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Islamabad, Pakistan, National Institute of Population Studies, 2019 Jan. 573 p.The 2017-18 Pakistan Demographic and Health Survey (PDHS) was implemented by the National Institute of Population Studies (NIPS) under the aegis of the Ministry of National Health Services, Regulations and Coordination. This PDHS is the fourth to be conducted in Pakistan and follows surveys in 1990-91, 2006-07, and 2012-13. Data collection took place from 22 November 2017 to 30 April 2018. ICF provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide. Support for the survey was also provided by the Department for International Development (DFID) of the United Nations Population Fund (UNFPA). According to the Population Census of 2017, the total population of Pakistan is 207 million with a growth rate of 2.4% (Government of Pakistan 2017). The size of the population and the growth rate present serious challenges to governmental efforts to prevent food insecurity, water scarcity, rapid urbanisation, inadequate housing, and loss of economic opportunities. Such challenges necessitate regular assessment of their demographic impact through collection of reliable data in surveys such as the PDHS. The primary objective of the 2017-18 PDHS is to provide up-to-date estimates of basic demographic and health indicators. The PDHS provides a comprehensive overview of population, maternal, and child health issues in Pakistan. Specifically, the 2017-18 PDHS collected information on: Key demographic indicators, particularly fertility and under-5 mortality rates, at the national level, for urban and rural areas, and within the country’s eight regions; Direct and indirect factors that determine levels and trends of fertility and child mortality; Contraceptive knowledge and practice; Maternal health and care including antenatal, perinatal, and postnatal care; Child feeding practices, including breastfeeding, and anthropometric measures to assess the nutritional status of children under age 5 and women age 15-49; Key aspects of family health, including vaccination coverage and prevalence of diseases among infants and children under age 5; Knowledge and attitudes of women and men about sexually transmitted infections (STIs), including HIV/AIDS, and potential exposure to risk; Women's empowerment and its relationship to reproductive health and family planning; Disability level; Extent of gender-based violence; Migration patterns. The information collected through the 2017-18 PDHS is intended to assist policymakers and program managers at the federal and provincial government levels, in the private sector, and at international organisations in evaluating and designing programs and strategies for improving the health of the country’s population. The data also provides information on indicators relevant to the Sustainable Development Goals.
Population Review. 2016; 55(2):25-44.Level of religiosity is an indicator of the degree of involvement of people in religious beliefs/activities and a measure of attitudes to sexual-related activities, such as casual sex or using condoms to avert unplanned pregnancy or sexually transmitted infections. This paper uses nationally representative cross-sectional data collected in 2011/2012 to examine the relationship between religiosity and the likelihood of engaging in casual sex and condom use in Ghana. A sample of 4,168 males and females was used to assess sexual activities and condom use with casual sexual partner using binary logistic regression analysis. The study was based on the Reference Group Theory which suggests that religious teachings often dictate the sexual behaviors/attitudes of individuals and was informed by the fact that most conventional religions discourage pre-marital sex and adultery. The study examined how religiosity expressed by individuals impacts casual sex, which is considered a form of adultery. An attempt was made to discover if religiosity impacts condom use as a form of protection against HIV and other sexually transmitted infections and unplanned pregnancy. The results indicate that persons who attend religious meetings more than once a week are less likely to have a casual sexual partner compared to others who attend occasionally or less frequently. No differences between groups with lower level of religiosity are apparent. The level of religiosity did not affect condom use among those who have sex, when other variables are controlled for. Differences in age, sex, level of education, rural/urban residency and marital status are statistically related to condom use with a casual sex partner. The paper concludes that condom use with a casual sex partner may not largely depend on how religious or otherwise one may be, but rather on the individual’s risk perception based on a person’s socioeconomic status, particularly with respect to a person’s level of education.
Low-Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit.
Perspectives On Sexual and Reproductive Health. 2018 Dec 3;CONTEXT: Early access to contraception may increase postpartum contraceptive use. However, little is known about women's experiences receiving their desired method at the first postpartum visit or how access is associated with use. METHODS: In a 2014-2016 prospective cohort study of low-income Texas women, data were collected from 685 individuals who desired a reversible contraceptive and discussed contraception with a provider at their first postpartum visit, usually within six weeks of birth. Women's experiences were captured using open- and closed-ended survey questions. Thematic and multivariate logistic regression analyses were employed to examine contraceptive access and barriers, and method use at three months postpartum. RESULTS: Twenty-three percent of women received their desired method at the first postpartum visit; 11% a prescription for their desired pill, patch or ring; 8% a method (or prescription) other than that desired; and 58% no method. Among women who did not receive their desired method, 44% reported clinic-level barriers (e.g., method unavailability or no same-day provision), 26% provider-level barriers (e.g., inaccurate contraceptive counseling) and 23% cost barriers. Women who used private practices were more likely than those who used public clinics to report availability and cost barriers (odds ratios, 6.4 and 2.7, respectively). Forty-one percent of women who did not receive their desired method, compared with 86% of those who did, were using that method at three months postpartum. CONCLUSION: Eliminating the various barriers that postpartum women face may improve their access to contraceptives. Further research is needed to improve the understanding of clinic- and provider-level barriers. Copyright (c) 2018 by the Guttmacher Institute.
