Impact of Chronic Drought on Nutritional Status of the Community in Drought affected areas in India

Background: Communities affected by chronic drought conditions face a wide variety of challenges including an adverse effect on their nutritional status. The Government of India, during the year 2002-03, declared nine States viz., Andhra Pradesh, Karnataka, Tamil Nadu, Madhya Pradesh, Maharashtra, Rajasthan, Gujarat, Chhattisgarh and Orissa as drought affected. Material and Methods: At the request of Department of Agriculture, Government of India, a rapid community based cross-sectional study was carried out adopting multistage random sampling procedure with the objective to assess the nutritional status of community in these nine chronic drought affected states in India. Results: In general, the intakes of all the nutrients were grossly deficit as against their RDAs. The nutrition intervention programmes initiated by the Government of India, in general, contributed to meet the daily requirement of staples like cereals & millets in most of the States. Conclusion: In drought-affected areas, where the level of famine impact is unknown, an early rapid assessment of the nutritional status and the health needs of the population are critical to estimate the degree of impact to plan timely and appropriate interventions

Condom use and prevalence of syphilis and HIV among female sex workers in Andhra Pradesh, India – following a large-scale HIV prevention intervention

<p>Abstract</p> <p>Background</p> <p>Avahan, the India AIDS initiative began HIV prevention interventions in 2003 in Andhra Pradesh (AP) among high-risk groups including female sex workers (FSWs), to help contain the HIV epidemic. This manuscript describes an assessment of this intervention using the published Avahan evaluation framework and assesses the coverage, outcomes and changes in STI and HIV prevalence among FSWs.</p> <p>Methodology</p> <p>Multiple data sources were utilized including Avahan routine program monitoring data, two rounds of cross-sectional survey data (in 2006 and 2009) and STI clinical quality monitoring assessments. Bi-variate and multivariate analyses, Wald Chi-square tests and multivariate logistic regressions were used to measure changes in behavioural and biological outcomes over time and their association.</p> <p>Results</p> <p>Avahan scaled up in conjunction with the Government program to operate in all districts in AP by March 2009. By March 2009, 80% of the FSWs were being contacted monthly and 21% were coming to STI services monthly. Survey data confirmed an increase in peer educator contacts with the mean number increasing from 2.9 in 2006 to 5.3 in 2009. By 2008 free and Avahan-supported socially marketed condoms were adequate to cover the estimated number of commercial sex acts, at 45 condoms/FSW/month. Consistent condom use was reported to increase with regular (63.6% to 83.4%; AOR=2.98; p<0.001) and occasional clients (70.8% to 83.7%; AOR=2.20; p<0.001). The prevalence of lifetime syphilis decreased (10.8% to 6.1%; AOR=0.39; p<0.001) and HIV prevalence decreased in all districts combined (17.7% to 13.2%; AOR 0.68; p<0.01). Prevalence of HIV among younger FSWs (aged 18 to 20 years) decreased (17.7% to 8.2%, p=0.008). A significant increase in condom use at last sex with occasional and regular clients and consistent condom use with occasional clients was observed among FSWs exposed to the Avahan program. There was no association between exposure and HIV or STIs, although numbers were small.</p> <p>Conclusions</p> <p>The absence of control groups is a limitation of this study and does not allow attribution of changes in outcomes and declines in HIV and STI to the Avahan program. However, the large scale implementation, high coverage, intermediate outcomes and association of these outcomes to the Avahan program provide plausible evidence that the declines were likely associated with Avahan. Declining HIV prevalence among the general population in Andhra Pradesh points towards a combined impact of Avahan and government interventions.</p

Nutrition profile of under-five year rural children and correlates of undernutrition in central India

Background:&nbsp;High prevalence of undernutrition in Madhya Pradesh contributing to high mortality and morbidities among young children.&nbsp;Aims &amp; objectives: to assess prevalence of undernutrition and its co-relates among under 5 year children in Madhya Pradesh.&nbsp;Materials &amp; Methods: It was a community based cross- sectional study carried out in all the districts of Madhya Pradesh, India using systematic random sampling.&nbsp;Results:&nbsp;A total of 22,895 children (Boys:12379, Girls:10516), mean age 26.1 months, SD 15.9, were covered. The overall prevalence of underweight, stunting and wasting was about 52%, 49% and 26% respectively. The prevalence was significantly (p&lt;0.01) higher among boys as compared to girls. The risk of underweight, stunting and wasting was significantly higher among children belonging to SC+ST communities (OR: 1.36, 1.21 &amp; 1.23) as compared to others, among children of illiterate parents and landless labourers (OR: 1.27, 1.32 &amp; 1.15). The risk of stunting was significantly higher among children living in HHs without electricity (OR: 1.41) and HHs not using sanitary latrine (OR: 1.29). Similarly, the risk of wasting was significantly higher among households not having access to safe drinking water, mothers not cleaning their hands before feeding and among children with history of morbidity during preceding fortnight. Prevalence of underweight (28%), stunting (17%) and wasting (34%) was significantly (p&lt;0.01) lower among children who were exclusively breast fed up to 6 months.&nbsp;Conclusions:&nbsp;Multiple risk factors are associated with childhood undernutrition and needs multi-pronged and multi-sector approach to tackle the problem. The results will help planners to develop and implement appropriate intervention strategies, for effective control and prevention of undernutrition among under-five year children in Madhya Prades

Care practices during pregnancy, infant feeding practices and their association with nutritional status of infants in Gujarat, India

Background: Infant feeding practices plays an important role in nutritional status of children. Aims &amp; Objectives: To assess ante-natal care, delivery and infant feeding practices and their association with nutritional status. Material &amp; Methods: A community-based, cross-sectional study was carried out in all the districts using systematic random sampling. Information was collected from the selected household on socio-demographic, delivery and feeding practices and anthropometric measurements were carried out. Nutritional status was assessed using WHO Child Growth Standard. Proportion test, bivariate and multivariate regression analysis was done. Results: The overall prevalence of underweight, stunting and wasting was 26%, 21.5% and 16.5% respectively. Logistic regression analysis showed that the risk of underweight and stunting was 1.4-1.5 times higher among infant whose mother had undergone ≤3 ANCs or not availed ANCs, 1.4 times higher among infants delivered at home, having morbidity during previous fortnight and 3.6 times higher among low birth weight children. The risk of underweight and wasting was 1.2 times higher among infants with birth interval less than 2 years and 1.3-1.5 times higher among children whose mothers were washing their hands only with water after defecation. Conclusion: The undernutrition is associated with ante-natal care, delivery practices, low birth weight and hygienic practices