Rural Eastern India Research Articles

Pattern of Nonmotor Symptoms in Patients with Idiopathic Parkinson's Disease in a Tertiary Care Hospital of Rural Eastern India.

Idiopathic Parkinson's disease (IPD) is associated with a spectrum of nonmotor symptoms (NMS) that contribute as much to the burden of the disease as the more obvious motor abnormalities. There is a paucity of literature determining the association between NMS and the severity of IPD, especially in rural eastern parts of India. This study explores the frequency of NMS in patients with IPD and determines the association between NMS and the severity of IPD. A cross-sectional observational study involving 65 serially enrolled IPD patients (diagnosed as per United Kingdom Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria) was conducted over a period of 18 months. The patients were evaluated for disease severity as per the Hoehn and Yahr scale (original) and were subsequently evaluated with a predesigned and validated Parkinson's Disease Non-Motor Symptoms Questionnaire. Pearson's Chi-squared test for independence of attributes or Fisher's exact test was used for comparison of categorical variables across the groups. Continuous variables were compared using a one-way analysis of variance (ANOVA) test. The most common presenting NMS of IPD was low mood (n = 61; 93.85%), followed by apathy (n = 59; 90.77%), impaired concentration (n = 58; 89.23%), restless leg (n = 54; 83.08%), and tenesmus (n = 54; 83.08%). A majority of the neuropsychiatric symptoms, autonomic dysfunctions, sleep abnormalities, gastrointestinal manifestations, and sensory abnormalities individually showed a statistically significant relation with the severity of IPD. Common presenting NMS include neuropsychiatric manifestations, autonomic symptoms, sleep-related symptoms, and gastrointestinal manifestations. Most of the NMS are significantly related to disease severity.

Prevalence and Patterns of Ocular Comorbidities among Geriatric Population Residents in Rural Eastern India: A Cross-Sectional Study

Background: With the increase in overall life expectancy, the number of people above 60 years old will increase globally from 1 billion in 2020 to 1.4 billion in 2050 and is expected to double by 2.1 billion by 2050 with an increase in age-related comorbidities. Age-related ocular co-morbidities are a major comorbidity. According to India's visual impairment and blindness data, cataracts and severe and moderate visual impairment are the most common cases. Objective: To assess the ocular comorbidities among the geriatric population. Methods: A community-based cross-sectional study was undertaken in the field practice area of the Rural Health Training Center (RHTC), Jamujhari, Khordha, affiliated with the Department of Community Medicine, IMS & SUM Hospital, Bhubaneswar. Stratified random sampling was done, and one stratum constituted three nearby adopted villages. Four strata were included to select the households, and the first household was selected randomly in each village. A socio-demographic profile and detailed clinical history were collected, and the required clinical examinations were conducted after obtaining consent. Results: The prevalence of ocular morbidity (OM) was found to be 96.8%. Refractive error (RE) has the highest prevalence (86.52%), including prescription-corrected glasses users, whereas age-related macular degeneration (ARMD) and ectropion (EC) have the lowest prevalence (3.2%). Conclusions: The study findings show a need for proactive management and earlier screening for better quality of life in the geriatric population.

Comparison of bone health among pre-menopausal and post-menopausal females in rural Eastern India: A pilot study.

The aim of this study was to identify the at-risk female population (pre- and post-menopausal), identify the risk factors for low bone mineral density (BMD) and assess the knowledge of the subjects regarding osteoporosis by Osteoporosis Knowledge Assessment Tool (OKAT) in both the groups and to determine areas for early intervention in a predominantly rural and tribal area of Eastern India. This was a cross-sectional hospital-based study conducted in a predominant tribal and rural area of Eastern India. Females who were pre- and post-menopausal without a prior diagnosis of osteoporosis were included in the study. Factors affecting osteoporosis and quantified knowledge regarding the disease. A total of 388 females were included in the study (pre-menopausal = 190 and post-menopausal = 198). Although no significant difference was noted in the age at menarche between both the groups, a gradual significant shift in the age at menarche was noted in the younger females (p = .031). The mean OKAT score in the pre-menopausal and post-menopausal group was 9.5 ± 3.4 and 9.2 ± 3.5, respectively. 80% of females in the pre-menopausal group had normal T-scores whereas only 25% of the females in the post-menopausal group had normal T-scores. Targeted educational programs which influence the preventive health behaviour in general and osteoporosis knowledge in particular would bridge this gap. Peer-led community intervention programs which focus on behaviour change with respect to lifestyle and diet modification in the younger population should be the step ahead to reduce the prevalence of the disease.

