Accelerating Malnutrition Reduction in Orissa

Orissa has performed better than the Indian average in terms of the rate of malnutrition reduction. This positive trend is supported by NFHS data, independent survey data and the State's own monitoring data. Despite this good news, absolute rates remain high with 40 per cent of children under five malnourished, rising to 54 per cent amongst the tribal population. Encouraging progress but recognition of a long way to go has triggered the Department of Women and Child Development to develop a new operational plan to accelerate the pace of malnutrition reduction. The Nutrition Plan is based on five principles, the key being targeting the most vulnerable in high burden districts. Review of national and international experience, analysis of the Department's data, plus primary data collection to fill information gaps, have created an evidence?based Plan which provides a challenging but realistic map for reaching an average annual malnutrition reduction of 3.5 percent

Why Should 5000 Children Die in India Every Day? Major Causes and Managerial Challenges

Globally, more than 10 million children under 5 years of age, die every year (20 children per minute), most from preventable causes, and almost all in poor countries. Major causes of child death include neonatal disorders (death within 28 days of birth), diarrhea, pneumonia, and measles. Malnutrition accounts for almost 35 % of childhood diseases. India alone accounts for almost 5000 child deaths under 5 years old (U5) every day. India.s child heath indicators are poor even compared with our Asian neighbors, namely Malaysia, Sri Lanka, Thailand, Vietnam, China, Nepal and Bangladesh. Within India, the states of Bihar, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh account for almost 60 % of all child deaths India.s neonatal mortality, which accounts for almost 50 % of U5 deaths, is one of the highest in the world. India launched the Universal Immunization Program in 1985, but the status of full immunization in India has reached only 43.5 % by 2005-06. India started the Integrated Child Development Scheme (ICDS) in 1975 to provide supplementary nutrition to children, but 50 % of our children are still malnourished; nearly double that of Sub-Saharan Africa. The WHO/UNICEF training program on Integrated Management of Neonatal and Childhood Illnesses, known as IMNCI, started in India a few years ago, but the progress is very slow. What is unfortunate is the fact that most of these deaths are preventable through proven interventions: preventive interventions and/or treatment interventions, but the management of childhood illnesses is very poor. In this working paper, we bring out the nature and magnitude of child deaths in India (Chapter 1) and then share with you in Chapters 2, 3 and 4 our observations on the management of some of national programs of the government of India such as The Universal Immunization Program (UIP) The Integrated Child Development Scheme (ICDS) The Integrated Management of Neonatal and Child Illnesses (IMNCI) In the final chapter (Chapter 5), we highlight certain managerial challenges to satisfactorily address the child mortality and morbidity in our country.

Developing regional operations research training capacity in South Asia

This project’s overall objective was to create a self-sustaining regional operations research (OR) training and research center for South Asia at the International Institute of Population Sciences (IIPS), in Mumbai, India. The goal was to institutionalize operations research (OR) in IIPS by building the teaching and research capabilities of the faculty and research team. Capacity building was accomplished through a training of trainers that included an OR workshop in Nepal, two four-day OR workshops for program managers, one ten-day OR workshop for researchers, and a four-day scientific-writing course for researchers and program managers to provide guidelines for preparing research articles and reports. Nine OR studies were carried out, and 12 articles were published in peer-reviewed national and international journals. As noted in this report, capacity-building activities also produced an important multiplier effect in three additional organizations: The National Institute of Health and Family Welfare (NIHFW), New Delhi, India, the Center for Operations Research Training, Vadodara, India, and the Medical College of Ahmadabad, India

Relationship between Type of Feeding and Duration of Hospitalization of Infants Admitted for Diarrhea in Babylon Maternity and Paediatrics Teaching Hospital

