Child Health Programs Research Articles

The role of modeling in evaluation of maternal and child health programs: using the lives saved tool to help answer core evaluation questions

ABSTRACT This paper explains how The Lives Saved Tool (LiST), a computer-based model that estimates the impact of scaling up interventions on stillbirths, maternal, neonatal and child health, can contribute to evaluations of programs being delivered at scale to improve maternal and child health. LiST can be used to estimate the impact of a program in advance, allowing planners to refine, streamline and set appropriate program targets. LiST can also be used to estimate the impact of a program, which is particularly useful given the high costs of measuring changes in population health. Finally, LiST can be used to estimate the relative contributions of different interventions or sets of interventions within programs that are found to have a positive impact. The latest version of LiST allows users to manipulate both utilization and quality of service to generate estimates of effective coverage. In addition, a new, web-based version of LiST is now available, with a simpler and more streamlined interface designed to increase accessibility to beginning users. LiST modeling can help program planners, evaluators and funders respond to core evaluation questions related to program design and impact, providing evidence to support decisions about how best to use available resources to save the lives of women and children.

Evaluasi Program Provider Initiated Testing And Counseling (PITC) Pada Ibu Hamil Pada Masa Pandemi Covid-19 Di Puskesmas Muara Badak

Provider Initiated Testing and Counseling (PITC) is an important strategy to increase coverage of HIV testing for pregnant women as well as efforts to control HIV/AIDS in Indonesia and is part of the Maternal and Child Health (KIA) program. During the COVID-19 pandemic, new HIV/AIDS infections tended to increase, especially among housewives. During the COVID-19 pandemic, the Muara Badak Health Center found new HIV cases and tended to increase, while HIV screening for pregnant women decreased. This study aims to determine the implementation of the Provider Initiated Testing and Counseling (PITC) program for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of process (assessment of the mechanism for implementing the PITC program for pregnant women) and output (factors related to pregnancy). with program success). This type of research is cross sectional and the sampling technique used is accidental sampling. Collecting data using questionnaires and observation sheets with a sample of 86 pregnant women, Bivariate analysis using the Fisher's Exact Test and the Kolmogorov-Smirnov Test with a 95% confidence level (α = 0.05). The results showed that the implementation of the Provider Initiated Testing and Counseling (PITC) program evaluation activities for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of process, was declared to have gone quite well with a score of 32 (63%), while the implementation of evaluation activities the PITC program for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of output stated, the results of statistical tests between the success of the PITC program and the basic principles of PITC (p=1,000), knowledge (p=1,000), attitudes (p=0.000) using the Kolmogorov-Smirnov Test, and resistance (p=1,000). In conclusion, there is no relationship between the success of the PITC program and the basic principles of PITC, knowledge, and barriers. There is a relationship between the success of the PITC program and attitude. Muara Badak Health Center is expected to be able to monitor and evaluate the implementation of PITC.

Evaluating patient data quality in South Africa’s National Health Laboratory Service Data Warehouse, 2017-2020: implications for monitoring child health programmes

