Status Of Children In India Research Articles

Exhibiting the Changes in Nutritional Status of Children in India: An Empirical Insight from the Human Opportunity Index

Exhibiting the Changes in Nutritional Status of Children in India: An Empirical Insight from the Human Opportunity Index

Right To Genital Integrity: Law, Limbo and The Status of Intersex Children in India

As the movement for recognizing queer rights in India gains momentum, it is critical to evaluate the rights of a particularly neglected group within the LGBTQIA+ community: intersex children. Since 2018, the Indian Supreme Court has decriminalized consensual adult same-sex relationships and has recognized the right to privacy—including decisional and bodily privacy—as a fundamental right guaranteed by the Indian Constitution. However, even after these crucial decisions, intersex children are still subject to medically unnecessary surgeries without their consent. Many suffer long term consequences from such disentitlement. In this Article we examine the rights of children from an ethical and legal perspective in the Indian context. Drawing on classical, feminist, and queer bioethics frameworks, we briefly review the ethical violations inherent in performing genital surgeries on intersex children without their consent. We analyze India’s international legal obligations and argue that those obligations fill a significant gap in India's jurisprudence on sexual minorities. We also analyze the domestic legal framework, studying key decisions of various high courts, including the Indian Supreme Court, that have recognized the right to self-determination of gender identity. Finally, we suggest possible alterations to the current legal framework that, if implemented, will help further legal recognition of the rights of intersex children.

MOTHER'S EDUCATION AND CHILD HEALTH IN INDIA: MULTINOMIAL LOGIT ESTIMATION OF MALNUTRITION

Globally childhood malnutrition manifesting as stunting, wasting, underweight and overweight is the biggest cause of disease burden and millions of deaths of children under five years. India is home to more than one-third of the world's malnourished children despite being one of the first countries in the world to implement a strong and universal immunisation programme. Empirical evidence suggests a strong positive effect of maternal education on the health of children. This paper analyses the effect of maternal education on the nutritional status of children in India using the 2015-16 fourth round National Family Health Survey (NFHS-IV) data and applying the multinomial logistic regression method. The estimated odds ratios show that maternal education significantly reduces the risks of the child being stunted or wasted or underweight or all of these. A woman, with at least primary education gives better care and health to her child and helps reduce the risk of the child being malnourished. Months of breastfeeding, child's birth weight, mother's age, and place of delivery are the other determinants of the nutritional status of children in India.

Nutritional and immunization status of under-five children of India and Bangladesh

BackgroundThe nutritional and immunization status of children can play an important role in determining their future health status of a particular country. The aim of the present study is to investigate the nutritional and immunization status of under-five children in India and Bangladesh, and to find the difference in the status between these two countries.MethodsWe have used the National Family Health Survey data, 2015–2016 of India and Bangladesh Demographic Health Survey, 2017–2018 datasets. The sample sizes are 222,418, among them 8759 and 8759 children for India and Bangladesh respectively. The nutritional status of under-five children is measured by standard anthropometric indicators of height-for-age (HAZ) and weight-for-age (WAZ). Regarding child immunization status, only BCG, DPT, polio and measles vaccinations are considered for the present study. Multiple binary logistic model has been used for analysing the data.ResultsThis study reveals that the prevalence of stunting and underweight of under-five children in India are higher than Bangladeshi children. Secondary and higher educated mothers are more likely of having normal HAZ and WAZ children than up to primary educated mothers for both countries. Chances of having normal HAZ and WAZ are higher among non-poor category for both countries. The present study also shows that immunization status of Bangladeshi children is better than Indian children except measles. Religion of mother also shows influence on immunization status of children in India whereas Bangladesh shows no significant results regarding religion. Mother’s educational attainment and wealth index show influence on immunization status among children for both countries.ConclusionsThe study concludes that a remarkable number of under-five children are suffering from under nutrition for both countries, however Bangladeshi children have better nutritional and immunization status compared to Indian children. Higher wealth index, better educational attainment and lower unemployment of Bangladeshi mothers may be the causes for better nutritional and immunization status of children. Mother’s socio-economic factors have significant impact on determining the child’s health status. Our findings can help to government of Indian and Bangladesh for taking health policy to improve under-five children nutritional and immunization status.

