBJECTIVE: To review the Mid-upper arm circumference (MUAC) cut-off currently being used to identify Severe Acute Malnutrition (SAM) as currently defined using Weight-for-Height. METHODS: Cross-sectional study conducted in 24 villages of a Primary Health Centre in Wardha district of Maharashtra among 2650 children between the ages of 6 to 59 months. RESULTS: For identifying SAM, sensitivity of MUAC was 23.5% and specificity was 99.7% for cut-off <11.5 cm. Using Youden index, best Mid-upper arm circumference cut-off point to identify SAM was <13 cm with sensitivity of 74.5% and specificity of 92.7%. Using Receiver operating characteristics curve, best MUAC cut-off point was 12.8 cm with 74.5% sensitivity and 92.7% specificity. Area under curve was 0.88 (95%CI: 0.85-0.91). CONCLUSION: The current MUAC cut-off of <11.5 cm for detecting SAM needs to be increased to ensure that children, who need referral for management of malnutrition, are not missed.

Synthesis and characterization of chitosan-TiO2:Cu nanocomposite and their enhanced antimicrobial activity with visible light.

In the present investigation, novel strategy for the preparation of hybrid nanocomposite containing organic polymer (Chitosan) and inorganic (TiO2:Cu) nanoparticles (NPs) has been developed and demonstrated its biomedical application. The sol-gel and ultra-sonication method assisted for the preparation of uniformly distributed Chitosan-TiO2:Cu (CS-CT) nanocomposite. The structural properties of prepared CS-CT nanocomposite were studied by XRD and FTIR techniques. The XPS was used to estimate elemental composition of the nanocomposite. Thermal properties were studied using TGA. TEM and SEM analysis showed the non-spherical nature of NPs with the average mean diameter 16nm. The optical properties were analyzed with UV-vis diffuse reflectance spectroscopy to confirm optical absorption in the visible region of light. Where CS-CT showed 200% enhanced light mediated photocatalytic antimicrobial activity against microorganism (Escherichia coli and Staphylococcus aureus) as compared with control. The antimicrobial activity of CS-CT nanocomposite in presence of light is found to be enhanced than that of its components, this is due to synergistic effect of organic and inorganic material complimenting each other's activity. The OH radicals release studied by PL spectroscopy on the surface of nanocomposite was used to examine antibacterial activity. Cytotoxicity assessment of CS-CT on human fibroblast cells was performed by MTT assay.