Nutritional status of older adults in India: An exploration of the role of oral health and food insecurity factors.

Background: In this study, we attempted to generate insights into the determinants of nutritional status among older adults in India by exploring the role of factors including oral health, food insecurity, socioeconomic, demographic and health-related variables. The study also examined the moderating role of tooth loss with the association between chewing ability and nutritional status. Methods: The data was obtained from Longitudinal Ageing Study India (LASI) - Wave 1 (2017-18). The sample consisted of 27,411 older adults (Male = 13, 232; Female = 14, 179) aged 60 years and above. In addition to descriptive and bivariate analysis, we employed multinominal logistic regression analysis. Result: There was a significant association between the ability to chew solid food and tooth loss in the nutritional status of older adults. It was further revealed that tooth loss acted as a moderator (aRRR = 1.50, 95 % CI: 1.08-2.08) between the chewing ability and the risk of being underweight. The weight loss due to food insecurity increased the relative risk ratio of being underweight (aRRR = 1.58, 95 % CI: 1.25-2.00). Further evidence showed that self-rated health (SRH), Instrumental Activities of Daily Living (IADL), morbidity status and socioeconomic factors had a significant role in determining the nutritional status among older adults. Conclusion: Chewing ability, tooth loss, and food insecurity determine nutritional status among older adults. It is suggested to care for oral and general physical health as these factors increase the risk of nutritional deficits. Also, policy measures should be strengthened to address the specific health and food security needs of older adults from vulnerable socioeconomic circumstances.

Perplexing condition of child full immunisation in economically better off Gujarat in India: An assessment of associated factors.

BACKGROUND: Despite decent progress in Children Full Immunisation (CFI) in India during the last decade, surprisingly, Gujarat, an economically more developed state, had the second-lowest coverage of CFI (50%) in the country, lower than economically less developed states such as Bihar (62%). Further, the proportion of children with no immunisation in Gujarat has risen from 5% in 2005 to 9% in 2016. This paper investigated factors associated with the low level of CFI coverage in Gujarat. METHODS: The study used two types of datasets: (1) the information on immunisation from 7730 children aged 12-23 months and their mothers from the fourth round of the Gujarat chapter of National Family Health Survey (NFHS 2015-16). (2) A macro (district) level data on both supply and demand-side factors of CFI are compiled from multiple sources. Bivariate and multivariate linear and logistic regression techniques were employed to identify the factors associated with CFI coverage. RESULTS: In Gujarat, during 2015-2016, 50% of children aged 12-23 months did not receive full immunisation. The odds of receiving CFI was higher among children whose mothers had a Maternal and Child Protection (MCP) card (OR: 1.97, 95% CI 1.48-2.60) and those who received "high" maternal health services utilisation (OR: 1.59, 95% CI 1.10-2.26) compared to their counterparts. The odds of receiving CFI was about three times higher among the richest households (OR: 6.50, 95% CI 3.75-11.55) compared to their counterparts in the poorer households. Macro-level analyses suggest that poverty, maternal health care, and higher-order births are defining factors of CFI coverage in Gujarat. CONCLUSIONS: In order of importance, focusing on poverty, economic inequalities, pregnancy registration, and maternal health care services utilisation are likely to improve receiving CFI uptake in Gujarat. The disadvantageous position of urban areas and non-scheduled tribes in CFI coverage needs further investigation.

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."