BackgroundSouth Africa’s National Health Laboratory Service (NHLS), the only clinical laboratory service in the country’s public health sector, is an important resource for monitoring public health programmes.ObjectivesWe describe NHLS data quality, particularly patient demographics among infants, and the effect this has on linking multiple test results to a single patient.MethodsRetrospective descriptive analysis of NHLS data from 1st January 2017—1st September 2020 was performed. A validated probabilistic record-linking algorithm linked multiple results to individual patients in lieu of a unique patient identifier. Paediatric HIV PCR data was used to illustrate the effect on monitoring and evaluating a public health programme. Descriptive statistics including medians, proportions and inter quartile ranges are reported, with Chi-square univariate tests for independence used to determine association between variables.ResultsDuring the period analysed, 485 300 007 tests, 98 217 642 encounters and 35 771 846 patients met criteria for analysis. Overall, 15.80% (n = 15 515 380) of all encounters had a registered national identity (ID) number, 2.11% (n = 2 069 785) were registered without a given name, 63.15% (n = 62 020 107) were registered to women and 32.89% (n = 32 304 329) of all folder numbers were listed as either the patient’s date of birth or unknown. For infants tested at < 7 days of age (n = 2 565 329), 0.099% (n = 2 534) had an associated ID number and 48.87% (n = 1 253 620) were registered without a given name. Encounters with a given name were linked to a subsequent encounter 40.78% (n = 14 180 409 of 34 775 617) of the time, significantly more often than the 21.85% (n = 217 660 of 996 229) of encounters registered with a baby-derivative name (p-value < 0.001).ConclusionUnavailability and poor capturing of patient demographics, especially among infants and children, affects the ability to accurately monitor routine health programmes. A unique national patient identifier, other than the national ID number, is urgently required and must be available at birth if South Africa is to accurately monitor programmes such as the Prevention of Mother-to-Child Transmission of HIV.

Factors Related to the Achievement of the Target of the Maternal and Child Health Program at the Konawe District Health Center

Introduction: Based on the Konawe District Health Profile, it is known that in general the trend of delivery assistance coverage by health workers is known to be 91.20% in 2014, in 2015 there was no increase, namely 91.20%, for 2016 it decreased to 72.80%, for 2017 also increased to 75.70% but in 2018 it decreased drastically to 61.10%.&#x0D; Methods: This type of research is quantitative using a cross-sectional design, the research was conducted at the Konawe district health center, with a population of 29 health centers and a sample of 27 health centers and there were 5 people representing 1 health center so that the total sample of the study was 135 respondents.&#x0D; Result: It is known from the results of data analysis and obtained the value of X2Count or Chi- Square 66,849 &gt; from 3.841 or X2table and a Phi value of 0.587 which means it has a moderate relationship between ability and the achievement of the MCH program. It is known from the results of data analysis and obtained the value of X2Count or Chi-Square 72.824 &gt; from 3,841 or X2table and the value of Phi 0.603 which means it has a strong relationship between motivation and the achievement of the MCH program.&#x0D; Conclusion: There is a moderate relationship between the ability of health workers and the Maternal Health Program and a strong relationship between the motivation of health workers and the Maternal and Child Health Program.

EE252 Costing Analysis of Early Childhood Development Project of the Integrated Maternal and Child Health and Development Programme (2017-2020)

To understand key cost components for Early Childhood Development (ECD) package delivery, and contribute to the development of an affordable, feasible and scalable ECD model that can bring changes for children 0-3 years old in China, particularly in resource-limited rural poor areas, and explore possible ways of integrating the ECD model into the National Basic Public Health Services System.

A COMPARATIVE STUDY ON CHILDHOOD VACCINATION POLICY IN THE UNITED STATES, AUSTRALIA, EUROPE AND MALAYSIA

Vaccination from an early in life is one of the most effective medical strategies for reducing infant mortality and morbidity while also ensuring the well-being of society. Following World Health Organization (WHO) recommendations, vaccination is provided free of charge to children worldwide as part of the country's maternal and child health programmes. Nevertheless, many people believe vaccines are harmful and unnecessary, even though they are widely accepted as an effective preventive measure in public health. Many previously eradicated infectious diseases have reappeared because of vaccine hesitancy. Due to vaccine rejection, vaccine avoidance is becoming increasingly common around the world. As a result, the WHO has identified vaccine hesitancy as one of the top ten global health threats for 2019. However, policies that encourage parents to vaccinate their children, on the other hand, may increase their willingness to do so. Government policy instruments such as mandatory regulation, incentives, promotion, and education can be used to influence parental intentions. Policy measures can encourage parents' intentions to vaccinate their children. Consequently, governments can use policy instruments like required regulation, incentives and promotion to control parents' intentions. This paper examines relevant literature on childhood vaccination policies in several countries, including Malaysia, using academic journals and observations from various articles. It is hoped that this study will add to existing knowledge about childhood vaccination policies around the world.