Efficacy of B12 Fortified Nutrient Bar and Yogurt in Improving Plasma B12 Concentrations—Results From 2 Double-Blind Randomized Placebo Controlled Trials

Dietary vitamin B12 (B12) deficiency is common in Indians. Long-term compliance to tablet supplementation is poor in asymptomatic individuals. To study efficacy of B12 fortified nutrient bar and yogurt in improving plasma B12 concentrations in children and adults. Two double-blind, placebo-controlled directly observed therapy randomized controlled trials were conducted for 120 days: (1) Healthy children (10-13 years) were fed nutrient bar fortified with B12 (2 μg), multiple micronutrients B12 (1.8 μg) or placebo. (2) Healthy adults (18-50 years) were fed yogurt fortified with B12 (2 μg) or Propionibacterium (1 × 108 cfu/g) or placebo. B12, folate, homocysteine, and hemoglobin concentrations were measured before and post intervention. We randomized 164 children and 118 adults; adherence was 96% and 82%, respectively. In children, B12 fortified bars increased B12 concentrations significantly above baseline (B12 alone +91 pmol/L, B12+ multiple micronutrients +82 pmol/L) compared to placebo. In adults, B12 fortified yogurt increased B12 significantly (+38 pmol/L) but Propionibacterium and placebo did not. In both trials, homocysteine fell significantly with B12 supplementation. Rise of B12 and fall of homocysteine were influenced by dose of B12 and folic acid. There was no significant difference in change of anthropometry and hemoglobin between groups. B12 fortified foods are effective in improving B12 status in Indian children and adults. They could be used to improve B12 status in the national programs for children, adolescents, and women of reproductive age. They could also be used as over-the-counter products.

Fathers' Migration and Nutritional Status of Children in India: Do the Effects Vary by Community Context?

Due to international and internal migration, millions of children in developing countries are geographically separated from one or both of their parents. Prior research has not reached a consensus on the impacts of parental out-migration on children's growth, and little is known about how community contexts modify the impact of parental out-migration. We aim to assess the overall impacts of fathers' previous and current migration experiences on children's nutritional status in India and how the impacts are shaped by community socioeconomic contexts and community gender norms. Using data from the Indian Human Development Survey collected in 2011-2012, we estimated community fixed-effect regression models predicting the nutritional status of children (ages 10-15) and examined the interactions among fathers' migration, child's gender, and community contexts. The results showed that children of returned migrants had lower height and Body Mass Index (BMI) than children of non-migrants. Fathers' current absence was associated with lower height and BMI for adolescents in communities with high levels of socioeconomic development but not for those in communities with low levels of development. Fathers' current absence due to migration was especially harmful for girls in communities with strict norms of female seclusion. Our findings highlight that the effects of father's out-migration on children are conditioned by the level of communities' socioeconomic development and community gender contexts, which helps to reconcile the previously mixed findings on the effects of parental migration on child outcomes.

Vitamin D Status of Epileptic Children in India: A Prospective Cross-Sectional Study from a Tertiary Care Centre

AbstractVitamin D deficiency is prevalent all over the world, especially in tropical countries. In epileptics, antiepileptic drugs (AED) and associated comorbidities further impact vitamin D status. The aim of this study is to estimate the prevalence of 25(OH) vitamin D deficiency in epileptic children and evaluate probable risk factors. A cross-sectional study of 200 children between 1 and 18 years of age on AED was undertaken in the pediatric neurology clinic of a tertiary care center of Northern India. In all children, serum 25(OH) vitamin D levels, calcium, phosphorus, and alkaline phosphatase were estimated. The deficiency levels of vitamin D were categorized as: deficiency <20 ng/mL, insufficiency 20 to 30 ng/mL, and sufficiency >30 ng/mL. The potential risk factors for hypovitaminosis D, including type of epilepsy, AED regimen (specific medications, polytherapy vs. monotherapy), cerebral palsy, ambulatory status, intellectual disability, body mass index, gender, and vegetarianism were examined. Among the 200 enrolled children (60% boys), 106/200 (53%) were vitamin D deficient. There was no significant relation of vitamin D levels with gender, type of epilepsy, neurological deficit, and type of AED. An inverse relationship of higher phenytoin doses during monotherapy associated with lower vitamin D levels in monotherapy was found, thereby suggesting adverse effect of high doses of phenytoin on vitamin D levels. VDD is common among epileptic children on AED therapy. Vitamin D deficiency is common prevalent among epileptic children on AED therapy, and its detection and treatment correction should be an integral part of epilepsy management.