Culture, Health and Sexuality. 2018 Oct; 20(10):1087–1101.Data from a six-year study of married women’s sexual health in a low-income community in Mumbai indicated that almost half the sample of 1125 women reported that they had a negative view of sex with their husbands. Qualitative interviews and quantitative survey data identified several factors that contributed to this diminished interest including: a lack of foreplay, forced sex, the difficulty of achieving privacy in crowded dwellings, poor marital relationships and communication, a lack of facilities for post-sex ablution and a strong desire to avoid conception. Women’s coping strategies to avoid husband’s demands for sex included refusal based on poor health, the presence of family members in the home and non-verbal communication. Factors that contributed to a satisfactory or pleasurable sexual relationship included greater relational equity, willingness on the part of the husband to not have sex if it is not wanted, a more ‘loving’ (pyaar karna) approach, women able to initiate sex and greater communication about sexual and non-sexual issues. This paper examines the ecological, cultural, couple and individual dynamics of intimacy and sexual satisfaction as a basis for the development of effective interventions for risk reduction among married women.
Mediating risk through young women’s marital arrangements and intimate relationships in low-income communities in urban India.
Culture, Health and Sexuality. 2018 Oct; 20(10):1055-1070.This paper draws on ethnographic data collected from two lowincome communities in Mumbai India to explore types of risk and intimacy associated with marital practices. A rapidly globalising India offers access to media, social networks and changing gender norms that create opportunities for young women. Concurrently, enduring patriarchal norms impact marriage and the development of intimacy. Young women whose parents decide on early arranged marriages face inequity and difficulties in establishing emotional and physical intimacy with their husbands. Some young women and their families delay an arranged marriage to ensure educational and/or career advancement, seeking a husband and family that will appreciate her independence. Young women in delayed arranged marriages are more prepared for marital relationships but may experience difficulties meeting family and career expectations and establishing intimacy. Young women who develop their own relationships that evolve into ‘love’ marriages can initially achieve high levels of intimacy, but the strains stemming from the loss of family support can later undermine the spousal relationship. Within and across these different marital types, there is also a great deal of fluidity and variation in young women’s experiences as they adapt to globalised and patriarchal norms in urban India.
Nutritional status of the pre-school children in UHTC area of Santhiram Medical College, Nandyal, Kurnool district.
International Journal of Community Medicine and Public Health. 2018 Apr; 5(4):1591-1595.Background: Malnutrition is one of the major problems in the world which suffers middle income countries in the world, malnutrition is mainly of two types over weight and underweight, the present topic is concerned to the underweight of the children among the age group between 3 yrs to 6 yrs. The aims and objectives of the study were to assess the nutritional status of children among 3-6 yrs in UHTC area of SRMC Nandyal and to identify the influence of education, occupation, and socio economic status on the nutritional status of preschool children. Methods: Community based on cross sectional study. Sampling method used is 4pq/l2. Sample size was 210. Results: Total numbers of participants in the study are 210 members. 58% are males and 42.4% are females. Among the participants 42.4% fathers and 53.8% mothers are illiterates who occupy the majority. In occupation majority of the fathers and mothers are working as unskilled labour i.e. 61.4% and 53.3%. Among the participants majority of them belong to class IV i.e. 48.6%. When we see the grading of malnutrition 51% of them are moderately malnourished. Significance difference has been observed among the educational status of the mother and the nutritional status of the baby. Conclusions: In the present study most the children malnourished are boys. Education of mother played major role in degree of malnutrition higher the educational status lowers the malnutrition.
A study to assess the effectiveness of short training session on immunization knowledge of mothers attending immunization clinic.