Facilitators and barriers influencing utilization of services provided by community midwives in district Thatta, Pakistan: a qualitative exploratory study

BackgroundTo address the issue of high maternal mortality, the Government of Pakistan initiated a community midwifery program in 2006 to provide skilled birth attendance to women living in rural areas. Despite a large investment in the community midwifery program, research evidence from rural districts of Pakistan suggests that the utilization of maternal and newborn services through community midwives is very low. This exploratory study aimed to understand the facilitators and barriers influencing community midwives’ services utilization in district Thatta.MethodsA qualitative study was conducted in the rural district Thatta, Pakistan. Key-informant interviews (KIIs) were conducted with district officials of the Health department (Thatta), Maternal and Newborn Child Health Program, and Midwifery Association of Pakistan (MAP). In-depth Interviews (IDIs) were conducted with midwifery students who were currently enrolled in the midwifery program of the district; trained community midwives providing services in district Thatta, and trained community midwives not continuing their profession. IDIs were also conducted with community women to explore their views about the scope of midwifery practice and the factors influencing the utilization of community midwives’ services in district Thatta, Pakistan. Data were analyzed using qualitative thematic analysis.ResultsA total of 25 interviews (KIIs = 5; IDIs = 20) were conducted. Two overarching themes were identified: (I) community midwives’ skills and competencies; and (II) ownership and supportive supervision. The major hindering factors for community midwives’ service utilization included deficiencies in community midwives’ training particularly in clinical hands-on training, lack of ownership of community midwifery program, and lack of service structure by the CMWs regulatory body.ConclusionThe study has identified serious gaps in the CMWs program at the level of training and supervision of midwives in Pakistan. The study has also identified factors related to the training of CMWs that could facilitate the program in the context of Pakistan and similar settings.

Comparison of the agreement between WeChat-based self-administered and interviewer-administered data on infant and young child feeding in China: A test-retest study.

BackgroundMeasuring infant and young child feeding (IYCF) indicators is important in evaluating child health programs and making evidence-based decisions. With Internet and new media rapidly developing, communication apps such as WeChat (the most popular mobile social media platform in China) are widely used and can potentially be used as an alternative way to collect infant and young child feeding information. This study compares data agreement between a WeChat-based self-administered and an interviewer-administered survey on infant and young child feeding information.MethodsWe recruited 297 mothers of children aged 6-23 months in Fenxi County, Shanxi Province, China. Using the Test-Retest method, we first collected data through a self-administered survey using a WeChat-based electronic questionnaire and asked 36 questions on breastfeeding and complementary feeding knowledge, practices, and information sources. We then conducted an interviewer-administered survey using the same questionnaire and compared the data agreement between the two survey methods during the same day. Cohen's kappa score (κ) and intraclass correlation coefficients (ICC) were used for data agreement analysis for all 36 questions and six key IYCF indicators. The McNemar test was used to identify differences between the two survey methods for the six key indicators.ResultsThere was substantial or almost perfect agreement for 33 questions (κ/ICC>0.60), and slight or fair agreement for the other 3 questions (κ/ICC<0.40). Agreement of all six key IYCF indicators was substantial or almost perfect (κ = 0.78-0.94), while two indicators showed statistical differences between the two survey methods (P = 0.03 for “Minimum meal frequency” and P = 0.001 for “Minimum accepted diet”). Analysis of reasons for inconsistencies showed that 43.6% of all the inconsistencies were not caused by the self-administered survey method. The cost of the interviewer-administered survey was much higher than that of the self-administered survey: ¥45.9 (US$6.8) vs ¥19.7 (US$2.9) per questionnaire.ConclusionsThe WeChat-based self-administered method can be used for future data collection of infant and young child feeding information in China. Most of the questions and key indicators showed very good agreement without statistical differences between the two methods.

