Nutritional status of mothers and low birth weight in India.

OBJECTIVES: In this paper we examine the role of mothers' nutritional status and socio-biological aspects in determining the birth weight of their most recent child. METHODS: We used data from the second Indian National Family Health Survey conducted in 1998-1999. Analysis is based on children born within 12 months prior to the survey date (N = 10,042). We used a subjective measure of the size of infant at birth as an indicator for birth weight and employed logistic regression to estimate the effect of BMI and other determinants on birth weight of children in India as a whole and for 17 states separately. RESULTS AND CONCLUSIONS: Results show that mothers' nutritional status is the most important determinant of newborn children's birth weight. Safe drinking water, use of antenatal care and iron deficient anaemia were also significant contributors to low birth weight. Mothers' BMI impact is more pervasive across India than the impact of other factors on birth weight.

Socio-economic inequalities in child health: recent evidence from India.

This paper analyses the Indian National Family Health Survey (2005-2006) data to present certain broad descriptive features of child health inequalities in India and their distribution across well-defined socio-economic groups classified by gender and sector-of-origin, and their dispersal across space. This study finds that poorer sections of the population are beleaguered with ill health whether in the quest for child survival or due to anxieties pertaining to child nutrition. The concentration index value for the indicators of under-five mortality, full immunisation and underweight outcomes at the national level is calculated to be -0.159, 0.204 and -0.158, respectively. The other disturbing finding here is that there are reigning regional and gender disadvantages irrespective of the developmental status of the State. This study would not only help policymakers to recognise these persistent inequalities but also would help understand health performance at the state and regional levels thus facilitating targeting intervention.

Utilization of maternal health care services in Southern India

It present an article about postnatal care use in Indian southern states, patterns and determinants, planning and implementing programs, availability and accessibility, antenatal care, rural areas, and mother and child well-being.

Utilization of maternal health care services in Southern India.

This paper examines the patterns and determinants of maternal health care utilization across different social settings in South India: in the states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Data from the National Family Health Survey (NFHS) carried out during 1992-93 across most states in India are used. Results show that utilization of maternal health care services is highest in Kerala followed by Tamil Nadu, Andhra Pradesh and Karnataka. Utilization of maternal health care services is not only associated with a range of reproductive, socio-economic, cultural and program factors but also with state and type of health service. The interstate differences in utilization could be partly due to variations in the implementation of maternal health care program as well as differences in availability and accessibility between the states. In the case of antenatal care, there was no significant rural-urban gap, thanks to the role played by the multipurpose health workers posted in the rural areas to provide maternal health care services. The findings of this study provide insights for planning and implementing appropriate maternal health service delivery programs in order to improve the health and well-being of both mother and child.

Maternal mortality in India: estimates from a regression model.

This report outlines a new technique for the estimation of maternal mortality by relating the sex differentials in mortality for people of reproductive age to the age schedule of fertility. The application of this method to the data from the Sample Registration System for 1982-86 indicates a level of maternal mortality of 580 deaths per 100,000 live births for India as a whole, 638 deaths in rural areas, and 389 deaths in urban areas. Estimates derived for the major states suggest relatively high maternal mortality in the eastern and northern parts of the country. They also indicate a substantial decline in maternal mortality since the 1960s. The decline in the birth rate is estimated to have accounted for nearly one-fourth of the decrease in the maternal death rate and 5 percent of the fall in the maternal mortality ratio in the 10-year period between 1972-76 and 1982-86. The method of estimation described here is well-suited to the data circumstances in India.

PIP: This report uses a new method for estimation of the level of maternal mortality using the relationship between sex differences in mortality among reproductive age groups and age-specific fertility. This parametric method assumes a standard age pattern of maternal mortality among women 15-49 years old. Data requirements are identified as age-specific death rates from all causes by sex, age-specific fertility rates, the ratio of maternal mortality at different ages to ages 20-24 years (country specific or a similar country's data), and the age pattern of sex ratios of death rates excluding maternal mortality. This new method is applied to data obtained from the Sample Registration System and the National Sample Surveys of India. Data obtained from Matlab, Bangladesh, are used to express the ratio of the age pattern of maternal mortality to women 20-24 years old. Age-specific fertility and mortality rates are averaged during 1982-86 for 15 major states, excluding Kerala, Punjab, Orissa, and Rajasthan states. Regressions are constructed for estimating the level of rural maternal mortality for women 20-24 years old. When the model uses the dependent variable, the sex ratio of mortality, maternal mortality at age 20-24 years is estimated at 465 deaths per 100,000 live births. When the model is fitted to female death rates, maternal mortality at age 20-24 years is 480 deaths per 100,000 live births. Further adjustments are made to conform to state patterns. Final estimation of maternal mortality under two specifications reveals a maternal mortality ratio of 568 or 591 deaths per 100,000 live births during 1982-86. An average maternal mortality ratio of 580 for India is given as the equivalent of a maternal mortality rate of 82 per 100,000 women 15-49 years old, or 21% of deaths of females 15-49 years old. State variations range widely from 20 deaths per 100,000 women in Kerala to 160 in Uttar Pradesh. This estimation is comparable to adjustment of Survey of Cause of Death estimation, suggesting the reliability of this method.

Maternal and child immunization on infant survival in Kerala, India.

The authors examine the impact of maternal and child health programs on the reduction of infant mortality in the state of Kerala, India. "To assess the maternal and child health program, a survey was carried out in Ernakulam, Palakkad and Malappuram districts of Kerala under the auspices of the Centre for Development Studies, Trivandrum. The analysis indicates that the decline in the 1980s is [due to] the Universal Immunization program. The program gave ante-natal care and immunization and above all, brought the pregnant women closer to the health system."

Recent trends in age-specific mortality in India.

"In this paper we have analyzed the data from the Sample Registration System [SRS] on mortality by age and sex [in India] since 1970. Some of the major conclusions emerging from this analysis are: (i) Mortality has declined more rapidly among infants, children under 15 years and women of reproductive ages....(ii) Among adults, mortality has declined more rapidly among females than among males, the differential gain being largest in the age span 25-49. But in ages under 15, there is no evidence to suggest a gender differential in mortality decline. (iii) Among children and women of reproductive ages, mortality has declined more rapidly in urban areas than in rural areas but the reverse is true in the case of adult men.... The paper also analyzes the trends in mortality in major states of India during 1970-86." The authors observe a significant shift in patterns between 1978 and 1979, and conclude that this may be limited to changes in SRS data collection techniques.