Stunting and its determinants among adolescents in four schools of Bangalore city: Height for age- a vital metric for nutritional assessment

Background: National Family Health Surveys in India have not included nutritional status of the crucial age group of 10-14 years, when pubertal growth spurt typically occurs. BMI-for-age is commonly used to assess adolescent nutritional status which may misclassify stunted adolescents as normal or overweight. Objectives: To estimate prevalence and determinants of stunting among adolescents (10 to 19 years) in Bangalore city and to estimate the proportion of adolescents who are stunted, but otherwise assessed as normal or overweight using BMI-for-age. Methods: Cross sectional study conducted in four schools of Bangalore city using a self-administered questionnaire to capture socio-demographic details, dietary patterns and physical activity. WHO Anthroplus software was used to classify nutritional status based on height-for-age and BMI-for-age. Multiple logistic regression analysis was done to calculate adjusted odds ratios of independent co-variates associated with stunting. Results: Overall prevalence of stunting was 14% (95%CI:11.5-16.5%); 14.3% among females (95%CI:10.7-17.9%) and 13.6% among males (95%CI: 10.2-17.0%). Determinants of stunting were late adolescence [AOR=1.90(1.24-2.90),P=0.03], lower socio-economic class [AOR=2.75(1.39-5.41),P=0.03] and not taking weekly iron and folic acid supplements [AOR=2.78(1.48-5.21),P=0.001] Four of every five stunted children (81%) were classified as normal/ overweight/ obese using BMI-for-age. Conclusion: Stunting is a problem among urban adolescents in Bangalore. Height-for-age is a vital metric for assessing nutritional status of adolescents along with other metrics. We recommend strengthening of weekly iron and folic acid supplementation in schools and culturally specific targeted nutritional interventions for adolescents from economically weaker sections of society using a multi-sectoral and participatory approach

Assessing the burden of Covid-19 in the slums of Bangalore city: Results of Rapid Community Survey

Background: Karnataka, more so Bangalore, reported an increase in number of COVID-19 cases in early April 2021. Objective: To assess the burden of COVID-19 in the slums of Bengaluru city. Materials and Methods: A cross-sectional multi centre community-based study was done in the 2nd and 3rd week of April 2021 in 24 different slums in Bangalore city. WHO cluster random sampling technique was followed. Swabs for RTPCR test and 4 ml of venous blood was collected from 728 subjects more than 18 years of age. Results: A total of 51 (7%) subjects were positive for COVID-19 through RT-PCR. Majority 33 (56.9%) were in the age group of 18-44 years. 148 (20.3%) subjects were sero-positive on blood examination and 18-44 years was the (59.4%) preponderant age group. Overall seropositivity was 20.3% (95%CI; 17.4-23.2) and RT-PCR positivity is 7% (95%CI; 5.2-8.8%) among the subjects surveyed. In the inner core area of Bangalore, seropositivity was 24.2% (95%CI; 21.0 – 27.3) and RT-PCR positivity was 8% (95%CI; 6.1-9.9). Two doses of COVID-19 vaccine were taken only by 1.55% subjects during the study period. Conclusion: The study showed that one in 5 subjects were sero-positive to SARS-CoV-2 and one in 15 individuals had active COVID-19 infection

What motivates an ASHA? Narratives from Ramanagara district, Karnataka

Background: The National Rural Health Mission (NRHM) aimed to bridge the gap in rural health care with the introduction of the Accredited Social Health Activist (ASHA) in 2005. It is essential to identify the motivators and barriers to work performance by the ASHAs in order to facilitate better health care in the community. Objective: To identify the motivators and barriers to the work performance of ASHAs in the Solur PHC area, Ramanagara district, Karnataka. Material & Methods: A qualitative study was conducted in one PHC area of Ramanagara District, Karnataka. Four KIIs with government health functionaries and one FGD with nine ASHAs were conducted. A thematic frame-work approach was used for data analysis. Results: The main personal motivators were altruism and intrinsic satisfaction, while social support and team-work were important environmental motivators. De-motivating factors were financial problems such as insufficient pay and irregular financial incentives, as well as logistic difficulties, including transportation and safety. Conclusion: Personal, cultural, financial considerations and working conditions affect the performance of an ASHA. It is essential to address relevant issues faced by these health workers in order to improve their work satisfaction and efficiency