Delivering health programs for Aboriginal and Torres Strait Islander children: Carer and staff views on what's important.

The lack of evidence on the priorities of carers and their Aboriginal and Torres Strait Islander children undermines decisions to improve participant experiences and engagement. This study describes carer and staff perspectives on the aspects of health services delivery that are important to carers and children. Nineteen carers of Aboriginal and Torres Strait Islander children and 17 staff who work at child health programs across two urban Aboriginal Community Controlled Health Services (ACCHSs) and affiliate organisations in New South Wales, Australia participated in semi-structured interviews. We used thematic analysis to analyse the data. We identified five themes: valuing relational communication (building trust by keeping relationships at the centre, empowered to optimise child's development, feeling heard and known); confidence in provider's clinical and interpersonal skills (certain that the health issue will be resolved, engaging with the child to allay fears, facilitating timely health care); finding comfort and security in community embedded services (safety and acceptance in the familiar, strengthening child's connection to culture); support to access and navigate health services (accessible information appropriately presented, easy and flexible scheduling, easing the shame of financial hardship); sustaining service use (fulfilling expectations for service standards, demonstrating commitment through ongoing programs, clarity of benefits). Carers and staff reported that approaches to communication, the content of that communication, how access is facilitated and the service environment managed influences their decisions to interact with health services. With these data decision-makers can better focus resources to improve experiences with their services.

PURPOSe study: understanding the burden of stillbirths in south Asia

PURPOSe study: understanding the burden of stillbirths in south Asia

Implementation of a Coordinated Approach to Child Health Program at a Rural Elementary School During the COVID-19 Pandemic

ObjectivesA Coordinated Approach to Child Health (CATCH) is an evidence-based school health program focusing on increasing healthy eating and physical activity and reducing screen time. This project aimed to determine if CATCH program will have significant effects on self-rated knowledge, habits of physical activity, healthy eating (fruit and vegetable consumption), and screen time among 3rd and 5th-grade students at a rural elementary school during the 2020–2021 school year. MethodsTo evaluate this 4-month project, a pre- and post-intervention School Physical Activity and Nutrition (SPAN) survey was distributed to 51 3rd and 5th-grade students. The program included six 30-minute education sessions specific to grade level and healthy snacks including fruits and vegetables. A family fun event (virtual 2K walk/run due to COVID-19) was organized. Prizes (i.e., water bottles, jump ropes) were given to students for participating in the family fun event and at Track and Field day to encourage healthy behavior. ResultsA dependent paired samples t-tests and an exact McNemar test determined participants who completed both the pre and post intervention survey (n = 15) did not experience a significant change in healthier food choices, fruit consumption, vegetable consumption, screen time, and physical activity. Mean responses of students who completed the pre survey (n = 27) and post survey (n = 22) found a 28% increase in exercising for at least 30 minutes the day prior, a 22% increase in 2 hours or less of screen time the day prior, a 12% increase in eating vegetables 3 or more times the day prior, and a 6% increase in eating fruit 2 or more times the day prior. A Qualtrics survey found that 100% of teachers who completed the survey (n = 7) were satisfied with the program and 5 out of 7 teachers were interested in participating in the program the following school year, with one maybe and one not applicable (i.e., leaving district) response. ConclusionsAlthough the results of this project were not statistically significant, there were beneficial findings and lessons learned. Students reported an increase in favorable responses to recommended habits of physical activity, diet, and screen time following implementation of the CATCH program. Funding SourcesDeKalb County Community Foundation Community Needs Grant.