Effect of Antioxidant Supplementation on Total Antioxidant Status in Indian Children with Type 1 Diabetes

ABSTRACTHyperglycemia results in the overproduction of free oxygen radicals that impair the endogenous antioxidant defenses. A randomized controlled trial was conducted to compare the effect of 3 months of antioxidant supplementation in the form of foods rich in micronutrients with pharmacological supplement on total antioxidant status of Indian children with type 1 diabetes. Ninety children with diabetes (mean age 11.5 ± 3.6 yrs, 37 boys) were randomly allocated to three groups: Group 1 (n = 31) = DM controls; Group 2 (n = 30) = multimicronutrient syrup; and Group 3 (n = 29) = dietary supplements (nine snack recipes rich in micronutrients). They received intervention for 3 months. Healthy controls were enrolled from local schools. Fasting blood was tested for total antioxidant status (TAS) and glycosylated hemoglobin (HbA1C). Children with diabetes had lower TAS (0.70 ± 0.2 vs. 1 ± 0.24 mmol/l, p = .0001) compared to healthy controls. Anthropometric and biochemical parameters were similar at baseline for all groups of diabetic children. Group 1 showed significant deterioration in TAS at endline (0.72 ± 0.16 vs. 0.60 ± 0.17 mmol/l, p = .008). Increase in TAS recorded in Group 2 was from 0.66 ± 0.21 to 0.70 ± 0.16 mmol/l and in Group 3 was from 0.68 to 0.73 mmol/l. There was a significant difference between Group 1 and Group 3 for percentage change in TAS (−13% vs. 16%, p = .035). Postsupplementation there was an increase in TAS values in children with diabetes, but they were still lower than in healthy controls. Indian diabetic children have compromised antioxidant status, which may be improved by incorporation of multimicronutrient-rich recipes in their diets.

Household water treatment and the nutritional status of primary-aged children in India: findings from the India human development survey

BackgroundPoor water quality, one of the leading causes of diarrhea, is an issue for most developing countries. Although the health burden of poor-quality water has been studied extensively, there is a paucity of research regarding the impact of household water treatment (HWT) on children’s nutritional status using data from large-scale surveys. In this research, we study the effect of HWT on the nutritional status of primary-aged children in India using a secondary data set consisting of 20,315 children between the ages of 6 and 14 (10,523 males and 9,792 females) in 12,839 households from the second wave of the India Human Development Survey (IHDS-II).MethodsThe IHDS-II is a nationally representative, household-based, comprehensive, and face-to-face survey. Households were selected using stratified random sampling, and a team consisting of one male and one female interviewer visited each household between November 2011 and October 2012. A knowledgeable member, typically the male head of household, was interviewed about the socioeconomic condition of the household. An ever-married woman between the ages of 15 and 49, typically the wife of the male head of household, answered questions related to education and health. The height and weight of all eligible household members were measured by interviewers. Correlation between HWT and nutritional status was computed first, and the estimation of a generalized simultaneous equation model, in which a binary indicator of HWT and other covariates was included, was carried out afterward.ResultsBivariate analysis shows a negative association between the nutritional status of children and HWT. Additionally, findings from the generalized simultaneous equation model demonstrate that HWT increases the probability of producing normal-weighted primary-aged children by 1.7 %, while it decreases the probability of primary-aged children being thin by 2.5% and being severely thin by 1.7% in India.ConclusionsThis study indicates that HWT has the potential to advance the nutritional status of primary school-aged children in India.

Determinants of Vitamin D Status in Indian School-children.

