Factors Associated With Small Size at Birth in Nepal: Further Analysis of Nepal Demographic and Health Survey 2011

Background: The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children. Methods: Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.Results: A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams). The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males. Conclusion: One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal

Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal Demographic and Health Survey 2011

Background: Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the factors associated with utilisation of postnatal care services by mothers in Nepal based on the data from Nepal Demographic and Health Survey (NDHS) 2011. Methods: This study utilised the data from NDHS 2011. The association between utilisation of at least one postnatal care visit (within 6 weeks of delivery) and immediate postnatal care (within 24 hours of delivery) with selected factors was examined by using Chi-square test (?2), followed by multiple logistic regression.Result: Of the 4079 mothers, 43.2% reported attending postnatal care within the first six weeks of birth, while 40.9% reported attending immediate postnatal care. Mothers who were from urban areas, from rich families, who were educated, whose partners were educated, who delivered in a health facility, who had attended a four or more antenatal visits, and whose delivery was attended by a skilled attendant were more likely to report attending at least one postnatal care visit. On the other hand, mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to have attended at least one postnatal care visit. Similarly, mothers who were from the urban areas, from rich families, who were educated, whose partners were educated, who had attended four or more antenatal visits, who delivered in a health facility and had delivered in the presence of a skilled birth attendant were more likely to report attending immediate postnatal care. Mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to attend immediate postnatal care. Conclusion: The majority of postnatal mothers in Nepal did not seek postnatal care. Increasing utilisation of the recommended four or more antenatal visits, delivery at health facility and increasing awareness and access to services through community-based programs especially for the rural, poor, and less educated mothers may increase postnatal care attendance in Nepal

Global navigation satellite systems performance analysis and augmentation strategies in aviation

In an era of significant air traffic expansion characterized by a rising congestion of the radiofrequency spectrum and a widespread introduction of Unmanned Aircraft Systems (UAS), Global Navigation Satellite Systems (GNSS) are being exposed to a variety of threats including signal interferences, adverse propagation effects and challenging platform-satellite relative dynamics. Thus, there is a need to characterize GNSS signal degradations and assess the effects of interfering sources on the performance of avionics GNSS receivers and augmentation systems used for an increasing number of mission-essential and safety-critical aviation tasks (e.g., experimental flight testing, flight inspection/certification of ground-based radio navigation aids, wide area navigation and precision approach). GNSS signal deteriorations typically occur due to antenna obscuration caused by natural and man-made obstructions present in the environment (e.g., elevated terrain and tall buildings when flying at low altitude) or by the aircraft itself during manoeuvring (e.g., aircraft wings and empennage masking the on-board GNSS antenna), ionospheric scintillation, Doppler shift, multipath, jamming and spurious satellite transmissions. Anyone of these phenomena can result in partial to total loss of tracking and possible tracking errors, depending on the severity of the effect and the receiver characteristics. After designing GNSS performance threats, the various augmentation strategies adopted in the Communication, Navigation, Surveillance/Air Traffic Management and Avionics (CNS + A) context are addressed in detail. GNSS augmentation can take many forms but all strategies share the same fundamental principle of providing supplementary information whose objective is improving the performance and/or trustworthiness of the system. Hence it is of paramount importance to consider the synergies offered by different augmentation strategies including Space Based Augmentation System (SBAS), Ground Based Augmentation System (GBAS), Aircraft Based Augmentation System (ABAS) and Receiver Autonomous Integrity Monitoring (RAIM). Furthermore, by employing multi-GNSS constellations and multi-sensor data fusion techniques, improvements in availability and continuity can be obtained. SBAS is designed to improve GNSS system integrity and accuracy for aircraft navigation and landing, while an alternative approach to GNSS augmentation is to transmit integrity and differential correction messages from ground-based augmentation systems (GBAS). In addition to existing space and ground based augmentation systems, GNSS augmentation may take the form of additional information being provided by other on-board avionics systems, such as in ABAS. As these on-board systems normally operate via separate principles than GNSS, they are not subject to the same sources of error or interference. Using suitable data link and data processing technologies on the ground, a certified ABAS capability could be a core element of a future GNSS Space-Ground-Aircraft Augmentation Network (SGAAN). Although current augmentation systems can provide significant improvement of GNSS navigation performance, a properly designed and flight-certified SGAAN could play a key role in trusted autonomous system and cyber-physical system applications such as UAS Sense-and-Avoid (SAA)