International Journal of Community Medicine and Public Health. 2018 May; 5(5):2144-2150.Background: Parents knowledge about immunization is India’s primary tool against the menace of child not immunized completely. The parents especially mothers should have basic knowledge of immunization in under five children. Methods: The study evaluates knowledge and behaviour of mothers regarding the immunization of 250 infants who attended Immunization clinic of Madhav dispensary J.A. Hospital, Gwalior Madhya Pradesh by simple random sampling method under the PSBH project completed by MBBS Final Part I students. Results: Brief structured interview with transient training and structured questionnaire techniques were used to collect responses from the mothers. In total 59.32% mothers were aware about the immunization aspects and only 45.8% were about the mandatory vaccines had been rendering adequate knowledge and they were not much reflective of the same when being questioned on the knowledge parameter. The study revealed that out of 250 mothers, 40% were in the age group of 21-25 years. After immunization based brief transient training given to mothers, their knowledge about immunization aspects and individual vaccines under five children was significantly improved from pre test assessment mean score 118.1±59.3 to post test assessment 224.1±89.6 respectively. Conclusions: There are several loopholes in the mother’s knowledge regarding immunization. Many of them had no knowledge about compulsory vaccines. Despite inadequate knowledge and attitude of mothers towards infant immunization, the majority of mothers had good change (42.4%) and 32.3% due to seeking of information about practice of infant immunization and individual vaccine. From this point of view, it is possible to conclude that mothers’ immunization practice was not really based on their knowledge and attitude regarding immunization of infants. Maternal education and socio economic status were significantly associated with good knowledge.
International Journal of Community Medicine and Public Health. 2018 May; 5(5):1968-1973.Background: Unmet need represents the gap between women’s reproductive intentions and their contraceptive behavior. Meeting the unmet need for family planning would help to reduce the mortality and morbidity from unwanted pregnancies. Objectives of the study were to assess the unmet need for family planning and its determinants among married rural women. Methods: The present study was community based cross-sectional study conducted in rural area of Haryana from September 2015 to August 2016 among 500 currently married women (18-49 years). Results: The unmet need for family planning was 19.2% (4.8% spacing and 14.4% limiting). Education, occupation and desirable number of children were significantly associated with unmet need for family planning. The commonest reason for not using contraception among those with unmet need was fear of side-effects (37.5%) followed by in-laws disapproval (21.9%) and others. Conclusions: The unmet need for family planning was high. Women’s education and empowerment by protecting their health, wellbeing and rights, including their reproductive rights would prove to be beneficial.
Socio-demographic determinants of morbidities in infancy: a cross sectional study in urban field practice area of MRMC, Kalaburagi.
International Journal of Community Medicine and Public Health. 2018 May; 5(5):1859-1862.Background: The first few years of life is the most crucial period of life as this age is known for accelerated growth and development. Various studies in India have shown that respiratory and gastrointestinal tract infections are the leading cause of morbidity in infants. These infectious diseases are affected by several sociodemographic factors such as birth weight, gestational age, birth order, immunization status, day care attendance and socio-economic status of the family. Methods: A cross sectional study was conducted in the urban field practice area of department of community medicine MRMC, Kalaburagi from June 2016-October 2016. House to house survey using pre-structured and pretested questionnaire method was done. Results: Out of 104 infants in the present study it was found that majority 53% were females and 49% were males. Majority 61.5% of the infants belonged to low socioeconomic class and majority 54.8% of them were from nuclear families, most 62.5% of the infants had 1-2 siblings in the family and 34.6% had no siblings, 51% of the mothers were illiterate and majority 54.8% of the fathers were literate. Among all the morbidities majority 36.50% had fever. No significant association was found between various social factors. Conclusions: Though no significant association was found between morbidity and socio-demographic factors, but the socio demographic factors which showed more prevalence of morbidity among infants were females, number of siblings in the family and lower socio economic class. As these infants are the future citizens of the country hence their health should be the utmost priority for us and their health needs should be properly addressed.
International Journal of Community Medicine and Public Health. 2018 May; 5(5):1797-1802.Background: World Health Organization has defined low birth weight (LBW) as birth weight less than 2,500 grams. Giving birth to a LBW infant is influenced by several factors. Objective of the study was to measure the proportion of low birth weight babies delivered in V.S.S medical college and hospital, Burla and its association with socio-demographic factors. Methods: Hospital based cross -sectional study comprising of 1030 postnatal women who delivered single live baby in V.S.S Medical College and Hospital, Burla. Selection of study participants was done by systematic random sampling in the study period October 2012 to September 2014. Chi-square test was used to measure association between LBW and socio-demographic factors. Results: The proportion of LBW was found to be 27.76%. The proportion of LBW babies was high and significant in extremes of age i.e. teenage (44.19%) and 30 years and above age group (39.56%) and Muslim mothers (36.36%), illiterate mothers (53.52 %), manual labourer (67.14%), socioeconomic class IV and V (32.98%), consanguinity history (60.58%), smoky fuel (30.02%), consumption of tobacco (49.11%). Conclusions: The proportion of LBW (27.76%) was found to be higher than national average (21.5%).