Prevalence of HIV, hepatitis B and hepatitis C infections among patients with thalassemia attending a tertiary care (rural) hospital.

The Sunderban area of West Bengal is home to tribal and religious minorities inhabiting various islands. There is a high prevalence of thalassemia among poverty-stricken residents of this region living with meagre health care facilities. This work was planned to determine the proportion of four viral transfusion-transmitted infections (TTIs): HIV-1, HIV-2, hepatitis B virus (HBV) and hepatitis C virus (HCV) among thalassemia patients attending the sole rural medical college in the region. Thalassemia patients (n = 359, age ranging from 1 year to 60 years) attending the thalassemia clinic or being admitted to the indoor facilities for better management were included in the study. Only patients diagnosed with high-performance liquid chromatography (HPLC) and with classical clinical features were included in the study. Blood samples of these patients were tested for HIV as per NACO protocol. For HBV and HCV, samples were first tested serologically; reactive samples were collected and sent in the cold chain to a higher centre for nucleic acid amplification testing (NAAT) for qualitative and quantitative estimation. Clinical and laboratory data was collected, patients were followed up for complications and hospitalisation during the study period, and statistical analysis was performed. Majority of our patients had E-beta-thalassemia (245, 59.81%), followed by beta-thalassemia major (102, 28.30%). NAAT-confirmed HCV infection (14.21%) infection was the most common, followed by HBV (2.51%), and lastly by HIV-1 (0.58%) infection. Among infected thalassemia patients, the mean HCV RNA was 741063 ± 438514.67 IU/ml while the mean HBV DNA level was 4082863 ± 7298514 IU/ml. Co-infections of HIV-1 and HCV and that of HBV and HCV were noted in one patient each (0.28%). HCV-related liver disease (14.21%) and growth retardation (10.31%) were the most typical complication noted, and death occurred in five patients (1.39%) during the study period. Primary care physicians should know HCV infection is the most common TTI among thalassemia patients in rural eastern India.

The Quality of Life of Older Adults in Rural Eastern India and Its Influencing Factors: A Cross-Sectional Study.

Aims This study aimed to assess the quality of life (QoL) of older adults in rural Odisha, India, exploring its multidimensional nature across physical, psychological, social, and environmental domains. The impact of depression and various sociodemographic factors on QoL was also investigated. Methods The research was conducted in the Tangi block of Khordha district, Odisha, encompassing 468 older adults. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire, Geriatric Depression Scale (GDS-15), and sociodemographic questionnaire were used in data collection. Sampling employed a multistage approach, with statistical analysis utilizing Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY), including t-tests for normally distributed data and the Mann-Whitney U test for non-normally distributed data. Results The QoL of older adults in rural Odisha showed variability, with physical and social domains exhibiting relatively positive scores compared to psychological and environmental domains. Depression significantly impacted all QoL dimensions, with the most profound effect observed in global QoL and global health. Sociodemographic factors such as employment, substance use, elder abuse, adverse life events, and poverty were identified as significant determinants of global QoL. Additionally, recreational activity, elder abuse, education, and employment significantly affected all QoL domains. Conclusions This study reveals the complex landscape of QoL of older adults in rural Odisha. The findings emphasize the need for comprehensive interventions targeting mental health, social support, and environmental conditions to enhance the overall well-being of this population. Policymakers and healthcare professionals should consider these multidimensional factors to develop effective strategies for improving the QoL of older adults in similar contexts.

