Categorical Frailty Phenotype and Continuous Frailty Index: A Conceptual Overview of Frailty and Its Components among Older Persons in India

  Background: Frailty indicator can be an important indicator of understanding ageing and health in India. It will be interesting to examine and compared different model of frailty using the same dataset. The present paper aimed to compare two frailty models and examine the association between socioeconomic status with frailty and frailty components among older persons in India.  Methods: The WHO Study on Global AGEing and Adult Health (SAGE) Wave 1, collected between 2007 and 2010 in India was used for this study. Two frailty model was constructed. Education and wealth quintile was used as socio economic indicators. Sensitivity and specificity were calculated for comparing both frailty models. Linear regression and logistic regression were used. The regression analysis was separately done for each age group and gender category. The coefficients were reported separately for education and wealth quintile categories.  Results: Low sensitivity was observed between the two frailty models. The results suggest that frailty index was more useful in depicting wealth and education inequality among different gender and age groups in India. Wealth and education differences in, number of morbidities, morbidity symptoms and Self rated health (SRH) were most consistently significant across age groups and gender categories. BMI and functional limitation were even found significant at p-value <0.01 for education and wealth quintile.  Conclusion: The results of the analysis suggest that frailty index covers more dimension than categorical phenotype categories, and can be used as an indicator to depict the healthy aging.&nbsp

Has Muslim Got Benefited from the National Health Mission? A Situational Analysis of Maternal Health Services in India

BACKGROUND: It is a marked recognition that when the population is disaggregated by religion, wide disparities in the utilization of maternal health care services can be observed. The study was aimed to analyze the levels and trends of maternal health services among Muslims in India. The study also delineated the investigation of confounding factors attributed to maternal health services among the selected population.METHODS: The study utilized the data from the third and fourth round of National Family Health Survey (NFHS), conducted in 2005-06 and 2015-16 respectively. The bivariate and multivariate logistic regression models were employed to accomplish the study objectives.RESULT: There is an increasing trend in the distributional patterns of all three indicators (full ANC, SBA and PNC) during the last two successive surveys. Muslim women belonging to Southern States were seen to be utilizing more maternal health care services as compared to Muslim women in the Northern States. Muslim populated States like Assam, Bihar, Jharkhand, Uttar Pradesh and West Bengal were far cry to achieve the MDG-15 target of utilization of 100 percent skilled birth attendants in 2015. Education, media exposure and wealth status appeared to be major confounding factors for determining the utilization of maternal health services.CONCLUSION: The study revealed that the utilizations of maternal health services among Muslims have progressed during the last decade. It can be concluded that the NHM policy has played an instrumental role in increasing the utilization of maternal health services among Muslims

Disparities in the contraceptive use among currently married women in Muslim densely populated States of India: An evidence from the nationally representative survey.

Background: The rationalizations for low use of contraception and high fertility among Muslims compared to other religious group in India are highly controversial. The study was aimed to explain to what extent differences in the use of contraception exist among the religious groups and also examine its associated factors in the Muslim populated States in the country. Methods: The third round of District Level Household and Facility Survey (DLHS-3) was used to accomplish our objectives. Bivariate analysis was used to show the religion wise distribution of limiting, spacing and traditional methods of contraceptive use in relation to socio-economic characteristics. The multivariate logistic regression was also employed to estimate the odds ratio (95% CI) for contraceptive use. SPSS 20.0 version and Arc GIS 10.0 software were employed to carry out the analyses. Results: The study found that the prevalence of limiting contraceptive use was comparatively much lower among Muslims (19.9%) than Non-Muslims (39.3%). In comparison to Non-Muslims, Muslims used 3.5 percentage points and 2.6 percentage points spacing and traditional methods of contraception respectively. The Muslims women from Assam (3.4%), Uttar Pradesh (4.4%) and Bihar (8.3%) reported low use of limiting contraceptive methods as compared to other Muslim populated States. The highest difference in the limiting method was observed in Bihar (21 percentage points) and followed by West Bengal (19 percentage points) between Muslim and Non-Muslim. The level of education and place of residence appeared as the main explaining factors of family planning in the study. Conclusion: The study concluded that the significant inequalities exist among Muslims and Non-Muslims concerning the current use of limiting methods. The policy design and programmes should make on rural, uneducated women to take into account the inequalities in the contraceptive use. &nbsp

The Risk of Hypertension and Other Chronic Diseases: Comparing Smokeless Tobacco with Smoking

BackgroundIn the past, studies have compared smokeless tobacco and non-tobacco users for the risk of various chronic diseases. The differences in the risk of chronic diseases between smokeless tobacco user and smokers have not been explored. The objective of this study is to estimate the risk of chronic diseases among smokeless tobacco users compared to smokers.MethodsThe data were used from the Study on Global Ageing and Adult Health (SAGE) Wave-1, conducted in 2007–2008 in India. The study sample is the respondents who reported consuming any form of tobacco in last 1 month. The total sample size was 4,038 respondents. The odds ratio of chronic morbidities was estimated taking smokers as the reference category.ResultsThe odds ratios for (self-reported) diabetes, asthma, and hypertension were not significant for smokeless tobacco user compared to smoked tobacco users. The odds ratio of chronic lung diseases (CLDs) was significantly lower among smokeless tobacco users compared to smoked tobacco users. The odds ratio of hypertension (measured) combined with low education and belonging to lowest wealth quintiles were not significant for smokeless tobacco users compared to smoked tobacco users. Duration of the use of smokeless tobacco and quantity of use was found to have no significant relation with risk of chronic diseases as compared to smoking.ConclusionThis study did not find the significantly higher risk of chronic morbidities except for CLD for smokeless tobacco users compared to smoked tobacco users. The study suggests that the use of any form of tobacco may have a similar risk of chronic diseases

Does mothers’ pregnancy intention affect their children’s preventive and curative care in India? Evidence from a longitudinal survey

Objective To assess the effect of unintended births on preventive and curative care of children and their nutritional status.Design The study uses a cross-sectional prospective design.Setting Indian Human Development Survey (IHDS) data of two rounds were used in this study. Women data file was used to draw a representative sample of 3905 children who belong to under 5 years of age group.Statistical analyses We categorised birth as an unintended birth if the mother did not want to have an additional child at IHDS-I but gave birth during the intersurvey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births. Multivariate logistic regression models were applied to analyse the effect of unintended births on child immunisation and exclusive breast feeding, while multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status.Results The study shows that by controlling other factors, children from unintended births were less likely to be exclusively breast fed (OR 0.885, 95% CI 0.792 to 0.990, p<0.05) and receive full immunisation (OR 0.830, 95% CI 0.739 to 0.931, p<0.001). Moreover, poor nutrition was more prevalent among children from unintended births as they were more likely to be stunted and underweight.Conclusions The study confirmed the adverse effects of unintended pregnancy on children’s preventive and curative care. The findings of the study underscore the importance of formulating policies on more affordable, accessible and available means of family planning to reduce the unintended births