الخلفية: يعتبر حليب الأم أفضل أنواع التغذية للرضع.  توصي منظمة الصحة العالمية بالرضاعة الطبيعية الحصرية لمدة 6 أشهر، واستمرار الرضاعة الطبيعية حتى عمر عامين.  لها دور في الحد من المراضة والوفاة من الإسهال.  في العراق ، تعتبر أمراض الإسهال السبب الثاني الأكثر شيوعًا للوفيات بين الأطفال ، وبالتالي ، قد يساعد الترويج للرضاعة الطبيعية في الحد من الإسهال في العراق. الهدف من الدراسة: تحديد نوع التغذية لدى مرضى الإسهال ، وتقييم العلاقة بين نوع التغذية ومدة الاستشفاء بالنسبة للأطفال الذين يتم قبولهم للإسهال في مستشفى بابل للأمومة والطفولة التعليمي. المرضى والطرق: هذه الدراسة عبارة عن دراسة تحليلية رصدية أجريت في مستشفى بابل للأمومة والطفولة التعليمي خلال الفترة من أبريل 2018 إلى يونيو 2018 وتضمنت معلومات من 96 مريض أطفال تم قبولهم في المستشفى المذكور أعلاه للإسهال.  تم تقييم تعرض المرضى لحليب الثدي وكذلك الخصائص الأخرى. النتائج: شملت الدراسة ما مجموعه 96 مريضا تتراوح أعمارهم بين أيام تصل إلى 36 شهرا.  أظهر الانحدار الخطي فرقًا كبيرًا في مدة الاستشفاء بين أولئك الذين يرضعون رضاعة طبيعية وأولئك الذين لا يرضعون ، ر = 1.42 ، القيمة P = 0.001.  أظهرت ANOVA وجود علاقة كبيرة بين مستوى الجفاف ومدة الاستشفاء.  أظهر اختبار t للطالب وجود علاقة معنوية بين مصدر المياه ومدة الاستشفاء قيمة (P = 0.012). هناك علاقة كبيرة بين الرضاعة الطبيعية ومدة الاستشفاء لمرضى الإسهال عند تعديلها حسب الفئة العمرية والجنس.  أيضا هناك علاقة قوية بين مصدر المياه ومدة الاستشفاء.  وبالمثل، هناك ارتباط كبير بين شدة الجفاف ومدة الاستشفاء.Background: Breast milk is considered the best type of feeding for infants. WHO recommends exclusive breastfeeding for 6 months, and the continuation of breastfeeding for up to 2 years of age. It has a role in reducing morbidity and mortality of diarrhea. In Iraq, diarrheal diseases are considered 2nd most common cause of mortality among children, therefore, promotion of breast-feeding may help reduce diarrhea in Iraq. Aim of the Study: To identify the type of feeding in patients with diarrhea, and to assess the relationship between the type of feeding and the duration of hospitalization for infants admitted for diarrhea in Babylon Maternity and Paediatrics Teaching Hospital. Patients & Methods: This study is an observational analytical study conducted in Babylon Maternity And Paediatrics Teaching Hospital during the period from April 2018 through June 2018 and included information from a 96 pediatric patients admitted in the aforementioned hospital for diarrhea. Patients' exposure to breast milk was assessed as well as other characteristics. Results: Study included a total of 96 patients with age ranging from days up to 36 months. Linear regression has shown a significant difference in duration of hospitalization among those who are breastfed and those who are not, t=1.42, P-value=0.001.  ANOVA demonstrated a significant relationship between dehydration level and duration of hospitalization. Student’s t-test has shown a significant relationship between water source and the duration of hospitalization (P-value = 0.012). Conclusion: There is a significant relationship between breastfeeding and the duration of hospitalization of diarrhea patients when adjusted for age group and sex. Also there is a strong relationship between source of water and duration of hospitalization. Similarly, there is a significant correlation between severity of dehydration and the duration of hospitalization

Economic cost of tobacco use in India, 2004

ObjectiveTo estimate the tobacco-attributable costs of diseases separately for smoked and smokeless tobacco use in India.MethodsThe prevalence-based attributable-risk approach was used to estimate the economic cost of tobacco using healthcare expenditure data from the National Sample Survey, a nationally representative household sample survey conducted in India in 2004. Four major categories of tobacco-related disease-tuberculosis, respiratory diseases, cardiovascular diseases and neoplasms-were considered.ResultsDirect medical costs of treating tobacco related diseases in India amounted to $907 million for smoked tobacco and$285 million for smokeless tobacco. The indirect morbidity costs of tobacco use, which includes the cost of caregivers and value of work loss due to illness, amounted to $398 million for smoked tobacco and$104 million for smokeless tobacco. The total economic cost of tobacco use amounted to $1.7 billion. Tuberculosis accounted for 18$311 million) in India. Of the total cost of tobacco, 88% was attributed to men.ConclusionsThe cost of tobacco use was many times more than the expenditures on tobacco control by the government of India and about 16% more than the total tax revenue from tobacco. The tobacco-attributable cost of tuberculosis was three times higher than the expenditure on tuberculosis control in India. The economic costs estimated here do not include the costs of premature mortality from tobacco use, which is known to comprise roughly 50% to 80% of the total economic cost of tobacco in many countries