Can farmers with higher capabilities fend off falling into future Poverty? Empirical evidence from a tribal region in eastern India

The United Nations Sustainable Development Goals (SDGs) 1 (no poverty), targets those individuals who are below the poverty line and those who are vulnerable to falling below the poverty line (VtP). Farmers are more VtP due to limited resilience capacity against the covariate and idiosyncratic shocks. However, literature on farmers’ VtP and their capabilities to mitigate the adverse effects of shocks is relatively scant. Thus, this study aims to examine if higher capabilities lead to less VtP. Using a survey dataset from 222 farm households in rural eastern India, this study first estimated VtP by employing the Feasible Generalized Least Squares (FGLS) approach. Secondly, it used a counting approach and Propensity Score Matching (PSM) method to examine the relationship between the capabilities of households and their VtP. The FGLS results show that about 50% of households are VtP, which exceeds the actual poverty rate of about 36%. The counting approach results show that households with higher capabilities are less VtP. The PSM results indicate that a household’s VtP is reduced by 27–37% for those with higher capabilities. Thus, the policy targeting the household below poverty line and also VtP would significantly reduce poverty and contribute to achieving SDG1. This would involve identifying and targeting households most in need of assistance such as households with low income, lack of education, and limited access to resources. This study also suggests increasing the resilience capabilities of households by providing job skill training, diversifying income portfolios, insurance coverage, and social safety nets.

Evaluation of changes in the cognitive, affective, and psychomotor domains of learning following an interprofessional intervention for malaria and its control among the Bedia tribe, a particularly vulnerable tribal group, in rural Eastern India.

The "Bedia" tribal people are found all over India; they are poor, illiterate, and confined culturally. In many parts of India, malaria, a disease caused by mosquitoes, is becoming more common. Raising awareness and educating people about it is the best method to stop disease and maintain good health. This study aimed to determine the perception, attitudes, and practices of a particularly vulnerable tribal group-the "Bedia"-in the rural region of eastern India. A questionnaire with 19 structured questions has been created. The Bedia participants received the questionnaire from us. They had already responded. The intervention took the form of several health education workshops that were created in response to the deficiencies identified in the pre-test assessment's replies. The identical questionnaire used for the pre-test evaluation was given to each participant for the post-test who attended the training sessions. The current study found that while the first cognitive domain question on malaria transmission was not statistically significant, changes in malaria breeding grounds, regions with higher mosquito numbers, and the source of information about malaria are. Their knowledge of the treatment for malaria and the agent used to treat it is statistically significant in the current study, but the fifth question on the most common symptom of malaria was not statistically significant. The answers to the questions about "What you will do if you see someone suffering from malaria," "How much time was spent in the malaria control program," "Malaria detection," and "Regular usage of bed-nets" in the affective and psychomotor domains all had statistical significance. Our research on interventions to raise awareness of malaria in this tribal region of northern West Bengal, eastern India, bordering Bangladesh, was published for the first time to our knowledge. In the majority of the items from the cognitive, psychomotor, and affective learning domains, we have seen significant changes.

Do skills enable the reduction of emissions from household energy use? Findings from a survey of households in rural India

ABSTRACT We use new survey data from 1,203 households in rural Eastern India to estimate cross-sectional models of overall energy use and embedded emissions. Findings indicate that the primary driver of household energy use is household size and affluence. This is unsurprising and consistent with findings from the engineering literature on energy demand. However, there is also a substantial and significant moderating influence of skills on energy use. For emissions, we observe a bifurcated relationship in line with educational attainment. For those that have completed secondary education or more, skills are negatively associated with energy use and emissions, whereas for those with lesser qualifications more skills are associated with more energy use and emissions. The results are consistent with the environmental Kuznets curve, which implies that a critical level of affluence is required before environmental impacts start lessening. The results also echo a sociological critique of human capital theory − that individual abilities are not productive in and of themselves, but rather in relation to socially determined opportunity structures. Our findings show that this could also hold for greenhouse gas emissions.