Introduction:Due to the high prevalence of Vitamin D deficiency in spite of abundant sunshine and scarcity of studies investigating Vitamin D status in Indian children from rural and semirural areas, the objectives of this cross-sectional study were to: (1) assess the Vitamin D status of school-children in a semi-rural setting and (2) identify the determinants of Vitamin D status in these children.Materials and Methods:Data collected included anthropometric measurements (height and weight), body composition, three-one-day dietary recall method, demographic data, and sunlight exposure. Serum 25-hydroxyVitamin D (25(OH)D) was estimated by enzyme-linked immunosorbent assay (ELISA) technique. SPSS software was used for statistical analysis.Results:Anthropometric characteristics of the children were similar and mean serum 25(OH)D concentration was 58.5 ± 10.3 nmol/L with no significant differences between genders. Around 80% children reported sunlight exposure of 2 h or more. A majority (71%) of children were Vitamin D insufficient with serum 25(OH)D concentrations between 50 and 74.9 nmol/L. Determinants of Vitamin D identified were duration of sunlight exposure and body fat percent. Significant (P < 0.05) positive association of duration of sunlight exposure was observed with serum 25(OH)D concentrations, while BF% showed a negative association with serum 25(OH)D (β = –0.307; standard error = 0.1388; P < 0.05).Discussion:We have reported a high prevalence of Vitamin D insufficiency in school-children aged 6–12 years, from a semirural setting, in spite of a majority (80%) reporting >2 h of sunlight exposure. We have also demonstrated that duration of sunlight exposure and body fat percentage are the two important determinants of serum 25(OH)D concentrations in these children.

Bone health status in Indian children with type 1 diabetes as assessed by peripheral quantitative computer tomography (pQCT)

Bone health status in Indian children with type 1 diabetes as assessed by peripheral quantitative computer tomography (pQCT)

STATE-LEVEL DIETARY DIVERSITY AS A CONTEXTUAL DETERMINANT OF NUTRITIONAL STATUS OF CHILDREN IN INDIA: A MULTILEVEL APPROACH

This study aimed to identify the determinants of nutritional status of children in India with a special focus on dietary diversity at the state level. Household-level consumption data from three rounds of the Consumer Expenditure Survey of the National Sample Survey Organization (1993-2012) were used. Information on the nutritional status of children was taken from the National Family Health Survey (2005-06). Dietary diversity indices were constructed at the state level to examine diversity in quantity of food consumed and food expenditure. Multilevel regression analysis was applied to examine the association of state-level dietary diversity and other socioeconomic factors with the nutritional status of children. It was observed that significant variation in childhood stunting, wasting and underweight could be explained by community- and state-level factors. The results indicate that dietary diversity has increased in India over time, and that dietary diversity at the state level is significantly associated with the nutritional status of children. Moreover, percentage of households with a regular salaried income in a state, percentage of educated mothers and mothers receiving antenatal care in a community are important factors for improving the nutritional status of children. Diversity in complementary child feeding is another significant determinant of nutritional status of children. The study thus concludes that increasing dietary diversity at the state level is an effective measure to reduce childhood malnutrition in India.

Health Status of Children in India

India with a population of 1.21 billion population stand at the second position as the most populous country in the world after China. India comprises almost 13.1 per cent of child population aged 0-6 years. Children of today are tomorrow’s citizens; hence it is very necessary to provide better health care facilities to them. India accounted almost 43 per cent underweight children against 32 percent in Pakistan, 9 percent in South Africa. Nutritional level among the children is the basic element of their overall mental and physical development. Malnutrition among the children reduced significantly over the time, but still the number of malnourished children is very high in the country. Malnutrition and mortality among children are the two faces of a single coin. Mortality among infants and under-5 children is also a major concern. In India the number of under-5 mortality rate and infant mortality rates are 49 and 42, respectively. Thus there is a need, to be more focused on the child health issues. The main objective of this paper is to study the child health condition in terms of nutrition and survival rate. The study is based on the secondary data from various published reports of the government of India.

Trends in nutrient intakes, nutritional status, and correlates of undernutrition among rural children below 5 years of age: The National Nutrition Monitoring Bureau Survey 2012.

