Status and correlates of non-communicable diseases among children and adolescents in slum and non-slum areas of India's four metropolitan cities.

The emergence of non-communicable diseases (NCDs) in childhood poses a serious risk to a healthy adult life. The present study aimed to estimate the prevalence of NCDs among children and adolescents in slums and non-slums areas of four metropolitan cities of India, and in rural areas of the respective states The study further, investigated the effect of the place residence as slum vs. non-slum and other risk factors of the NCDs. Nationally representative data from the Comprehensive National Nutrition Survey (CNNS) was used.. Estimates were based on children (5-9 years) and adolescents (10-19 years) for whom biomarkers predicting diabetes, high total cholesterol, high triglycerides and hypertension were determined. Weight, height and age data were used to calculate z-scores of the body mass index. Overweight and obesity was higher in urban areas than in rural areas among children and adolescents. Regional differences in the prevalence of diseases were observed; children in Delhi and Chennai had a higher likelihood of being diabetic while children in Kolkata were at a greater risk of high total cholesterol and high triglycerides. The risk of hypertension was strikingly high among non-slum children in Delhi. Children from slums were at a higher risk of diabetes compared to the children from non-slums, while children and adolecents from non-slums were at a greater risk of high triglycerides and hypertension respectively than their counterparts from slums. Male children and adolecents had a higher risk of diabetes and high cholesterol. Screening of children for early detection of NCDs should be integrated with the already existing child and adolescent development schemes in schools and the community can help in prevention and control of NCDs in childhood.

Continuum of maternal health care services and its impact on child immunization in India: an application of the propensity score matching approach.

Continuum of care throughout pregnancy, delivery and post-delivery has proved to be a critical health intervention for improving the health of mothers and their newborn children. Using data from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015-16, this study examined the correlates of utilization of maternal health care services and child immunization following the continuum of care approach in India. The study also assessed whether the continuity in utilizing maternal health care services affects the immunization of children. A total of 33,422 survey women aged 15-49 were included in the analysis of maternal health care indicators, and 8246 children aged 12-23 months for the analysis of child immunization. The results indicated that about 19% of the women had completed the maternal health continuum, i.e. received full antenatal care, had an institutional delivery and received postnatal care. Women with a higher level of education and of higher economic status were more likely to have complete continuum of care. Continuity of maternal health care was found to be associated with an increase in the immunization level of children. It was observed that 76% of the children whose mothers had complete continuum of care were fully immunized. Furthermore, the results from propensity score matching revealed that if mothers received continuum of care, the chance of their child being fully immunized increased by 17 percentage points. The results suggest that promotion of the continuum of maternal health care approach could help reduce not only the burden of maternal deaths in India, but also that of child deaths by increasing the immunization level of children.

INTIMATE PARTNER VIOLENCE AND UNINTENDED PREGNANCY AMONG ADOLESCENT AND YOUNG ADULT MARRIED WOMEN IN SOUTH ASIA.

This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005-2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15-24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.

Data quality of birthweight reporting in India: Evidence from cross-sectional surveys and service statistics.

The study aims to assess the quality of birthweight data collected in two surveys, including the National Family Health Survey (NFHS) and the Comprehensive National Nutrition Survey (CNNS), and as reported in the statistics from the Health Management Information System (HMIS). The study also aims to assess the implications of the data on the estimates of low birthweight (LBW). The percentage of newborns whose birthweight is missing continues to be high in the recent surveys (NFHS-4: 22%, CNNS: 30%) despite an improvement from 66% in NFHS-3. The under-coverage of birthweight data in HMIS is around 40%. In the surveys, the percentage of missing data on birthweight is higher among newborns belonging to poor households, Scheduled Tribes, and Scheduled Castes. Irrespective of whether birthweights are reported from the health cards or from mother's recall, there's a high reporting at multiples of 500g and heaping at 2,500g. The prevalence of missing data on birthweight and of heaping is higher among children born at home in comparison to facility-based births. Birthweight data of dead children who were more likely to have had a lower birthweight is highly underreported. The paper demonstrates state-level variations in birthweight reporting and inconsistencies across surveys and HMIS. In 2015-16, the prevalence of LBW as per HMIS data was 12.5%, whereas during the same period, NFHS-4 and CNNS reported a prevalence of 18%. The findings suggest that LBW is likely to be underestimated when missing data as well as heaping at 2,500g are highly prevalent. To generate robust LBW estimates in India, there is an urgent need to devise methods to ensure coverage of all live births (including early neo-natal deaths) as well as the stillbirths, irrespective of the facility where the deliveries take place.

Menstrual hygiene practices and its association with reproductive tract infections and abnormal vaginal discharge among women in India.

OBJECTIVE: The objective was to explore the determinants of menstrual hygienic practices and its effect on Reproductive Tract Infections (RTI) among ever married women in India. METHODS: District Level Household and Facility Survey-3 (DLHS) India data have been used in the study. The respondents constituted ever married women (N = 577,758) in the age group of 15-49. Bivariate and multivariate techniques were employed using IBM SPSS statistics 20. Individual effects of socio economic, demographic and gynecological factors on menstrual hygienic practices, RTIs and abnormal vaginal discharged respectively were calculated using binary logistic regression. RESULTS: A meager 15% of women used sanitary pad/locally prepared napkins during menstruation in India. Both RTI and Vaginal discharge were positively related with non-use of hygienic methods. The women who used unhygienic method during menstruation were more likely to have any symptom of RTI (OR = 1.046, p < 0.001, CI = 1.021-1.071) and vaginal discharge (OR = 1.303, p < 0.001, CI = 1.266-1.341). CONCLUSION: The reason for the symptoms of RTI may be diverse and not only limited to the unhygienic menstrual practices although this may be one of the reasons causing reproductive morbidity. Awareness, affordability and privacy are some of the major concerns that need immediate attention to promote the use of sanitary pad during the time of menstruation. Establishing relation between menstrual practices and RTI is in its initial stage of investigation and hence needs further research.