Background: The prevalence of low birth weight (LBW) is a major public health issue in India; however, the optimal growth pattern for such infants is not clear. The purpose of this study is to understand the causal association between LBW and stunting of preschool children in India. Methods: The National Family Health Survey-4 is a large cross-sectional survey based on a nationally representative sample of 699,686 women in the age group of 15–49 years and was conducted during 2015–2016 in India. The study used the children’s file with a sample of 259,002 of 0–59 months for investigation. Results: The data revealed that 38.7% of the children in India were stunted. The bivariate analysis revealed that, of the women who did not attend any antenatal care (ANC) meetings, 46.8% had stunted children compared to the women who attended more than three ANC meetings, which 30.7% had stunted children. The low birth weight children experienced a much higher chance of stunting compared to children with a normal birth weight (44.3% vs. 33.8%). The multivariable odds ratios of logistic regression, after adjusting for the confounding characteristics, showed that pregnant women attending more than three ANC meetings compared to not attending any ANC meetings experienced a 19% lower adjusted odds ratio (AOR) of having stunted children (AOR = 0.81; CI 0.78, 0.85; p < 0.001). Another important variable, such as women with underweight body mass index (BMI) compared with normal BMI, had 6% higher odds of having stunted children (AOR = 1.06; CI 1.03, 1.10; p < 0.001). Similarly, women who belong to the Scheduled Caste compared to the General Caste had 36% higher odds of having stunted children (AOR = 1.36; CI 1.30, 1.42; p < 0.001); and children aged 13–23 months compared to children up to one-year-old or younger had 141% higher odds of being stunted (AOR = 2.41; CI 2.32, 2.51; p < 0.001). The conspicuous finding is that LBW babies, after adjusting for other important confounding factors, such as BMI and ANC, experienced 19% higher odds of stunted children (AOR = 1.19; CI 1.14, 1.24; p < 0.001) compared to normal birth weight babies. Conclusions: The results revealed LBW is associated with stunting of preschool children in India.
Aims: Anemia accounts for 40% of maternal deaths in India. In order to address this problem, the Government of India implemented the largest programme with the greatest potential to reduce maternal mortality by free distribution of Iron-Folic Acid (IFA) supplementations especially during Antenatal Care (ANC) visits. But the major concern among the policymakers and researchers has been poor adherence to the supplement among pregnant women. However, we tend to think that given the severity of the problem, there is no investigation on the adherence issue. Hence, the aim of the paper is to understand whether IFA consumption by pregnant women in India is largely a distribution problem of IFA supplements through ANC. Background: The distribution of Iron-Folic Acid (IFA) supplementation is not working especially through Antenatal Care (ANC) attendance. The program implementers believe that it is because of lack of adherence to IFA supplements by pregnant women. It is important to investigate the problem before any policy changes are made without proper evidence. Objectives: The purpose of this study is to examine whether the problem of IFA consumption by pregnant women is due to the problem of public distribution of IFA supplements through ANC attendance. Methods: This study had used the fourth round of District Level Household Survey data, which collects information on IFA supplements, their distribution and consumption. Bivariate and tri-variate analyses were used to understand the relationship between IFA distribution to pregnant women and their consumption patterns in 19 Indian states and two Union Territories (UTs) of pregnant women (88,487) and between the age of 15-49 years. Results: In almost all the states except Chhattisgarh, more than 75% of the pregnant women consumed 100 or more IFA supplements when they received 100 or more IFA supplements from providers. Similar is the case even among those women who received 100 or more IFA supplements through 1 or 2 ANC attendance except Arunachal Pradesh (60%), Meghalaya (67%), Pondicherry (57%) and Andaman and Nicobar (0%). The consumption of IFA supplements among pregnant women gets better than 75% if they receive 100 or more supplements only after attending three or more ANCs. Conclusion: It seems that distribution is a problem in the consumption of IFA supplements by pregnant women in India. Full antenatal attendance by the women could be part of the problem but not supplying at least 100 IFA supplementations to even those who attend ANC due to stock-outs and ineffective management is a serious concern. Hence, Governments should distribute at least the recommended 100 IFA supplements to the women in their 1st ANC attendance to address anaemia.
1 September 2020 in Clinical Epidemiology and Global Health
The early detection of anaemia is important for its subsequent control and incidence among women of childbearing age. This study aimed to assess the anaemia status of preconception young married women in India using National Family Health Survey-4 data collected in 2015–16. A total 65,238 sample preconception young married women were analysed using univariate, bivariate and multivariate techniques. A majority belonged to the Hindu religion (81.7%), lived in rural areas (64.5%) and had secondary level education (51.8%), and 41.7% had not yet given birth. The percentage suffering from anaemia was 51.3%. The prevalence of anaemia was higher among younger women (55.3%), those from Scheduled Tribes (59.0%), those living in rural areas (52.8%), the non-educated (55.9%), those in the poorest wealth quintile (56.9%), those from the East region (57.0%) and those with a low body mass index (BMI) (58.4%). The adjusted odds ratios indicated that, after controlling for significant background factors, Hindu, Scheduled Tribe, Scheduled Caste, East region, already having a child, too thin for their height and poorer and poorest wealth quintiles had higher odds of suffering from anaemia compared with the reference groups. The odds of suffering from anaemia decreased with age and education. The study showed a high burden of anaemia and associated risk factors among preconception young married women in India. The finding will inform decision-makers when planning interventions to decrease anaemia among women of childbearing age in India.
Background: In recent years, the hysterectomy, a surgical removal of the uterus, has received increased attention in health policy debates in India. The trigger for this was a series of media reports that highlighted an unusual surge in the number of women undergoing hysterectomies with a significant number of cases involving young and early menopausal women from low-income families. When menopause occurs as a result of hysterectomy, then the hormones such as estrogen and progesterone affect how the body cells respond to insulin. To date, we have not come across a national study following blood glucose levels among women who undergo a hysterectomy. Methods: The study used the Indian fourth round of National Family Health Survey data, which is a cross-sectional nationally representative sample of 699,686 women in the age group 15–49 years and conducted during 2015–16. Bivariate and multivariate logistic regressions were used to examine the effect of hysterectomy on blood glucose level of > 140 mg/dl among women of reproductive age groups. Results: The blood glucose level of > 140 mg/dl was much higher among women who had undergone a hysterectomy (12.2%) compared to non-hysterectomy women (5.7%). The pattern holds true among relevant background characteristics such as age, place of residence, education, caste, religion, wealth, marital status, body mass index (BMI), anaemia and consumption of tobacco. The adjusted odds after controlling for significant background factors, women who underwent hysterectomy experienced 15% higher odds of blood glucose level of > 140 mg/dl compared those who did not. Conclusions: The results indicated increased blood glucose level among women post hysterectomy. Hence, the government of India should consider developing evidence-based policies and programming to provide effective targeted interventions for the better reproductive health of women.
11 May 2020 in Diabetes & Metabolic Syndrome: Clinical Research & Reviews