A review of breast cancer awareness among women in India: Cancer literate or awareness deficit?

BACKGROUND: Breast cancer is the most common female cancer worldwide including India, where advanced stages at diagnosis, and rising incidence and mortality rates, make it essential to understand cancer literacy in women. We conducted a literature review to evaluate the awareness levels of risk factors for breast cancer among Indian women and health professionals. METHODS: A structured literature search using combined keywords was undertaken on bibliographic databases including MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health (CINAHL) and SCOPUS. Searches were restricted to research published in English language peer-reviewed journals through December, 2014 in India. RESULTS: A total of 7066 women aged 15-70 years showed varied levels of awareness on risk factors such as family history (13-58%), reproductive history (1-88%) and obesity (11-51%). Literacy levels on risk factors did not improve over the 8-year period (2005-2013). On average, nurses reported higher, though still varied, awareness levels for risk factors such as family history (40.8-98%), reproductive history (21-90%) and obesity (34-6%). Awareness levels were not consistently higher for the stronger determinants of risk. CONCLUSION: Our review revealed low cancer literacy of breast cancer risk factors among Indian women, irrespective of their socio-economic and educational background. There is an urgent need for nation- and state-wide awareness programmes, engaging multiple stakeholders of society and the health system, to help improve cancer literacy in India

Accelerating progress toward reducing child malnutrition in India: A concept for action

"1. The facts: Child malnutrition in India India is home to 40 percent of the world's malnourished children and 35 percent of the developing world's low-birth-weight infants; every year 2.5 million children die in India, accounting for one in five deaths in the world. More than half of these deaths could be prevented if children were well nourished. India's progress in reducing child malnutrition has been slow. The prevalence of child malnutrition in India deviates further from the expected level at the country's per capita income than in any other large developing country. 2. The challenge: Accelerating progress in reducing child malnutrition in India India has many nutrition and social safety net programs, some of which (such as Integrated Child Development Services [ICDS] and the Public Distribution System [PDS]) have had success in several states in addressing the needs of poor households. All of these programs have potential, but they do not form a comprehensive nutrition strategy, and they have not addressed the nutrition problem effectively so far. 3. Strategic choices for improved child nutrition India lacks a comprehensive nutrition strategy. Various choices for nutrition strategies can be considered. A review of some of the more successful country experiences suggests that all of them implemented complex, multisectoral actions with more or less emphasis on service-oriented nutrition policies (as in Indonesia), incentive-oriented nutrition policies linked to community or household participation and performance (as in Mexico), or mobilization-oriented nutrition policies (as in Thailand). These choices are not mutually exclusive. India now has the opportunity to “leapfrog” toward innovative nutritional improvement based on the experiences of other countries and on experiences within India itself. 4. Cooperation for policy actions To accelerate progress in reducing child malnutrition, India should focus on the following four cross-cutting strategic approaches: a. ensuring that economic growth and poverty reduction policies reach the poor; b. redesigning nutrition and health policies and programs by drawing on science and technology for nutritional improvement, strengthening their implementation, and increasing their coverage; c. increasing investments and actions in nutrition services for communities with the highest concentration of poor; and d. focusing programs on girls' and women's health and nutrition. IFPRI, in collaboration with Indian experts and international networks, could bring much-needed experience with programs and policies around the world to bear on this effort. An evidence-based, research-intensive approach with “learning while implementing”—which has shown success in other countries—is recommended. There is no time or reason to wait for taking action." from TextMalnutrition in children, Policies, Integrated Child Development Services (ICDS), Public Distribution System (PDS), Nutrition, stakeholders, Global Hunger Index, Gross national income per capita, Hunger, Child mortality,