Breastfeeding Initiation Trends by WIC Participation and Race/Ethnicity Among Low-Income Women in 24 States, United States, 2009–2017

ObjectivesTo describe long-term breastfeeding initiation trends by prenatal WIC participation and race/ethnicity among low-income women in the U.S.MethodsWe used birth certificate data (2009–2017) for 24 states that adopted the 2003 birth certificate revision by 2009. The analytic sample included term births with hospital costs covered by Medicaid. Descriptive characteristics of WIC participants and WIC-eligible nonparticipants were assessed by year and race/ethnicity. Adjusted breastfeeding initiation prevalence was estimated using linear regression with county fixed effects, controlling for sociodemographic, obstetric, and health factors. Trends were compared by WIC status overall and within racial/ethnic groups.ResultsBreastfeeding initiation increased for WIC participants and WIC-eligible nonparticipants (2009 to 2017). WIC participants had consistently lower breastfeeding initiation (2009: 68.6%; 2017: 78.0%) compared to nonparticipants (2009: 72.1%; 2017: 81.3%). The gap between WIC participants and nonparticipants narrowed more for Non-Hispanic Asian/Pacific Islander and non-Hispanic American Indian/Alaska Native women due to a larger increase among WIC participants (% Change: 32.4% and 12.9%, respectively) compared with nonparticipants (% Change: 11.4%, 6.4%).ConclusionsBreastfeeding statistics are often underrepresented among certain racial/ethnic groups, particularly for low-income populations. These findings can inform WIC and other maternal child health program efforts to improve breastfeeding initiation and reduce disparities.Funding SourcesThis study was funded by cooperative agreement between the United States Department of Agriculture Economic Research Service and the University of Maryland, College Park. The findings and conclusions in this publication are those of the authors and should not be construed to represent any official USDA or US Government determination or policy.

Dampak Pandemi Covid-19 terhadap Tren Pelayanan KIA di Kabupaten Tangerang Tahun 2020

The Indonesian government has declared the COVID-19 outbreak a national disaster on March 14, 2020 The COVID-19 pandemic has had an impact on maternal and child health services. The decline in antenatal care visits and health services for infants and toddlers occurred during the COVID-19 pandemic as a result of policies such as Large-Scale Social Restrictions (PSBB) during the pandemic. The research method uses a mixed methods approach with a deductive-sequential design. The population in this study were all mothers, infants and children. toddlers who are in Tangerang district while the samples in this study are mothers, infants and toddlers whose data is available on the Recover Covid dashboard. The results of the study show indicators of Maternal and Child Health programs that have been negatively affected by the COVID-19 pandemic, including K1 and K4 coverage, children under five being monitored for growth and development, IDL and maternal mortality. Suggestions from this study need to arrange a village visit schedule, optimize referral hospitals for maternity patients with COVID-19, improve delivery facilities and infrastructure for mothers with COVID-19 and support APBD from local governments

Caste, Awareness and Inequality in Access to Maternal and Child Health Programs: Evidence From India

Caste, Awareness and Inequality in Access to Maternal and Child Health Programs: Evidence From India

Female’s Experience with Post-placental Intrauterine Contraceptive Device Use in a Tertiary Care Centre in Pakistan