International Journal of Community Medicine and Public Health. 2018 Dec; 5(12):5077-5081.Background: Breast milk is the best, safest and most nutritious food for infants. Though breast feeding is almost universal, there are yet some myths and false beliefs surrounding the practice due to various cultures and traditions in India. In the present study an attempt was made to understand various aspects of infant feeding practices among the Sugali tribes of Khammam district, Telangana state. Methods: A cross sectional study was conducted among Sugali community in Khammam mandal of Khammam district in Telangana from March to June 2010. In which 314 families with pre-school children were interviewed using a pre-designed semi-structured questionnaire. Results: Nearly 80% (251) of the mothers had said that they initiate breast feeding after one hour of delivery, while only 6% initiated breastfeeding within one hour delivery. About 54% of the mothers were giving colostrum to their newborns, while others (45.86%) were giving pre-lacteal feeding to the infants including jaggery water and honey. It was observed that most (71.65%) of the mothers were continuing to breastfeed their children more than 18 months. Only 11.78% of the mothers started weaning before 6 months of age. Socio-economic status, literacy rate and working status of the mothers were some of the influencing factors. Conclusions: The study identified the practices of infant feeding, their determinants among the sugali tribes and recommendations to improve their practices. False beliefs and difficulties regarding breast feeding need to be addressed through heath education and family support.
International Journal of Community Medicine and Public Health. 2018 Jun; 5(6):2580-2584.Background: Worm infestation is a major problem in children from developing countries due to poor sanitary and hygienic conditions. As the worm infestation is highly associated with the anaemia in children and generalized malnutrition as well as micronutrient malnutrition it is important to assess the deworming practice among mothers of under five children. Thus this study was aimed to assess the deworming practice to their children among mothers of under five children in Kancheepuram district and to find out the association between education level of the mothers and deworming practice, residence (rural/urban) of the mothers and deworming practice. Methods: A cross- sectional study was conducted among 208 mothers of under five children in the field practice area urban and rural health centre of Sree Balaji Medical College for duration of four month using a pretested questionnaire. Results: Among 208 mothers 105 (50.5%) is from rural and 103 (49.5%) is from urban. Among them 40 (19.2%) were illiterate and 168 (80.8%) were literate. About deworming practice 40 (19.2%) mothers have never done deworming to their children, 32 (15.4%) mothers have done deworming to their children only after the worm infestation symptoms appears and 136 (65.4%) mothers have done deworming to their children regularly. Education level of the mothers (p=0.000) and the residence (rural/urban) of the mothers (p=0.000) are significantly related to the deworming practice. Conclusions: Deworming practice among rural mothers and illiterate mothers is low. Hence awareness should be created among them about the deworming practice in preventing the complication caused by the worm infestation and should promote the habit of regular deworming to their children.
Maternal and Child Nutrition. 2018 Nov 9; 16 p.Childhood malnutrition remains endemic in South Asia, although the burden varies by country. We examined the anthropometric status and risk factors for malnutrition among children aged 0-59 months through the 2015 National Nutrition Survey in Bhutan. We assessed in 1,506 children nutritional status (by z-scores of height-for-age [HAZ], weight-for-height [WHZ], and weight-for-age [WAZ]), estimating prevalence, adjusted for survey design, of stunting, wasting, underweight, and overweight (<-2 for HAZ, WHZ, and WAZ and >2 for WHZ). Children were also assessed for pedal oedema. We conducted multivariable linear/logistic regression analysis to identify child, maternal, and household risk factors for childhood undernutrition and overweight, excluding children with oedema (1.7%). Mean (SE) HAZ, WHZ, and WAZ were -0.82 (0.13), 0.10 (0.04), and -0.42 (0.05), respectively. Prevalence of stunting, wasting, underweight, and overweight were 21.2%, 2.6%, 7.4%, and 2.6%, respectively. In multivariable regressions, risk of stunting significantly increased by age: 5.3% at <6 months (reference), 16.8% at 6-23 months (OR = 3.06, 95% CI [0.63, 14.8]), and 25.0% at 24-59 months (OR = 5.07, [1.16, 22.2]). Risk of stunting also decreased in a dose–response manner with improved maternal education. None of the examined variables were significantly associated with wasting or overweight. Despite a WHZ distribution comparable with the World Health Organization reference (with ~2.6% vs. an expected 2.5% of children beyond 2 z in each tail), stunting persists in one fifth of preschool Bhutanese children, suggesting that other nutrient deficits or nonnutritional factors may be constraining linear growth for a substantial proportion of children.