Interrogating “Marginality” in Bombay Cinema: An Exhaustive Historiography

Interrogating “Marginality” in Bombay Cinema: An Exhaustive Historiography

Informal plastic waste recycling firms in rural eastern India: Implications for livelihood and health

BackgroundIn India, a significant proportion of the total workforce encompasses the informal sector as their primary source of livelihood. However, one of the most severe difficulties in this informal sector is how to best work with them to improve their livelihoods, working conditions and efficiency. ObjectivesThis paper primarily intends to investigate the role of informal plastic waste recycling factories on workers' livelihoods. Further, it will assess the prevalence of self-reported health disorders with multiple responses and their predictors for recycling plastic factory workers (RFWs). MethodsThis is a cross-sectional survey of RFWs. Primary data was collected from one dominating plastic factory hub of Malda district, West Bengal, through purposive sampling from July to August 2021. Descriptive statistics and the relative risk ratio method were applied to fulfil the objectives. ResultsThe findings portray both the positive and negative implications of these factories. Despite the significant economic benefits, its informal working environment makes workers' health more vulnerable in the long run. Nearly 78% of factory workers are faced muscular pain as a prominent one. Further, statistical analysis indicated a substantial positive relationship between the magnitude of workers' health disorders with increasing years of work experience and demographic attributes (p < 0.05 and p < 0.10). ConclusionThese findings conclude that preserving economic growth and hazards remains a significant concern for policymakers. Also, there is an urgent need to formalise these informal factories while improving the living, working conditions, and efficiency of recycling factory workers.

Clinical and biochemical features of hypokalemic paralysis: a study from rural Eastern India

BackgroundHypokalemic paralysis is characterized by episodic attacks of flaccid muscle weakness of variable duration and severity associated with hypokalemia. Overall, there is a scarcity of data regarding hypokalemic paralysis from Indian subcontinent particularly from rural areas.MethodsA total of 50 consecutive patients of hypokalemic paralysis who were admitted in our hospital were recruited in this study.ResultsFifty patients of hypokalemic paralysis were admitted to our department over a period of 4 years. Forty-two (84%) patients presented with classic acute onset quadriparesis, while eight patients had atypical presentation. Five patients had paraparesis, two had hemiparesis and one patient presented with isolated neck muscle weakness without any limb weakness. Thirty-two patients had primary hypokalemic periodic paralysis (HoPP) and 18 had secondary hypokalemic paralysis. There was no significant difference in severity of weakness (p = 0.53), number of episodes of weakness (p = 0.66) and serum CPK levels (p = 0.36) between primary and secondary hypokalemic paralysis. Secondary cases required significantly prolonged time for recovery as well as higher potassium supplements as compared to the primary HoPP. The severity of weakness of proximal muscles measured in MRC grading showed a significant correlation with serum potassium levels (p = 0.010), but did not show any correlation with CPK Levels (p = 0.86).ConclusionHypokalemic paralysis is an important cause of acute flaccid paralysis in the Emergency Room that often improves dramatically with potassium supplements. While secondary cases often require treatment of underlying etiology, primary hypokalemic paralysis often requires chronic treatment with acetazolamide and/or potassium-sparing diuretics.

Effects of community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India (JIAH trial): A cluster-randomised controlled trial

ObjectivesTo evaluate whether and how community youth teams facilitating participatory adolescent groups, youth leadership and livelihood promotion improved school attendance, dietary diversity, and mental health among adolescent girls in rural India. DesignA parallel group, two-arm, superiority, cluster-randomised controlled trial with an embedded process evaluation. Setting, intervention and participants38 clusters (19 intervention, 19 control) in West Singhbhum district in Jharkhand, India. The intervention included participatory adolescent groups and youth leadership for boys and girls aged 10–19 (intervention clusters only), and family-based livelihood promotion (intervention and control clusters) between June 2017 and March 2020. We surveyed 3324 adolescent girls aged 10–19 in 38 clusters at baseline, and 1478 in 29 clusters at endline. Four intervention and five control clusters were lost to follow up when the trial was suspended due to the COVID-19 pandemic. Adolescent boys were included in the process evaluation only. Primary and secondary outcome measuresPrimary: school attendance, dietary diversity, and mental health; 12 secondary outcomes related to education, empowerment, experiences of violence, and sexual and reproductive health. ResultsIn intervention vs control clusters, mean dietary diversity score was 4·0 (SD 1·5) vs 3·6 (SD 1·2) (adjDiff 0·34; 95%CI -0·23, 0·93, p = 0·242); mean Brief Problem Monitor-Youth (mental health) score was 12·5 (SD 6·0) vs 11·9 (SD 5·9) (adjDiff 0·02, 95%CI -0·06, 0·13, p = 0·610); and school enrolment rates were 70% vs 63% (adjOR 1·39, 95%CI 0·89, 2·16, p = 0·142). Uptake of school-based entitlements was higher in intervention clusters (adjOR 2·01; 95%CI 1·11, 3·64, p = 0·020). Qualitative data showed that the community youth team had helped adolescents and their parents navigate school bureaucracy, facilitated re-enrolments, and supported access to entitlements. Overall intervention delivery was feasible, but positive impacts were likely undermined by household poverty. ConclusionsParticipatory adolescent groups, leadership training and livelihood promotion delivered by a community youth team did not improve adolescent girls’ mental health, dietary diversity, or school attendance in rural India, but may have increased uptake of education-related entitlements. Trial registrationISRCTN17206016

