Factors Influencing Antenatal Care Services Utilization in Empowered Action Group (EAG) States, India: A Spatial and Multilevel Analysis

The study investigated individual-household community and district level factors associated with antenatal care services utilization in Empowered Action Group states India Nationally-representative data drawn from the District Level Household Survey 2007-08 were used A sample of 116 973 currently married women aged 15-49 years who delivered a child during the three years preceding the survey was considered for analysis Both descriptive and multivariate analysis were used to analyze the data generated and level of significance was set at 5 0 05 The findings revealed that household socio-economic status and mother s education were the most important factors associated with antenatal care services utilization The adjusted model showed that the place of residence community education community impoverishment were significantly associated with antenatal care services utilization Spatial analysis finding revealed that districts with higher urban percentage and higher proportion of antenatal care services utilization were clustered together and low-urban percentage-low proportion in the spac

Factors affecting maternal health care seeking behaviour in northeast states, India: evidence from district level household survey-4 (2012-2013)

Background: In context of reducing maternal mortality ratio, Government of India has implemented various programs and public health facility centres in order to provide quality services at the time of delivery. In this paper, we assessed the factors for home, private and public health facility sector utilization of delivery care in Northeast state, India. District Level Household Survey fourth round was used to carried out analysis and data was extracted for the childbirth during the last five years preceding the survey.Methods: The outcome variable was categorical, thus multinomial logistic regression was used to assess the factors of each variable independently on the predictor variables. To check the collinearity, variance inflation factor (VIF) was computed for all variables prior to inclusion of multilevel logistic regression.Results: This shows that equal proportion of delivery was conducted at home (45%) and public health facility (45.2%) in comparison with private health facility (9.8%). For the choice set of public versus home, women with higher number of living children, wealth quintile and living in urban areas were associated with greater odds of delivering at public health facility centres.Conclusions: The initiative programs can be implemented by the government by sending trained professionals with supplements required by pregnant women at each and every district in order to promote maternal health and recruit more interdisciplinary team, which will be responsible for maintaining women and infant health, and thus providing appropriate medical advice

Pattern of Substance Abuse, Sexual Behavior and its Determinants among Unmarried Youth in India

This paper describes patterns of substance abuse sexual behaviour and its determinants among unmarried youth in India and also evaluates how these patterns are associated with each others Data come from the Youth in India Situation and Needs Study a sub-nationally representative survey conducted during 2006 2008 Logistic regression analysis binary and multinomial showed relationships between predictor variables and alcohol consumption and alcohol and sexual risk indicators as well as two of the sexual health indicators associated with premarital sex Substance use was significantly high among the age group of 20-24 years Factors such as substance use by caste tribe any member in family paid work and lower educational status were significantly associated with substance use by study subjects The prevalence of substance use was high among male youths as compared to female youths Male youth recognized more Premarital sexual behavoiur than the female youth Premarital sex were significantly higher among youths who had some disposable income in hand i e those belonging the paid work or both paid and unpaid work Youth is most important period of human life as they are easily influenced by habits and behavoiurs of their parents siblings or peers and initiate substance use as well as premarital sex Therefore improvement of educational and employment status of youths strongly needed Youths and their parents urgently need health education regarding the consequences of substance use and unsafe pre marital se

Factors associated with unmet need of family planning in Bihar, India: a spatial and multilevel analysis

Background: Many women in low and middle-income countries would like to limit or delay their pregnancy, but they do not enough access to consistent use of modern contraceptive methods. The concept of unmet need for family planning is focus to reproductive health policies, as it endures serious implications for the women, the child, family and the whole society. The aims of the study are to assess the spatial dimensions of extent of unmet need for family planning and also identify association between individual, household, community and district level covariates with the level of unmet need for family planning among married women of reproductive age group in Bihar, India.Methods: The study uses data from fourth round of the National Family Health Survey (NFHS-4). To meet the objective the analysis included descriptive, spatial visualization, spatial autocorrelation and multilevel logistic model. In the first step of analysis the multivariate analysis was used to know the levels of unmet need for family planning by selected background characteristics.Results: This study indicating that nearly one in five or more women experiences unmet need for family planning suggests that the problem remains of considerable magnitude and that action is needed to fill the gap in contraceptive use, which is currently estimated at a lowest 24 percent. Apart from providing a current estimate of unmet need, our study identified a number of relevant socioeconomic and demographic factors likely to shape the probability that a women experiences unmet need. It is observed across individual level, community/psu level and district level.Conclusions: Considering this fact, family planning program in Bihar should also focus on eliminating misconceptions and fear about contraception through proper counselling of couples and information, education and communication activities in the community and try to improve the quality of advice and care services related to family planning

