scholarly journals Missed opportunities for delivering nutrition interventions in first 1000 days of life in India: insights from the National Family Health Survey, 2006 and 2016

2021 ◽  
Vol 6 (2) ◽  
pp. e003717
Author(s):  
Phuong Hong Nguyen ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Vani Sethi ◽  
Alok Kumar ◽  
...  

ObjectivesExisting health and community nutrition systems have the potential to deliver many nutrition interventions. However, the coverage of nutrition interventions across the delivery platforms of these systems has not been uniform. We (1) examined the opportunity gaps between delivery platforms and corresponding nutrition interventions through the continuum of care in India between 2006 and 2016 and and (2) assessed inequalities in these opportunity gaps.MethodsWe used two rounds of the National Family Health Survey data from 2005 to 2006 and 2015–2016 (n=36 850 and 190 898 mother–child dyads, respectively). We examine the opportunity gaps over time for seven nutrition interventions and their associated delivery platforms at national and state levels. We assessed equality and changes in equality between 2006 and 2016 for opportunity gaps by education, residence, socioeconomic status (SES), public and private platforms.ResultsCoverage of nutrition interventions was consistently lower than the reach of their associated delivery platforms; opportunity gaps ranging from 9 to 32 percentage points (pp) during the pregnancy, 17 pp during delivery and 9–26 pp during childhood in 2006. Between 2006 and 2016, coverage improved for most indicators, but coverage increases for nutrition interventions was lower than for associated delivery platforms. The opportunity gaps were larger among women with higher education (22–57 pp in 2016), higher SES status and living in urban areas (23–57 pp), despite higher coverage of most interventions and the delivery platforms among these groups. Opportunity gaps vary tremendously by state with the highest gaps observed in Tripura, Andaman and Nicobar islands, and Punjab for different indicators.ConclusionsIndia’s progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equality gaps remained. It is critical to close these gaps by addressing policy and programmatic delivery systems bottlenecks to achieve universal coverage for both health and nutrition within the delivery system.

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 874-874
Author(s):  
Phuong Nguyen ◽  
Purnima Menon ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Alok Kumar ◽  
...  

Abstract Objectives Most nutrition interventions can be delivered through health systems. However, the progress to scale up effective nutrition interventions and achieve universal health coverage has not been uniform. We aimed to 1) examine the opportunity gaps (OGs) between delivery platforms and corresponding nutrition interventions through the continuum of care (from pregnancy up to early childhood) in India between 2006 and 2016; and 2) assess inequalities in these OGs. Methods We used two rounds of National Family Health Survey data collected in 2005–06 and 2015–16 (n = 36,850 and 190,898 mother-child dyads with the last child aged of 0–5 years, respectively). We examine the OGs over time for a set of seven nutrition interventions and their associated delivery platforms during antenatal, delivery, postnatal and early childhood care at the national, state and district levels. We then assessed equality and changes in equality between 2006–2016 for the OGs by education, residence, socioeconomic status, public and private platforms. Results Coverage of nutrition interventions was consistently lower than the reach of their associated delivery platforms, with the OGs ranging from 9–32 percentage points (pp) during pregnancy, 17pp during delivery, and 9–26pp during childhood in 2006. Between 2006 and 2016, coverage improved for most indicators but the OGs became wider. The OGs were larger among women with higher education, higher SES status and living in urban areas, despite higher coverage of most interventions and the delivery platforms among these groups. Compared to private facilities, public facilities performed better in counseling/support for breastfeeding but were poorer in iron and folic acid supplementation. OGs vary tremendously by state and district, highlighting governance and implementation successes and challenges. Conclusions India's progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equity gaps must be closed by addressing policy and programmatic health systems bottlenecks to achieve universal coverage for both health and nutrition. We recommend this analytic approach to track and assess OGs in scaling up nutrition through health systems in India and worldwide. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by IFPRI.


2019 ◽  
Vol 41 ◽  
pp. e2019050 ◽  
Author(s):  
Mili Dutta ◽  
Y Selvamani ◽  
Pushpendra Singh ◽  
Lokender Prashad

OBJECTIVES: India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.METHODS: Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.RESULTS: The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.CONCLUSIONS: In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.


Author(s):  
Vishal Vennu ◽  
Tariq A. Abdulrahman ◽  
Saad M. Bindawas

Overweight, obesity, hypertension, and diabetes increase the risk of non-communicable diseases and all-cause mortality worldwide. Previous studies have not determined the prevalence of these conditions/diseases throughout India. Therefore, this study was aimed to address this limitation. Data on these conditions/diseases among men and women aged ≥ 18 years were obtained from the fourth National Family Health Survey conducted throughout India between January 2015 and December 2016. The prevalence and prevalence rate per 100,000 population were calculated at the national level and by age group, sex, and type of residence for each state and union territory. The national prevalence of overweight, obesity, hypertension, and diabetes were 14.6%, 3.4%, 5.2%, and 7.1%, respectively. The highest prevalence of these conditions/diseases at the national level was seen among those aged 35–49 years (54 years for men), especially women living in urban areas. In India, 1 out of every 7, 29, 19, and 14 individuals at the national level had overweight, obesity, hypertension, and diabetes, respectively—between 2015 and 2016. These results are important for the healthcare system and government policies in the future. Moreover, targeted efforts are required to establish public health strategies for the prevention, management, and treatment of these conditions/diseases throughout India.


Author(s):  
Sunil Rajpal ◽  
William Joe ◽  
Malavika A. Subramanyam ◽  
Rajan Sankar ◽  
Smriti Sharma ◽  
...  

The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world’s largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015–2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0–72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother–child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan

An amendment to this paper has been published and can be accessed via the original article.


2019 ◽  
Vol 15 (4) ◽  
Author(s):  
Tarun Shankar Choudhary ◽  
Akanksha Srivastava ◽  
Ranadip Chowdhury ◽  
Sunita Taneja ◽  
Rajiv Bahl ◽  
...  

2021 ◽  
Vol 6 (4) ◽  
pp. 335-340
Author(s):  
Ekta Belwal ◽  
Shalini Pandey ◽  
Supta Sarkar

Anemia is the most prevalent deficiency disease and one among the major nutrition related goals globally. Children and women of reproductive age are the most vulnerable groups for anemia everywhere. While there are various nutritional and non-nutritional factors causing anemia, Iron deficiency is the most prominent of them. In India, more than half population of preschool age children and reproductive age women is suffering from anemia. Indian government had started anemia prophylaxis efforts a half century ago and still continuing to battle with this ever prevalent disease to bring down its occurrence. National Family Health Survey is the large-scale survey conducted in India to provide high-quality data on health and family welfare and related emerging issues. The data provided not only helps in formulation, revision and monitoring of the policies and programs but in situating the development of India globally. Studying the time trend for anemia prevalence and other related parameters reported in NFHS surveys helps how well India has performed until now and how far is from its goal to become Anemia free country. Keywords: Anemia, iron deficiency, health survey, child health, maternal health.


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