The perceptions, health-seeking behaviours and access of Scheduled Caste women to maternal health services in Bihar, India.
Reproductive Health Matters. 2018 Nov 7; 1-12.The caste system is a complex social stratification system which has been abolished, but remains deeply ingrained in India. Scheduled Caste (SC) women are one of the historically deprived groups, as reflected in poor maternal health outcomes and low utilisation of maternal healthcare services. Key government schemes introduced in 2005 mean healthcare-associated costs should now be far less of a deterrent. This paper examines the factors contributing to this low use of maternal health services by investigating the perceptions, health-seeking behaviours and access of SC women to maternal healthcare services in Bihar, India. Eighteen in-depth, semi-structured interviews were conducted with SC women in Bihar. Data were analysed using Framework Analysis and presented using the AAAQ Toolbox. Main facilitating factors included the introduction of accredited social health activists (ASHAs), free maternal health services, the Janani Shishu Suraksha Karyakram (JSSK), and changes in the cultural acceptability of institutional delivery. Main barriers included inadequate ASHA coverage, poor information access, transport costs and unauthorised charges to SC women from healthcare staff. SC women in Bihar may be inequitably served by maternal health services, and in some cases may face specific discrimination. Recommendations to improve SC service utilisation include research into the improvement of postnatal care, reducing unauthorised payments to healthcare staff and improvements to the ASHA programme.
BMC Women's Health. 2018 Oct 29; 18(1):178.BACKGROUND: Evidence suggests that gender equality positively influences family planning. However, the evidence from urban Africa is sparse. This study aimed to examine the association between changes in gender norms and modern contraceptive use over time among women in urban Nigeria. METHODS: Data were collected in 2010/2011 from 16,118 women aged 15-49 living in six cities in Nigeria (Abuja, Benin, Ibadan, Ilorin, Kaduna, and Zaria) and again in 2014 from 10,672 of the same women (34% attrition rate). The analytical sample included 9933 women living in 480 neighborhoods. A four-category outcome variable measured their change in modern contraceptive use within the study period. The exposure variables measured the changes in the level of gender-equitable attitudes towards: a) wife beating; b) household decision-making; c) couples' family planning decisions; and d) family planning self-efficacy. Multilevel multinomial logistic regression models estimated the associations between the exposure variables at the individual and neighborhood levels and modern contraceptive use controlling for the women's age, education, marital status, religion, parity, household wealth, and city of residence. RESULTS: The proportion of women who reported current use of modern contraceptive methods increased from 21 to 32% during the four-year study period. At both surveys, 58% of the women did not report using modern contraceptives while 11% reported using modern contraceptives; 21% did not use in 2010/2011 but started using by 2014 while 10% used in 2010/2011 but discontinued use by 2014. A positive change in the gender-equitable attitudes towards household decision-making, couples' family planning decisions, and family planning self-efficacy at the individual and neighborhood levels were associated with increased relative probability of modern contraceptive use (adoption and continued use) and decreased relative probability of modern contraceptive discontinuation by 2014. No such associations were found between the individual and neighborhood attitudes towards wife beating and modern contraceptive use. Accounting for the individual and neighborhood gender-equitable attitudes and controlling for the women's demographic characteristics accounted for 55-61% of the variation between neighborhoods in the change in modern contraceptive use during the study period. CONCLUSION: Interventions that promote gender equality have the potential to increase modern contraceptive use in Nigerian cities.
Factors influencing perception and knowledge of exclusive breast feeding practices among nursing mothers in rural area of Thane district of Mumbai.
