Knowledge and practice pattern of integrated child development services scheme supervisors (AWS) following capacity building and remote supportive supervision.

Background: Nutritional status of under-5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house-to-house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.

Sociodemographic and environmental factors influencing acute respiratory infections among under-five children of chars (riverine islands) of Tinsukia District, Assam: A community-based cross-sectional study.

Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under-five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health-care facilities. A community-based cross-sectional study was carried out among 380 under-five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under-five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru-Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.