Wealth-based disparities in the prevalence of short birth interval in India: insights from NFHS-5.

BACKGROUND: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. METHODS: We used information on 109,439 women of reproductive age (15-49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. RESULTS: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15-24 (OR: 12.01, p < 0.001) and 25-34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. CONCLUSION: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country.

Socioeconomic inequality in teenage pregnancy in Papua New Guinea: a decomposition analysis.

BACKGROUND: Teenage pregnancy is a global public health issue, and it poses a serious threat to the health and socioeconomic status of mothers and their newborn children. Although Papua New Guinea has recorded one of the highest teenage pregnancy rates among Asia-Pacific countries, few studies have conducted research on the related inequality in the country. Therefore, this study aimed to assess socioeconomic inequality in teenage pregnancy and its contributing factors in Papua New Guinea. METHODS: Data for this cross-sectional study were obtained from the 2016-2018 Papua New Guinea Demographic and Health Survey. The analytical sample consisted of 2,864 girls aged 15-19 years. We employed Erreygers normalized concentration index (ECI) and concentration curves to measure and depict socioeconomic inequality in teenage pregnancy. Decomposition analysis was likewise performed to identify the contributions of determinants to the observed inequality. RESULTS: Weighted ECI for teenage pregnancy was - 0.0582 (P < 0.001), thereby indicating that teenage pregnancy in Papua New Guinea is disproportionately concentrated among poor girls. Decomposition analysis suggested that education level (65.2%), wealth index (55.2%), early sexual debut (25.1%), region (8.5%), and sex of household head (4.1%) are the main determinants explaining the pro-poor socioeconomic inequality in teenage pregnancy. CONCLUSIONS: A pro-poor socioeconomic inequality of teenage pregnancy was present in Papua New Guinea. This inequality may be alleviated by such interventions as ensuring that teenage girls receive education; implementing poverty alleviation projects, eliminating child, early, and forced marriages; strengthening promotion for household head to support teenagers in accessing sexual and reproductive health education; improving geographical accessibility to health facilities on contraceptive services, and taking necessary precautions and responses to sexual misconduct.

Decomposing maternal socioeconomic inequalities in Zimbabwe; leaving no woman behind.

BACKGROUND: Several studies in the literature have shown the existence of large disparities in the use of maternal health services by socioeconomic status (SES) in developing countries. The persistence of the socioeconomic disparities is problematic, as the global community is currently advocating for not leaving anyone behind in attaining Sustainable Development Goals (SDGs). However, health care facilities in developing countries continue to report high maternal deaths. Improved accessibility and strengthening of quality in the uptake of maternal health services (skilled birth attendance, antenatal care, and postnatal care) plays an important role in reducing maternal deaths which eventually leads to the attainment of SDG 3, Good Health, and Well-being. METHODS: This study used the Zimbabwe Demographic Health Survey (ZDHS) of 2015. The ZDHS survey used the principal components analysis in estimating the economic status of households. We computed binary logistic regressions on maternal health services attributes (skilled birth attendance, antenatal care, and postnatal care) against demographic characteristics. Furthermore, concentration indices were then used to measure of socio-economic inequalities in the use of maternal health services, and the Erreygers decomposable concentration index was then used to identify the factors that contributed to the socio-economic inequalities in maternal health utilization in Zimbabwe. RESULTS: Overall maternal health utilization was skilled birth attendance (SBA), 93.63%; antenatal-care (ANC) 76.33% and postnatal-care (PNC) 84.27%. SBA and PNC utilization rates were significantly higher than the rates reported in the 2015 Zimbabwe Demographic Health Survey. Residence status was a significant determinant for antenatal care with rural women 2.25 times (CI: 1.55-3.27) more likely to utilize ANC. Richer women were less likely to utilize skilled birth attendance services [OR: 0.20 (CI: 0.08-0.50)] compared to women from the poorest households. While women from middle-income households [OR: 1.40 (CI: 1.03-1.90)] and richest households [OR: 2.36 (CI: 1.39-3.99)] were more likely to utilize antenatal care services compared to women from the poorest households. Maternal service utilization among women in Zimbabwe was pro-rich, meaning that maternal health utilization favoured women from wealthy households [SBA (0.05), ANC (0.09), PNC (0.08)]. Wealthy women were more likely to be assisted by a doctor, while midwives were more likely to assist women from poor households [Doctor (0.22), Midwife (- 0.10)]. CONCLUSION: Decomposition analysis showed household wealth, husband's education, women's education, and residence status as important positive contributors of the three maternal health service (skilled birth attendance, antenatal care, and postnatal care) utilization outcomes. Educating women and their spouses on the importance of maternal health services usage is significant to increase maternal health service utilization and consequently reduce maternal mortality.