International Journal of Community Medicine and Public Health. 2018 Jun; 5(6):2486-2490.Background: Exclusive breastfeeding (EBF) is recommended as the best feeding alternative for infants up to six months and has a protective effect against mortality and morbidity. Exclusive breastfeeding (EBF) is one of the optimal infant and young child feeding practices. Globally, <40% of infants under 6 months of age are exclusively breastfed. According to NFHS4 data (2015-16) the prevalence of EBF in the rural area of Maharashtra was 60.6% which was far less than the 100% recommended by the United Nation Children Emergency Fund. Study was conducted to find the mothers knowledge and perception on breast feeding practices and other factors which influences breast feeding practices in the study area. Methods: A cross sectional descriptive study was employed. From the population of 8000, by applying convenient sampling technique, 152 mothers attending the primary health centre with children less than 2 years of age were enrolled after taking informed consent. Results: The prevalence of exclusive breast feeding was 63.15%. There was a significant association between socio-demographic characteristics of mothers such as occupation (p<0.05), type of family (p<0.05) and the practice of exclusive breastfeeding. Conclusions: As it was found that exclusive breast feeding was practiced well by mothers who were housewives which shows that employment was the major obstacles for breast feeding.
Knowledge of obstetric danger signs among pregnant women attending antenatal clinic at rural health training centre of a medical college in Hyderabad.
International Journal of Community Medicine and Public Health. 2018 Jun; 5(6):2471-2475.Background: One of the major causes for the death of women is due to maternal mortality. Around 529,000 women die annually from maternal causes (World Health Organization (WHO) estimate) Majority of these deaths occur in the less developed countries. An Indian woman dies from complication related to pregnancy and child birth for every 7 minutes. For every woman who dies =30 more women suffer injuries, infection and disability. In Sub-Saharan Africa, where one of every 16 women dies of pregnancy related causes during her lifetime, compared with only 1 in 2,800 women in developed regions. Raising awareness of women about obstetric danger signs would improve early detection of problems and helps in seeking timely obstetric care. Methods: A cross sectional study was conducted among pregnant women who attended antenatal clinics between May 2014–August 2014 at field practice areas of RHTC, KAMSRC. A total 274 pregnant women had given consent and participated in the study. Data was collected by interview in local language and a predesigned and pretested questionnaire was used which include socio demographic profile, parity, ANC visits, gravid, knowledge regarding danger signs during pregnancy, post-partum period. Socio-economic status was assessed according to Modified Kuppuswamy’s classification (as per June 2015 CPI). Results: About 35.7%, pregnant women have good awareness 21.2%, average and 43% have poor knowledge about danger signs of pregnancy. Pregnant women in the age group of >30 years, educational status and occupational status of pregnant women and their husbands and pregnant mothers who had regular antenatal check-ups had significant associations with the awareness of obstetric danger. Conclusions: Our study concludes that there is need of creating awareness and increasing the knowledge of women about obstetric danger signs.
International Journal of Community Medicine and Public Health. 2018 Jun; 5(6):2277-2285.Background: LBW is a significant public health problem globally. In India every 3rd newborn is a LBW contributing to about 40% of the global burden. The objective of the study was to determine the prevalence of LBW and premature births and their associated maternal factors. Methods: A cross sectional study was done in antenatal women attending Rama Medical College Hospital& Research Centre, Hapur. Maternal factors and socioeconomic factors collected from 406 mothers were coded and analyzed using the SPSS 16. Chi square test was applied and p value less than 0.5 was considered as statistically significant. Results: Prevalence of LBW was 31.8% and prematurity was 25.6% in the study. LBW and premature babies were more associated with joint families, =Rs. 2999/- monthly income, maternal illiteracy and house wives. LBW and Premature babies decreased with increase in income, Hb >11.1 gms and = 100 IFA tablets intake. The rates of LBW were the same whether mothers had no ANC or full ANC. This raises doubts about the content of the ANC. Conclusions: A good quality dedicated and sincere comprehensive ANC package including 4 ANCs, 100 IFA, 2TT/Booster, simple serial measurement of BP, weight, haemoglobin, fundal height and abdominal girth during each visit and screening for complications, counselling for birth and emergency preparedness, newborn care, breast feeding would help avert LBW and premature birth.
Socio-economic determinants of reproductive tract infections affecting the women (15-49 years): a cross sectional study in a tertiary care hospital of Chhattisgarh.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3130-3135.Background: RTIs/STIs are a common public health problem in developing countries, contributing to a huge economic burden among individuals and health systems. RTI's excluding HIV constitutes the second major cause of disease burden (after maternity related causes) in women of developing countries. This cross sectional study is carried out with objectives of, to study socio-economic profile of respondents and to determine socio-economic factors of RTI, affecting the women of reproductive age group attending CIMS, Hospital Bilaspur (C.G.). Methods: A descriptive cross sectional study conducted in a tertiary care hospital CIMS, Bilaspur (Chhattisgarh) from May 2015 to October 2016. Total 450 cases were studied. Predesigned and pretested questionnaire was used to collect information regarding the socio-demographic profile and clinical profile of women’s regarding RTI. Statistical analysis was done using SPSS and Chi-square test was applied. Results: 4.3% (450) patient attending Obstetrics and Gynecology OPD were found to be suffering from RTI. Out of the 450 women, 83.8% of the women had experienced at least one symptom suggestive of RTI previously. Abnormal vaginal discharge was reported by 88.9% followed by lower abdominal pain (78.9%), genital ulcer (34%) and menstrual irregularity 75.8% of women. Symptoms of RTI were higher in old age, illiterate, those with employed, rural residential, Schedule tribe category, poor socio-economic status, separated, divorce and widow and women their husband educated up to primary class. Conclusions: Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.