Background:In spite of several national nutrition intervention programs that have been in operation since the past four decades, undernutrition continues to be an important public health problem in India.Aim:The aim of the present study was to assess the trends in food and nutrient intakes and nutritional status of children in India below 5 years of age.Setting and Design:A community-based, cross-sectional study was carried out in ten National Nutrition Monitoring Bureau states by adopting a multistage random sampling procedure.Methods:Data were collected on the household (HH) socioeconomic and demographic particulars, and anthropometric measurements of the children, such as their length/height and weight, were noted. A 24-h dietary recall method was used for assessing dietary intake.Results:Intake of all the foodstuffs except pulses, vegetables, and fats and oils declined over a period of time (1975–1979 to 2011–2012) while the intake of all the micronutrients except Vitamins A and C declined during the same period. The prevalence of undernutrition, i.e. underweight, stunting, and wasting has declined from 76%, 82%, and 27%, respectively in 1975–1979 to 42%, 44%, and 19%, respectively, in 2011–2012 among 1-5 year children. The severe form of undernutrition has also declined during the same period. The prevalence of undernutrition was significantly (P < 0.01) higher among children of illiterate mothers, those belonging to lower socioeconomic status, and those living in nuclear families.Conclusions:The prevalence of undernutrition declined over the period despite the decrease in food and nutrient intake. However, the pace of decline was slower and it was attributed to improved health-care services coupled with control of communicable diseases and increase in the HHs income. Further efforts are needed to improve the literacy of parents, environmental and personal hygiene, along with the food security of HHs through a public distribution system.

Relationship between Physical Fitness and Functional Status in Indian Children with Spastic Cerebral Palsy-A Cross Sectional Study

A major problem with cerebral palsy children in India is that they lag behind in daily functional life activities that limits their participation in performance related physical fitness and limits them in achieving their greatest potential in functional status. The aim of the study is to find weather the fitness components are related to the functional status in Indian children with spastic cerebral palsy

Evaluation of Thyroid Hormone Status in Children with Steroid Resistant Nephrotic Syndrome: A North India Study.

Steroid resistant nephrotic syndrome (SRNS) has a chronic and progressive course. Limited data is available evaluating thyroid function parameters in SRNS patients. The aim of the present study was to evaluate the thyroid hormone status in Indian children with SRNS. The present cross-sectional study included 50 patients aged 1-12 years with SRNS. As per Up:Uc ratio divided into three groups: Group A) 16 patients of SRNS in complete remission Group B) 14 patients of SRNS in partial remission Group C) 20 patients of SRNS in relapse. Serum levels of FT3, FT4 and TSH were measured in all. 20% of the children (n=10) with SRNS had hypothyroidism (7 subclinical hypothyroidism and 3 with overt hypothyroidism). One child was found to be in complete remission, 4 in partial remission and 5 in relapse phase. TSH levels were found to be significantly elevated in children with relapse (p = 0.042). Serum albumin showed a significant negative correlation with Up:Uc ratio ( p < 0.0001) whereas total cholesterol showed a significant positive correlation (p < 0.001). On correlating TSH level with Up:Uc ratio a significant positive correlation ( p = 0.0098) was observed. Subclinical hypothyroidism in SRNS is temporary and may improve with remission. However prolonged proteinuria in SRNS patients may lead to progressive damage of the renal tubules and impaired absorption of Low Molecular Weight (LMW) proteins which may further exhaust the thyroid reserve and lead to overt hypothyroidism. Therefore thyroid examination should be routinely advocated in these children.

Bone status of Indian children and adolescents with type 1 diabetes mellitus

Bone status of Indian children and adolescents with type 1 diabetes mellitus

Body fat percentage and its correlation with dietary pattern, physical activity and life-style factors in school going children of Mumbai, India