Factors influencing, SWOT analysis and emerged strategies for improving the use of digital data platforms in immunisation program by frontline health care providers: a study from rural Eastern India

Background: Digital health is a multidisciplinary concept that intermingles technology and healthcare for better service provision. Recently, these platforms are getting better utilised during the COVID-19 pandemic. We attempted to understand the factors influencing the use of digital data platforms by the frontline health workers and do a situational analysis using SWOT (strength, weakness, opportunity and threats) framework. Methods: We adopted a qualitative research method to explore both internal and external factors in a rural block of Odisha, India. 15 In-depth interviews (IDI) were conducted among the FHWs telephonically. Analysis was done using MAXQDA software. Based on findings and extensive literature review, a conceptual framework was developed.Results: The study explored that elder age, low education, less interest, fear of health problems, less experience in using applications, married, and work duplication were the internal factors causing reluctance and, user-friendliness, the language for operating, training on application use, handholding support, including troubleshooting, availability of internet, network and electric power supply were the external factors that influence the use. Further, opportunities such as the availability of IT platforms for data storage and troubleshooting, technological advancement, Government promotional initiatives and availability of resources through other programs could be strategically leveraged. Also, our study proposes strategies such as making the applications simple, informative, and user-friendly using advanced technology, better development of applications that are leveraging the "digital India" initiative. Conclusions: Exploring and understanding the situational factors and based on that, adopting context-appropriate strategies will help to achieve better and wider use of the digital platforms.

Correlation between predominantly subclinical peripheral arterial disease in patients with ischemic stroke: A study using ankle–brachial index from rural eastern India

Introduction: Peripheral arterial disease (PAD) decreases arterial perfusion leading to limb ischemia. It is considered one of the markers of subclinical atherosclerosis process. For this reason, it can be a major risk factor for ischemic stroke. Early detection of PAD has an important role in preventing ischemic stroke. Materials and Methods: This study was carried out in District Hospital, Barasat, Kolkata, from March 2011 to March 2013. Eighty-two patients with ischemic stroke (aged 40–80 years) were recruited. Patients having atrial fibrillation and diabetes mellitus and embolic source were excluded. Ankle–brachial index (ABI) was performed with ultrasonography Doppler in each patient. PAD was diagnosed when the ABI was below 0.9. The severity of stroke was assessed by the National Institutes of Health Stroke Scale. Statistical Analysis: For continuous variables, analysis of variance was used to compare three or more groups of patients and Student’s t-test for two groups. Chi-square test or Fisher’s exact test was used for categorical variables. For all analytical purposes, a two-tailed P &lt; 0.05 was considered statistically significant. Results: According to ABI, 62 patients had no pad, 13 patients had mild, and 7 patients had severe PAD. High total cholesterol and low-density lipoprotein were significantly associated with low ABI (P = 0.001). High total cholesterol levels and low ABI were significantly correlated (P &lt; 0.001). A significant association between moderately-low ABI and recurrent stroke was noted (P = 0.019). Conclusion: PAD is significantly associated with recurrent ischemic strokes. Evaluation of ABI for PAD revealed increased risk of recurrent stroke.