Awareness about mother and child health services among tribal women of reproductive age group in Kurnool division of Kurnool district, Andhra Pradesh.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3111-3115.Background: Maternal and neonatal mortality and morbidity continue to be high in tribal areas despite the existence of various national programmes in India especially due to lack of awareness about MCH services among tribal women. This study was planned with the aim of assessing the knowledge of married tribal women of reproductive age group about MCH services. Methods: This community based longitudinal study was carried out in January to June 2014 in Bairluti, tribal area at Kurnool district in Andhra Pradesh. 168 married women of reproductive age group were selected by simple random sampling. All the participants were interviewed using a predesigned pretested semi structured questionnaire. Results: Awareness about vitamin A supplementation, family planning temporary methods, birth waiting homes, JSY, 108 services was observed to be poor among participants. Awareness about postnatal services, institutional delivery, family planning permanent methods was found to be inadequate. Whereas more than 50% of the study subjects had knowledge regarding antenatal services, home delivery by trained person, complete immunization and feeding practices. Health workers and family members were the major source of information. Literacy status had statistically significant association with knowledge about MCH services. Statistically significant improvement in awareness is observed after educational intervention. Conclusions: Knowledge of tribal women about MCH services was observed to be inadequate. Maternal literacy plays a key role in better utilization of MCH services. IEC activities with health education sessions will help to increase awareness.
Prevalence and correlates of domestic violence in a resettlement colony of union territory of Chandigarh, India.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3079-3083.Background: Domestic violence is not just a problem of the lower and middle classes. Domestic violence is a pervasive problem in India that cuts across age, education, social class and religion. Present study was done with the objectives to study the prevalence of domestic violence issue; to measure different types of domestic violence (i.e. physical, sexual and emotional) ; and to assess the correlation of different socioeconomic factors with occurrence of domestic violence in rural field practice area of Government Medical College and Hospital, Chandigarh. Methods: A cross sectional study was conducted in rural field practice area amongst 800 women of reproductive age group by interview technique after obtaining an informed consent from. The questionnaire was based upon National Family Health Survey-3 questionnaire. The data was fed in Microsoft Excel and analyzed using Epi Info statistical software. Results: The prevalence of any type of domestic violence was 17.75%. Most common type of violence was humiliation, followed by physical violence in the form of slap (14.5%), twist, push, punch and kick. More severe forms like burns, dislocation, cuts were low (1.75%). The prevalence of sexual violence was found to be 1%. Domestic violence was associated with illiteracy in women (p=0.001), low income of women (p<0.001), reserved category of family (p<0.001), alcohol consumption in husband (p<0.001), low income or unemployed husband (p<0.001). No association of domestic violence was found with unemployment in women and illiteracy in husband. Conclusions: It needs more education, empowerment and sensitization in both men and women to change the patriarchal nature of Indian society and to break the culture of silence and tolerance against such heinous crime of inhumanity.
Perceptions and practices about menstrual hygiene among women of reproductive age group (15-49 years) attending out-patient department of CIMS, Bilaspur Chhattisgarh.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3074-3078.Background: Women suffer due to their ignorance on hygienic requirement during menstruation. Hygiene related practices of women during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to RTI. In this paper our objectives is to detect the menstrual health problems and to assess menstrual hygiene practices among women of reproductive age group (15-49 years) attending OPD of CIMS Bilaspur Chhattisgarh (Obstretic and Gynaecology, OPD). Methods: Females of reproductive age group (15-45 years) attending routine obstretics and gynaecology OPD during 1st May to 15th September 2015 were included in the study after taking their verbal consent at CIMS hospital. Pretested semi-structured questionnaire were used to take history regarding knowledge and practices related to menstrual hygiene. Statistical test like chi-square test were applied using Epi info 7 software. Results: 36% of study population belonged to the 21-30 year age group. About 75% were married. Majority of women had primary education (43.3%) and 54.3% belonged to lower middle class. Majority of women 51.8% used cloth during menstruation; about 45.7% used the same cloth by washing and reusing every month. Conclusions: Most women were found to follow unhygienic practices. Hence, efforts such as improving female literacy and health education regarding the various risk factors should be made by the policy makers to increase menstrual hygiene among rural population. Literacy status was found to be significant for awareness about menstruation and the use of sanitary pads.