Background: Insertion of a post-placental intrauterine contraceptive device (PPIUCD) has been recommended by the World Health Organization (WHO) as one of the safe and effective methods of temporary contraception. In the immediate post-delivery period, females are highly driven and in need of an effective method for contraception so that child-rearing can be easy without unintended pregnancy. Objective: To assess the outcome of females accepting PPIUCD in terms of insertion, complications, and discontinuation rate at 6 weeks and 6 months. Methods: Retrospective, cross-sectional study conducted at the Department of Obstetrics and Gynecology, Lahore General Hospital, Pakistan, from May 2015 to August 2019. The data were collected and analysed after approval from the hospital ethical committee and were retrieved from the maternal and neonatal child health programme. Record of clinical visit and telephonic survey for miscellaneous complaints at 6 weeks and 6 months were evaluated from the medical records department and relevant data were extracted. The data were analysed using the IBM Statistical Package for the Social Sciences (SPSS® Statistics) V21.0 software (International Business Machines Corporation [IBM], New York, USA) and the results were expressed in descriptive statistics in frequencies and percentages. Results: Total live births during the study period were 43,065. PPIUCD was inserted in 5,275 females (12.24%). Only 13% presented for clinical follow-up; 87% had a telephonic conversation. Of these, 33% were advised to have a clinical visit; 83% reported no complaints. Reassurance was needed in 11% and threads were trimmed in 2%. Problems reported were displaced intrauterine contraceptive device (IUCD; 3.3%); spontaneous expulsion (24.0%); vaginal infections (4.7%); missing strings (3.0%); cramping (25.0%); dyspareunia (6.0%); spotting (52.0%); and vaginal discharge (16.0%). Ultrasound was advised (3.0%), as were symptomatic treatment (14.0%) and antibiotics and IUCD removal (0.7%). IUCD was discontinued by 6.7% of the females for various reasons: family pressure (0.3%); wanting a further child (0.7%); and opting for another method of family planning (14.0%). IUCD was removed and reinserted in 4.9%. Conclusion: PPIUCD has a low turnover rate of follow-up but has high compliance with devices and a low complication rate; however, complications can be reduced by improving patient selection and clinical follow-up. It provides an excellent window of opportunity for providing effective long-term contraception to the patients who need it the most.

Determinants of Antenatal Care Utilization Among Childbearing Women in Burkina Faso.

IntroductionAntenatal care (ANC) is one of the pillars of maternal and child health programs aimed at preventing and reducing maternal and child morbidity and mortality. This study aims to identify the factors associated with ANC use, considering both health care demand and supply factors in the single analysis.MethodsWe used data from the endline survey conducted to evaluate the impact of the performance-based financing (PBF) program in Burkina Faso in 2017. This study was a blocked-by-region cluster random trial using a pre–post comparison design. The sample was derived in a three-stage cluster sampling procedure. Data collection for the endline surveys included a household survey and a facility-based survey. Women of childbearing age who gave birth at least once in the past 2 years prior to this survey and residing in the study area for more than 6 months were included in this study. Multilevel statistical techniques were used to examine individual and contextual effects related to health care demand and supply simultaneously and thus measure the relative contribution of the different levels to explaining factors associated with ANC use.ResultsThe working women were five times [odd ratio (OR): 5.41, 95% confidence intervals (CI) 4.36–6.70] more likely to report using ANC services than the women who were not working (OR: 5.41, 95% CI 4.36–6.70). Women living in a community with high poverty concentration were 32.0% (OR: 0.68, 95% CI 0.50–0.91) less likely to use ANC services than those in a community with low poverty concentration. Women living in a community with a medium concentration of women's modern contraceptive use were almost two times (OR: 1.88, 95% CI 1.70–2.12) more likely to use ANC services than those living in a community with a low concentration of women's modern contraceptive use. Women living in the health area where the level of ANC quality was high were three times (OR: 2.96, 95% CI 1.46–6.12) more likely to use ANC services than those in the health area where the ANC quality was low.ConclusionPolicies that increase the opportunity for improving the average ANC quality at the health facility (HF), the level of women's modern contraceptive use and women employment would likely be effective in increasing the frequency of use of antenatal services.

Knowledge Of Pregnant Women About The Benefits Of Pregnancy Books In Ottawa

This study was conducted using quantitative study approach with cross sectional design and the data collected is primary data obtained by distributing questionnaires. The study was conducted on pregnant women who checked their pregnancy at canal Hospital in canada. based on the results of research conducted that the utilization of pregnant women's books as much as 74.4% who utilize pregnant books, while 25.6% who do not utilize pregnant books, variables related to utilization is vaiabel family encouragement and availability of time and the most dominant is family encouragement(or=2.659). Suggestions from the authors need to strengthen maternal and child health programs by continuously evaluating the performance of health workers in socializing the importance of pregnant books for pregnant women.