Analysis of Five Years Data of Special Newborn Care Unit in a Rural Medical College: Scope for Improvement in Neonatal Mortality and Morbidity

Introduction: Neonatal mortality is the most important contributor towards infant mortality. Special Newborn Care Units (SNCUs) are part of the facility based newborn care of National Health Mission (NHM) and cornerstones for reducing neonatal mortality. Aim: To study the mortality and morbidity data of a tertiary care SNCU of rural tribal Eastern India and find out the focus area for improvement. Materials and Methods: This was a retrospective observational study carried out on 19397 babies admitted in the SNCU of Midnapore Medical College, Midnapore, West Bengal, India, from February 2016 to January 2021. Data were collected from the SNCU admission register and computerised reporting data of SNCU. In this study, five years admission and mortality data of the SNCU was analysed. Results: There were 67729 live births during the period between February 2016 and January 2021, out of which 8627 were admitted to the SNCU (inborn). There were 1195 deaths among the inborn babies, thus the mortality rate was13.8%. The number of outborn babies admitted during the study period was 10770, out of which 1357 babies died, thus the mortality rate was 12.6%. There was significantly higher mortality among inborn babies than outborn babies (13.8% vs. 12.6%). The major causes of admissions in the SNCU were prematurity (n=10167, 52.5%), Low Birth Weight (LBW) (n=11519, 59.3%), jaundice (n=4692, 24.19%), Hypoxic Ischaemic Encephalopathy (HIE) (n=4278, 22%) and sepsis (n=2161, 11.14%). The main causes of mortality were HIE (n=766, 30%), and sepsis (n=709, 27.78%), followed by respiratory distress syndrome (n=162, 6.3%), congenital malformations (n=77, 3%), and meconium aspiration syndrome (n=37, 1.45%). Conclusion: Prematurity and LBW were the major causes of morbidity and mortality. Sepsis and HIE were the major direct causes of mortality. Hence to reduce neonatal morbidity and mortality focus should be on preventing the above causes.

Across the stolen Ponds: The political geography of social welfare in rural eastern India

• Non-homogeneous political incentives are found to determine social welfare provisions in rural India. • On ground distributive politics around welfare provision is shaped by innovative forms of clientelist transactions. • Political alignment patterns within local governments are decisive in shaping distributive outcomes. • Underlying social structures and practices can inhibit democratic decentralisation initiatives. Despite a strong state and a slew of poverty reduction/welfare programmes, the provision of basic services to the rural poor in India remains puzzlingly inadequate. Moving away from the usual trend of aggregate welfare impact analysis that characterises most studies on this theme, we explore the on-ground distributive politics around the implementation of India’s flagship social welfare programme, the National Rural Employment Guarantee Scheme (NREGS). Based on a mixed-method study in the state of West Bengal, using observational primary data and ethnographic material across 46 sample village councils ( gram panchayats ) from 2013 to 2018, we draw attention to the non-homogeneity in the way political incentives of welfare provision are orientated towards different parties and individual stakeholders. In doing so, we traverse across multiple domains of political economic concepts, particularly that of partisan alignment, clientelism and patronage, and unpack the differentiated constellation of localised political incentives founded on a unique form of transactional paradigm called settings. We show how these on-ground transactions provide a multitude of political incentives for ruling/opposition political parties and panchayat functionaries, often going beyond conventional ethno-favouritism ideas of patronage and assuming a more personalised context. In turn, we also argue that the idea of settings is useful in providing a deeper understanding of local state-society relations and the political geography of welfare provisions in rural eastern India.

Climate change, cyclone and rural communities: Understanding people's perceptions and adaptations in rural eastern India

Tropical cyclones represent one of India's toughest natural threats. This paper lists the challenges and mitigation efforts to resolve significant disasters in the coastal areas of eastern India in particular. Humans must learn to counter and live with the effects of such natural disasters as they are unavoidable. The construction of natural hazard structures has always been supported by various national and international disaster mitigation organisations. New building design standards are proposed, as planning and growth to reduce the possibility of potential structural damage. Damage is caused to the roof, walls, openings, and foundation of a building due to the use of non-disaster proof construction practices. A brief introduction on the damaging effects of noteworthy cyclones is provided. It has been highlighted the increasing frequency of cyclones since the start of the 21st century due to climate change. A focus is maintained on the challenges faced by rural regions of India for the eastern coastline especially in the housing sector. Climate change and further cyclones have caused the loss of crops and thus livelihood, which is the main concern for the rural people. A section on the challenges to the housing reconstruction provisions for the rural community, as provided by the Government of India is depicted. Lastly, the paper provides various solutions for a cyclone-resistant structure and disaster prevention as per the challenges faced by the rural community.