Predictors of low birth weight babies born in tribal tertiary health care setting: a cross sectional study.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):3049-3055.Background: A baby s weight at birth is a strong indicator of maternal and newborn health and nutrition. Strategies to reduce prevalence of LBW are important in order to achieve the third Sustainable Development Goals (SDG 3)-reduce child mortality. With this background the present study was undertaken to estimate proportion of LBW babies born at tribal tertiary health care institution and to find out predictors of the LBW among babies. Methods: The present cross sectional study was undertaken at tertiary health care setting. We restricted analyses to singleton live births, and following an initial descriptive summary of the deliveries, logistic regression analysis was conducted to investigate the association of various factors. Results: Our results show proportion of LBW was 17.84% in babies born at tribal tertiary health care setting. There is no significant difference of LBW in different socio-demographics of the mother. However; significant difference was observed in tribal and non-tribal women and women with low literacy lever; wherein significant predictors were related to utilization of antenatal care (ANC), ICDS services, etc. Statistical significance was ascertained based on a p<0.05. Conclusions: In this study; significant predictors were low maternal education, <4 ANC visits, inadequate consumption iron and folic acid, low hemoglobin percent level, and no additional diet at ICDS during current pregnancy. It has also provided basic information pertinent to quality of ANC care and it influence on LBW. Findings of this study are useful for maternal and child health policy makers, practitioners and those who provide health care during pregnancy
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):2959-2967.Background: An exclusive breastfeeding for 6 months and an extended breastfeeding for 24 months protects the infant from infectious disease and promotes child spacing. Therefore, the knowledge, attitude and practice about infant and child feeding is important to overcome morbid conditions prevailing among mothers and her child. The present study aimed at investigating the factors influencing an exclusive breastfeeding among currently married tribal women in Jharkhand, India. Methods: A cross sectional study was conducted among the 919 currently married Santal, Oraon, Mahli and Ho women in the age group of 15-29 years from forty villages of Purbi Singhbhum district of Jharkhand using interview schedule method. Results: The mean duration of exclusive breastfeeding and breastfeeding up to 24 months was found to be 4.1 and 12.9 months respectively. Also, not much difference in the average duration of exclusive breast feeding was found between working and non-working women. The results of multinomial regression showed maternal age (OR=1.92, p<0.05), place of delivery (OR=2.3, p<0.05), distance from health facility (OR=4, p<0.01) and sex of last child born (OR=2.5, p<0.01) among the significant determinants for exclusive Breastfeeding. Conclusions: The duration and initiation of breastfeeding in a marginalised society depends to a great extent on how family members participate and decide on the type of feeding for new-borns. Also, several public health education campaigns should be launched aiming at increasing the familiarity of family relations on exclusive breastfeeding.
Nutritional status assessment of children aged 0-5 years and its determinants in a tribal community of Coimbatore district.
International Journal of Community Medicine and Public Health. 2018 Jul; 5(7):2835-2845.Background: Nutritional assessment in children is very important to prevent nutritional disorders and to decrease the morbidity and mortality. The present study was undertaken to assess the prevalence and determinants of malnutrition among children aged 0-5 years in a tribal community of Coimbatore district. Anaikatty and Palamalai tribal areas of Perianaikenpalayam block (population=347062) was selected for our study. Methods: A total of 206 children aged 0-5 years were included in the study after implementing the exclusion criteria. Results: Overall prevalence of malnutrition found to be 51%. These 51% (105) malnourished children consisted of 41.3% underweight, of which 11.2% were severely underweight. Prevalence of stunting was 32.5%, of which 6.3% were severely stunted. About 21.8% children were wasted and 6.8% were severely wasted among them. Socio-demographic factors like total number of family members exceeding four, mother’s educational status, father’s educational status, mother’s occupational status, socio-economic status, alcohol usage by any family member, and mother’s nutritional status were found to be significantly associated with malnutrition on univariate analysis. Conclusions: The problems of low standard of living, hunger, starvation, malnutrition, agricultural illiteracy, poor antenatal care, disease, poor sanitary and housing facilities, etc. has to be improved totally by implementation of policy that already exists.