Low Birth Weight Baby and Its Associated Factors among Rural Women in Bangladesh: A Decision Curve Analysis

Background: Low birth weight is considered to be one of the main risk factors for infant mortality and morbidity. It is associated with a range of both short- and long-term consequences. Objectives: The study examined the factors contributing to low birth weight of the baby in Bangladesh. This study also attempted with the objective of ensuing a prediction of low birth weight. Methods: The study was a case-control quantitative survey. A three-stage cluster sample design was used to conduct the survey. A total of 674 (337 cases and 337 control) mothers/care givers of under 1 year children were selected from 2 districts of Bangladesh. Binary logistic regression and decision curve analysis were used to investigate the factors which attribute to low birth weight baby born. Results: The findings of the study revealed that mean birth weight was 2.1±0.4 kg among low birth weight children whereas it was 3.0±0.5 kg for normal birth weight children. The mean age of sampled mothers was 25.2±5.4 years. Every 2 in 3 mage got married before 18 years. The prevalence of low birth weight baby among the women with secondary or higher education was lower (47.4%) compared to the women no formal education (65.4%). Analysis revealed that several socio-demographic factors like parental education level, maternal age at first marriage, working status were significantly associated with low birth weight of the baby (p&lt;0.05). Some biological and medical factors like multiple births, maturity of the birth, prenatal care and taking iron and folic acid during pregnancy were also significantly associated with low birth weight baby born. Finally, decision curve analysis technique predicted a net benefit of 0.3907 for the profitable model with highest number of factors. This result implies that the fitted model can predict 39% low birth weight based on independent factors. Conclusion: Prediction model indicates that parental and biological factors are caused for low birth weight baby born in rural areas. Maternal and child health program should focus behavioural change regarding create awareness of disadvantage of early marriage, intake IFA supplementation, at least 4 ANC visit to reduce low birth weight baby born. Bangladesh Med Res Counc Bull 2021; 47(1): 42-49

Prevalence and factors associated with Anaemia in Married Women of Reproductive age group: Evidence from North East India.

The prevalence of anaemia and its continuous growth, especially among women, is a global health concern. The present study aims to examine the prevalence of anaemia and its determinants in the North Eastern region of India. The study used secondary data from the National Family Health Survey 2015-2016 on women of reproductive age group in India. The data were adjusted for sampling weight, stratification and cluster sampling design for analysis. Binary logistic regression and multivariable regression analysis were performed to determine factors associated with anaemia. Of the 65941 participants, 25993 (40%) had anaemia. High prevalence of mild or moderate anaemia was found among women with following socio-demographic characteristics: residing in the rural area (41.20%), having no education (43.07%), belonging to the low-income family (43.39%), having a well as source of drinking water (46.29%), using the traditional method of contraception (44.55%), underweight (42.18%) and those who had first delivery before 20 years of age (40.66%). Logistic regression (adjusted odds ratio) showed that women in the following categories were more likely to develop anaemia: in the age-group of 35-49 years, with no education, with poor wealth, having low nutrition levels; using traditional contraception and women who ate pulses or fish once a week. Alarming rates of anaemia (two in every five), found in the study, need effective strategies for fortification of iron supplement among women. Generation of mass awareness in this regard by utilizing the ongoing adolescent, maternal, child health and nutrition programmes will help in reducing the incidence of anaemia among women.

Child health programmes in India

Health entitlements and wisdom pointed to expeditious identification and reverent control of diarrheal had been a crucial part of the CSSM. The health Evidence TM tool was used to 1) find and obtain relevant research evidence; 2) assess the methodological quality of the research evidence, and 3) synthesize the evidence. Individuals must make certain that their occupations do not create any health issues. All people value their jobs since they provide them with a source of money. Some people may not be content, yet they must work in order to make a living. When children work in dangerous industries, it is critical that they receive suitable training and have the necessary skills.