Childhood Head Growth And Educational Attainment In An Indian Cohort

Background: There is minimal information about the association of head growth at different stages of childhood with cognitive ability. Objective: To determine the relationship of newborn head size and head growth during infancy, childhood and adolescence with attained education, a proxy for cognitive ability. Study design: Prospective birth cohort study. Setting: Married women living in South Delhi between 1969 and 1973. Participants: The New Delhi Birth Cohort study followed up 8030 newborns born in 1969-1973 with head circumference, weight and height measurements at birth and 6-12 monthly until adulthood. Of these, 1526 men and women were followed up at the age of 26-32 years. Outcomes: Association between years of schooling, as an indicator of cognitive ability, and newborn head circumference and conditional measures of head growth during infancy, childhood and adolescence. Results: In unadjusted analyses, newborn head size was positively associated with years of education [(? (95% CI)=0.30 (0.14 to 0.47) years per SD head circumference], as was head growth from birth to 6 months [? (95% CI)=0.44 (0.28 to 0.60) years per SD conditional head growth], 6 months to 2 years [? (95% CI)=0.31 (0.15 to 0.47) years per SD conditional head growth] and 2 to 11 years [? (95% CI)=0.20 (0.03 to 0.36) years per SD conditional head growth]. There were similar findings for height and body mass index (BMI). In the adjusted model containing all growth measures, gestational age, and socioeconomic status (SES) at birth as predictors, only SES was positively associated with educational attainment. Conclusion: Educational attainment in this population is positively associated with socioeconomic status and its influence on inter-related early life (fetal, infant and childhood) factors like nutritional status and brain growth.

Surgical conditions - A neglected aspect of public health: Call to action

The burden of surgical conditions is large, though unrecognized. Surgical interventions are cost – effective, but thought to be otherwise. Investments aimed at including surgery at primary care level are affordable. Globally, a momentum is being created to strengthen surgery infrastructure especially for the poor in the low and middle income countries – who bear the burden most. In India, the Association of Rural Surgeons of India, and a body for implementing Lancet Commission of Global Surgery, India are taking lead. A blue print of activities needed to bring surgery on the centre stage of public health in India has been developed. The IPHA can play a catalytic role and use its convening power in getting various associations of public health professionals in India to partner surgeons in this effort. Integration of surgery in public health has the potential to improve equity, access, and universal health coverage.