Implementation of drone based delivery of medical supplies in North-East India: experiences, challenges and adopted strategies

Timely delivery of medical supplies is essential in the healthcare sector, which is hampered by factors such as poor transportation network, traffic and adverse environmental conditions. Alternatively, drone operations can leapfrog the last mile logistic solutions in hard-to-reach terrains. The present paper elucidates the implementation process of drone-based delivery of medical supplies, operational challenges and innovations adopted by scientists in Manipur and Nagaland. Three districts, Bishnupur, Imphal West and Churachandpur from Manipur and two districts, Mokokchung and Tuensang from Nagaland, were selected for the study. Regulatory and ethical approvals and coordination with state health and administrative authorities were accorded. Implementation and operational challenges faced by the research team were recorded elaborately in the field diaries and assessed qualitatively. The experiences encountered by the team for case-to-case based permission and coordination with the central and state aviation authorities, district administration and health authorities were observed. The drone-related technical and logistic challenges were identified as the deployment of suitable drones, payload capacity, time management for operations, and transportation of drones. The officials adopted mitigation strategies to overcome field-based challenges. Drone-based deliveries of medical supplies are proving to be time efficient, however, overcoming operational challenges could provide an effective long-term deployment strategy

Challenges and opportunities in mixed method data collection on mental health issues of health care workers during COVID-19 pandemic in India

Background: The present paper describes the key challenges and opportunities of mixed method telephonic data collection for mental health research using field notes and the experiences of the investigators in a multicenter study in ten sites of India. The study was conducted in public and private hospitals to understand the mental health status, social stigma and coping strategies of different healthcare personnel during the COVID-19 pandemic in India.Methods: Qualitative and quantitative interviews were conducted telephonically. The experiences of data collection were noted as a field notes/diary by the data collectors and principal investigators.Results: The interviewers reported challenges such as network issues, lack of transfer of visual cues and sensitive content of data. Although the telephonic interviews present various challenges in mixed method data collection, it can be used as an alternative to face-to-face data collection using available technology.Conclusions: It is important that the investigators are well trained keeping these challenges in mind so that their capacity is built to deal with these challenges and good quality data is obtained

Factors affecting maternal health care seeking behaviour in northeast states, India: evidence from district level household survey-4 (2012-2013)

Background: In context of reducing maternal mortality ratio, Government of India has implemented various programs and public health facility centres in order to provide quality services at the time of delivery. In this paper, we assessed the factors for home, private and public health facility sector utilization of delivery care in Northeast state, India. District Level Household Survey fourth round was used to carried out analysis and data was extracted for the childbirth during the last five years preceding the survey.Methods: The outcome variable was categorical, thus multinomial logistic regression was used to assess the factors of each variable independently on the predictor variables. To check the collinearity, variance inflation factor (VIF) was computed for all variables prior to inclusion of multilevel logistic regression.Results: This shows that equal proportion of delivery was conducted at home (45%) and public health facility (45.2%) in comparison with private health facility (9.8%). For the choice set of public versus home, women with higher number of living children, wealth quintile and living in urban areas were associated with greater odds of delivering at public health facility centres.Conclusions: The initiative programs can be implemented by the government by sending trained professionals with supplements required by pregnant women at each and every district in order to promote maternal health and recruit more interdisciplinary team, which will be responsible for maintaining women and infant health, and thus providing appropriate medical advice

Prevalence of Exclusive Breastfeeding Practices and Its Associated Factors in Maharashtra: A Spatial and Multivariate Analysis

India is committed to achieving its National and Millennium Development Goal 4 of reduction in infant mortality. Government of India has been implemented initiative to promote breastfeeding through the national health program. WHO has recommended that every child should be exclusively breastfed (EBF) for the first six month of life, with partial breastfeeding continued until two years of age. The present study is to assess the prevalence of EBF and associated factors among mothers having children age 0-6 months in Maharashtra. Data were extracted from for Maharashtra from District Level Household and Facility Survey (DLHS-4), conducted during 2012-13. A sample of married women, aged 15-49 years, having children age 0-6 months were considered as unit of analysis. Median duration of EBF, full breastfeeding and any breastfeeding were computed using current status data on breastfeeding for the selected background characteristics and EBF prevalence was calculated using 24 hour recall method. The result shows that prevalence of EBF in the last 24 hours preceding the survey was low. The study showed that women residing in the rural setting had longer median duration of EBF and Illiterate women had longer median duration (2.89) than the women having higher education, also showed women who are in poorest quintile had longer median duration of EBF