Agricultural GHG emission and calorie intake nexus among different socioeconomic households of rural eastern India

A study was conducted to examine the interrelationships among socioeconomic factors, household consumption patterns, calorie intake and greenhouse gas emissions factors in rural eastern India based on household survey data. Findings indicated that higher monthly per capita incomes (12.1–80.1$) were associated with greater average calorie intakes (2021–2525 kcal d−1). As estimated by the FEEDME model, in total 17.2% of the population was calorie malnourished with a regional disparity of 29.4–18.2% malnourishment. Greenhouse gas (GHG) emissions were calculated only on the basis of crop and livestock production and consumption. Rice accounted for the highest share of total GHG emissions, on average 82.6% on a production basis, which varied from 58.1% to 94.9% in regional basis. Rice contributed the greatest share (~ 65% and 66.2%) in terms of both calories and GHG emissions (CO2 eq y−1), respectively, on a consumption basis. We conclude that extensive rice farming and increasing animal product consumption are dominant factors in the higher carbon footprint in this region and are likely to further increase with increase in per capita income. This study provides useful information to help for better crop planning and for fine-tuning food access policy, to reduce carbon footprint and calorie malnutrition.

Application of fuzzy DEA and machine learning algorithms in efficiency estimation of paddy producers of rural Eastern India

PurposeData envelopment analysis (DEA) has wide applications in the agricultural sector to evaluate the efficiency with crisp input and output data. However, in agricultural production, impreciseness and uncertainty in data are common. As a result, the data obtained from farmers vary. This impreciseness in crisp data can be represented in fuzzy sets. This paper aims to employ a combination of fuzzy data envelopment analysis (FDEA) approach to yield crisp DEA efficiency values by converting the fuzzy DEA model into a linear programming problem and machine learning algorithms for better evaluation and prediction of the variables affecting the farm efficiency.Design/methodology/approachDEA applications are focused on the use of a common two-step approach to find crucial factors that affect efficiency. It is important to identify impactful variables for minimizing production adversities. In this study, first, FDEA was applied for efficiency estimation and ranking of the paddy growers. Second, the support vector machine (SVM) and random forest (RF) were used for identifying the key leading factors in efficiency prediction.FindingsThe proposed research was conducted with 450 paddy growers. In comparison to the general DEA approach, the FDEA model evaluates fuzzy DEA efficiency giving the user the flexibility to measure the performance at different possibility levels.Originality/valueThe use of machine learning applications introduces advanced strategies and important factors influencing agricultural production, which may help future research in farms' performance.

Predictors of the diets consumed by adolescent girls, pregnant women and mothers with children under age two years in rural eastern India.

Adolescents, pregnant women and mothers of children under 2 years of age are in stages of life characterized by higher nutritional demands. The study measured the dietary diversity of 17,680 adolescent girls, pregnant women and mothers of children under age 2 years in the eastern Indian states of Bihar, Chhattisgarh and Odisha using data from the Swabhimaan baseline survey conducted in 2016. The association of women's mean Dietary Diversity Scores with socioeconomic, health and nutrition service indicators was assessed. The sampled population was socioeconomically more vulnerable than the average Indian population. There was not much variation in the types of foods consumed daily across target groups, with diet being predominantly cereal (98%) and vegetable (83%) based. Nearly 30% of the mothers had low Dietary Diversity Scores, compared with 25% of pregnant women and 24% of adolescent girls. In each target group, more than half of the respondents were unable to meet the Minimum Dietary Diversity score of at least five of ten food groups consumed daily. Irrespective of their background characteristics, mean Dietary Diversity Scores were significantly lower in Bihar than in Chhattisgarh and Odisha for all target groups. Having at least 6 years of education, belonging to a relatively rich household and possessing a ration card predicted mean dietary diversity. Project interventions of participatory women's group meetings improved mean Dietary Diversity Scores for mothers and adolescent girls. Considering the association between poverty and dietary diversity, the linkage between girls and women and nutrition-focused livelihoods and supplementary nutrition programmes needs to be tested.