Introduction: Nutritional status of Indian children is a double-edged sword, reflecting dual burden of malnutrition. The standard norm of body mass index (BMI) percentiles may not reflect adiposity in children at both ends of the spectrum of malnutrition. The aim of the following study was to estimate body fat percentage of school-going children of different socio-economic strata and to compare it with BMI percentiles in an effort to identify the lean obese in malnourished children. An attempt was also made to correlate body fat percentage with dietary intake pattern and life-style factors including levels of physical activity, breakfast-eating patterns, frequency of eating out and sleep patterns. Materials and Methods: The sample comprised of 764 school-going children aged 10-17 years from private and government schools of Mumbai with a majority in the age group of 10 to 15 years. Results: The results indicate a high prevalence of underweight in government and private school children (82.7% and 55% respectively) based on BMI percentiles. A high percentage of government school and private school children (69.1% and 39.4%, respectively) were also classified in the category of very less body fat. The mean BMI was 18.97±3.79 and 16.09±2.9, respectively and the mean body fat percentage was 17.43±9.79 and 11.29±7.0 respectively in private and government school children There was an increase in the percentage of children who were overweight and obese in private schools (from 4.9% to 22.9%) and in government schools (from none to 4.3%) when they were classified based on body fat percentage. A number of children in underweight and normal categories of BMI did show high body fat percentage. Body fat was positively correlated to poor quality of eating and lifestyle factors including quantum of refined flour bakery products (P=0.001), eating out frequency (P=0.001), less duration of sleep (P=0.001), increased TV-viewing (P=0.013); it was negatively correlated to frequency and quantity of salad consumption (P=0.001), regular breakfast-consumption pattern (P=0.001) and increased level of physical activity (P=0.001). Conclusion: The study gives an insight in body fat percentage of Indian children and its relationship to dietary pattern and life-style factors.

Association of Inadequately Iodized Salt Use With Underweight Among Young Children in India

This article explores the association between use of inadequately iodized cooking salt and underweight among young children in India. Considerable variation was found in the use of non-iodized salt (0 parts per million) across regions, economic status, and social groups. Results show that economic status and social affiliation of the households were the important predictors of non-iodized salt usage. Moreover, results from the multinomial logit model show that use of inadequately iodized salt is significantly associated with lower weight-for-age Z score, after adjusting for potential confounding variables. Nonuse of adequately iodized (15+ parts per million) salt is statistically associated with moderate underweight (relative risk ratio [RRR] = 1.09; 95% confidence interval [CI] = 1.07-1.11) and with severe underweight (RRR = 1.18; 95% CI = 1.15-1.21). Concerted effort is needed to correct the inequity in the access to iodized salt to improve the nutritional status of children in India.

Micronized ferric pyrophosphate supplied through extruded rice kernels improves body iron stores in children: a double-blind, randomized, placebo-controlled midday meal feeding trial in Indian schoolchildren

Micronized ferric pyrophosphate (MFPP) in extruded rice kernels mixed in a rice-based meal could be an effective strategy for improving iron status of children in India. The objective was to determine the impact of MFPP supplied through extruded rice kernels in a rice-based meal on iron status of children participating in the midday meal (MDM) scheme in India. The sensory characteristics of cooked rice containing MFPP in extruded rice kernels, in vitro availability, and loss of iron during cooking from a typical MDM consisting of 125 g rice (dry weight) containing 19 mg Fe [fortified rice (FR); normal rice mixed with Ultra Rice (extruded kernels containing MFPP of ∼3.14-μm mean particle size)] in comparison with unfortified rice (UFR) were tested. A double-blind, 8-mo, placebo-controlled trial was conducted in 5-11-y-old schoolchildren (n = 140) who were randomly assigned to receive either an FR-MDM or a UFR-MDM. Average consumption amounts of the MDM, height, weight, hemoglobin, ferritin, and C-reactive protein were measured at baseline and at 8 mo. The sensory qualities of cooked FR and UFR were similar. The in vitro iron availability from FR-MDM (1.3%) was significantly (P < 0.05) lower than that from UFR-MDM (3.3%). Providing FR-MDM to the schoolchildren for 8 mo improved ferritin significantly (P < 0.001), by 8.2 ± 2.10 μg/L. However, the increase in hemoglobin was similar between groups (FR: 0.99 ± 0.10 g/dL; UFR: 1.15 ± 0.10 g/dL), which suggests that other factors beyond additional iron intake had a large influence on hemoglobin concentration. The prevalence of iron deficiency decreased significantly (P < 0.05) in the FR group (33-14%) and increased marginally in the UFR group (31-37%). The prevalence of anemia and iron deficiency anemia was similar between groups at baseline and at 8 mo. Regular intake of 19 mg Fe/d in MFPP supplied through extruded rice kernels improves iron stores and reduces iron deficiency among schoolchildren in India.