Susceptibility of green and conventional building materials to microbial growth.

Green building materials are becoming more popular. However, little is known about their ability to support or limit microbial growth. The growth of fungi was evaluated on five building materials. Two green, two conventional building materials and wood as a positive control were selected. The materials were inoculated with Aspergillus versicolor, Cladosporium cladosporioides and Penicillium brevicompactum, in the absence and presence of house dust. Microbial growth was assessed at four different time points by cultivation and determining fungal biomass using the N-acetylhexosaminidase (NAHA) enzyme assay. No clear differences were seen between green and conventional building materials in their susceptibility to support microbial growth. The presence of dust, an external source of nutrients, promoted growth of all the fungal species similarly on green and conventional materials. The results also showed a correlation coefficient ranging from 0.81 to 0.88 between NAHA activity and culturable counts. The results suggest that the growth of microbes on a material surface depends on the availability of organic matter rather than the classification of the material as green or conventional. NAHA activity and culturability correlated well indicating that the two methods used in the experiments gave similar trends for the growth of fungi on material surfaces.

Extensive analysis of radiocesium concentrations in wild mushrooms in eastern Japan affected by the Fukushima nuclear accident: Use of open accessible monitoring data.

After the Fukushima Daiichi Nuclear Power Plant accident, there has been an increasing concern regarding the contamination of wild mushrooms with radiocesium (134Cs and 137Cs) in eastern Japan. In this study, we analyzed the radioactivity monitoring data of 3189 wild edible mushrooms of 107 species collected by the 265 local municipalities in eastern Japan to investigate the radiocesium levels in wild mushrooms. Results of the analysis showed that radiocesium concentrations in mushrooms were normalized with radioactivity deposition data from aircraft monitoring, and then we evaluated the effects of species, sampled location, sampling year and regional deviation between 134Cs and 137Cs activity of specimens using a hierarchical Bayesian approach considering spatial autocorrelation (an intrinsic CAR model). Normalized activity concentration by species ranged from 1.1×10-4 to 2.3×10-2 (m2 kg-1, fresh weight). As reported in previous studies, the mycorrhizal species tended to have higher radiocesium concentrations. Some saprophytic species (e.g. Pholiota lubrica) also had high concentrations. For the mushroom species that were also evaluated in the post-Chernobyl studies, we found that the same species had similar trends of absorption capacities. Our results indicate the extensive analysis of public monitoring data is helpful to understand the situation of mushroom contamination and evaluate the internal dose by ingestion of wild mushrooms according to species and areas.

Numerical simulation of airflow and particle distributions with floor circular swirl diffuser for underfloor air distribution system in an office environment.

In the present study, an underfloor air distribution (UFAD) system with a circular swirl diffuser was simulated in an office room using a three-dimensional model when thermal sources were present in the room. An Eulerian-Lagrangian model was used to predict the characteristics of air and particle phases. In the Lagrangian particle model, the effects of drag, lift, Brownian, and thermophoresis forces were considered. The results showed that the circular swirl diffuser has better airflow and thermal conditions compared with the circular direct diffusers. It was also shown that the studied UFAD system provides good thermal comfort condition. The local and mean normalized particle concentrations in different heights of the room were found reasonable, and the particle removal efficiency was between 55 and 65% for all the particle sizes. The results also showed that the large particles due to their large weight stayed in lower heights of the room and deposited on the floor. The particle concentration in the breathing zone of manikins was also investigated, and it showed that though the manikins seated close to inlet registers have appropriate thermal comfort, they encounter the highest particle concentration in their breathing zone.