Where to deliver? Analysis of choice of delivery location from a national survey in India

<p>Abstract</p> <p>Background</p> <p>In order to reduce maternal mortality, the Indian government has increased its commitment to institutional deliveries. We assess the determinants of home, private and public sector utilization for a delivery in a Western state.</p> <p>Methods</p> <p>Cross sectional analyses of the National Family Health Survey – 2 dataset.</p> <p>Setting</p> <p>Maharashtra state. The dataset had a sample size of 5391 ever-married females between the ages of 15 to 49 years. Data were abstracted for the most recent birth (n = 1510) and these were used in the analyses. Conceptual framework was the Andersen Behavioral Model. Multinomial logistic regression analyses was conducted to assess the association of predisposing, enabling and need factors on use of home, public or private sector for delivery.</p> <p>Results</p> <p>A majority delivered at home (n = 559, 37%); with private and public facility deliveries accounting for 32% (n = 493) and 31% (n = 454) respectively. For the choice set of home delivery versus public facility, women with higher birth order and those living in rural areas had greater odds of delivering at home, while increasing maternal age, greater media exposure, and more then three antenatal visits were associated with greater odds of delivery in a public facility. Maternal and paternal education, scheduled caste/tribe status, and media exposure were statistically significant predictors of the choice of public versus private facility delivery.</p> <p>Conclusion</p> <p>As India's economy continues to grow, the private sector will continue to expand. Given the high household expenditures on health, the government needs to facilitate insurance schemes or provide grants to prevent impoverishment. It also needs to strengthen the public sector so that it can return to its mission of being the safety net.</p

Residual effects of natural Zn chelates on navy bean response, Zn leaching and soil status

greenhouse experiment was conducted on weakly acidic and calcareous soils to evaluate the aging and residual effects of three natural organic Zn chelates [Zn-ethylenediaminedisuccinate (Zn-EDDS), Zn-polyhydroxyphenylcarboxylate and Zn-aminelignosulfonate] each administered in a single application to a first navy bean (Phaseolus vulgaris L.) crop at several different Zn application rates. In a second navy bean crop, we determined the following parameters: the extent of Zn leaching, the amount of available Zn remaining in soils, the amount of easily leachable Zn, the size of Zn fractions in soils, the pH and redox potential, the dry matter yield, and the soluble and total Zn concentrations in plants. The residual effect after 2 years of Zn fertilization mainly depended on the aging effect of Zn chelates and losses due to Zn leaching. The data relating to the evolution from the first to the second crop showed that the aging effect was noticeable in the calcareous soil. In the latter soil, the Zn-S,S-EDDS treatments showed greater decreases in the Zn uptake by plants than the other Zn treatments and the greatest Zn uptake by plants occurred when Zn was applied as Zn-aminelignosulfonate (10 mg Zn kg−1 rate, 6.85 mg Zn per lysimeter; 5 mg Zn kg−1 rate, 3.36 mg Zn per lysimeter). In contrast, in the calcareous soil, the maximum amount of Zn uptake, for the three chelates was 0.82 mg Zn per lysimeter. Consequently, a further application of Zn would be needed to prevent Zn deficiencies in the plants of a subsequent crop. The behaviour of the pH and Eh parameters in the soils and leachates did not depend on the natural Zn sources applied. In this study, the easily leachable Zn estimated by BaCl2 extraction was not adequate to predict Zn leaching from the soils in subsequent crops