Akhil Bandhu Biswas

Assessment of Nutritional Status by Composite Index for Anthropometric Failure: A Study Among Slum Children in Bankura, West Bengal

A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.

Status of birth preparedness and complication readiness in Uttar Dinajpur District, West Bengal

CONTEXT Birth Preparedness and Complication Readiness (BPCR) is crucial in averting maternal morbidity and mortality. OBJECTIVES To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Uttar Dinajpur, West Bengal. MATERIALS AND METHODS This is a cross-sectional, community-based, mixed methods study. Two-stage, 40 cluster sampling technique was used to select three pregnant and six recently delivered women separately. Information on socio-demographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. In-depth interviews with one respondent per cluster were also conducted. For statistical analysis Z test was used. RESULTS Around 50% of the respondents planned for first antenatal check-up (ANC) within 12 weeks, four or more ANCs and institutional delivery. Proportion of women aware of at least one key danger sign each of pregnancy, labor, postpartum, and newborn ranged from 12.1% to 37.2%, whereas 58.3% knew at least one key component of essential newborn care. Around two-thirds and one-third of women, respectively, especially those from backward and below poverty line (BPL) families knew about cash incentive and referral transport schemes. Proportions of women with first ANC within 12 weeks, four or more ANCs, institutional delivery, saving money, identifying transport, and blood donor were 50.4%, 33.6%, 46.2%, 40.8%, 27.3%, and 9.6%, respectively. Hindu religion, backward castes, BPL status, and education ≥ 5 years influenced the practices except for two regarding ANC. Overall BPCR index of the study population was 34.5. CONCLUSION Preparedness in health system, ensuring competence, and motivation of workers are needed for promoting BPCR among the study population.

Association of child feeding practices with nutritional status of under-two slum dwelling children: a community-based study from West Bengal India.

A cross-sectional study was conducted among 245 under-two slum-dwelling children in Bankura town, West Bengal, to assess their feeding practices and its association with nutritional status. Childs gender, number of family members, standard of living (SLI), and household food security (HFS) were assessed through interview of mothers/ caregivers. Child feeding practices were measured with Composite Child Feeding Index comprising of age-appropriate, multiple, infant and young child feeding (IYCF) indicators and expressed in standardized IYCF score. Weight and length of the children were measured and the nutritional status was assessed using World Health Organization Growth Standard 2006. Standardized IYCF score was significantly lower in undernourished children than those with normal grades. Per unit increase in standardized IYCF score was likely to reduce the prevalence of underweight, stunting and wasting by 2-3% after adjusting for other variables. Low/ very low HFS, low SLI and female gender were associated with underweight and stunting.

Skill of Frontline Workers Implementing Integrated Management of Neonatal and Childhood Illness: Experience from a District of West Bengal, India

A cross-sectional study was conducted in Purulia district, West Bengal, India, to assess the skill of 155 frontline workers implementing Integrated Management of Neonatal and Childhood Illness (IMNCI) and the logistic support thereof. The skills of counting respiratory rate, assessing immunization status in both age groups, assessment of breastfeeding in young infants and plotting of weight in a growth chart in case of children aged 2-59 months were acquired by majority of workers. Around two-thirds workers synthesized correct classification and nearly 60% gave appropriate management of at least one subgroup. In 30-40% cases, carers received feeding advices. Around 50% casesheets were complete and timely report submission rate was nearly 70%. Necessary equipments were available with majority of workers except the utensils for preparation of ORS. The supply of essential drugs varied from 33.5 to 71.6%. These findings suggest that IMNCI program offered a scope for capacity-building and infrastructure strengthening of the health system.

Awareness and perception of mothers about functioning and different services of ICDS in two districts of West Bengal

Integrated Child Development Services, a national programme of the Government of India has health, nutrition, and pre-school education components of services. To ascertain awareness, perception of mothers about functioning and different services of ICDS a cross-sectional community based study was conducted between June to September 2007 in Howrah and Purulia districts of West Bengal. A total of 1235 mothers were included as study subjects. As per opinion of the mothers 73% AWCs opened regularly, behaviour of the AWWs was friendly (71.6%) and 63% mothers opined that ICDS is beneficial to their children. 84.2% mothers were aware of any ICDS services. Quantity and quality of supplementary food was acceptable to 88% and 72.7% mothers respectively. 79.2% and 87.5% mothers did not receive any advice on child feeding and growth chart. Making beneficiaries aware about services by targeted interventions will ensure better utilization of ICDS.

Goitre prevalence, urinary iodine and salt iodisation level in a district of West Bengal, India.

Objectives: We carried out a study to assess the prevalence of goitre, measure urinary iodine excretion (UIE) levels and to estimate salt iodine content at the household level in Howrah district of West Bengal, India. Methods: Study Design: This is a Cross-sectional descriptive study conducted in September–December 2006. Setting: Primary schools located in 30 clusters (villages and wards) randomly selected through <5001>30 cluster<5002> sampling methodology. Participants: 2400 school children, aged 8–10 years. Indicators: The indicators used in this study to assess for IDD were recommended by the WHO/UNICEF/ICCIDD. Goitre was assessed clinically by the standard palpation technique. The urinary iodine excretion level was analyzed by the wet digestion method. Salt samples consumed at the household level were collected and tested by the spot iodine testing kit to measure iodine content. Results: The Total Goitre Rate (TGR) was 13.7% (95% CI = 12.3–15.1%). Grade 1 was 11.4% and Grade 2 (visible goitre) was 2.3%. The TGR was influenced by the age and sex factors but not by religion and residence. The median urinary iodine excretion level was 13 μg/dL (normal range: 10–20 μg/dL) and none had a value less than 5 μg/dL. There was significant negative correlation between UIE levels and the age and place of residence factors. Almost 80% of salt samples tested had adequate iodine content (≥ 15 ppm). Consumption of iodized salts was lower among Hindus and in rural area. Conclusion: In conclusion, the Howrah district is in a transition phase from iodine deficiency to iodine sufficiency.

Are the Adolescent Behaviors too Risky? A School-based Study in a District of West Bengal, India

A cross-sectional study was undertaken among 2068 school-going adolescents of a subdistrict area of West Bengal, India for assessment of entire array of risk behaviors and their correlates. Aggressive, suicidal, substance use and sexual risk behaviors were measured using a self-administered, multi-item, validated questionnaire in the local vernacular. Prevalence of physical fights, weapon carrying in the last 30 days and gang fights in the last 12 months were 27.1%, 7.3% and 13.0%, respectively. Current users of tobacco, alcohol and illicit substances were 7.1%, 3.4% and 2.0%, respectively. Suicidal ideation and attempts were reported by 11.7% and 3.5% of students. Almost one-tenth of respondents had premarital sexual intercourse. Male gender, low subjective economic status, exposure to electronic media and poor academic achievements were associated with most of the studied risk behaviors, except that females showed more propensities to suicidal behavior. The magnitude and pattern of adolescent risk behaviors, though less studied in India, warrants urgent, coordinated actions.

Enduring starvation in silent Population: A study on prevalence and factors contributing to household food security in the tribal population in Bankura, West Bengal

BACKGROUND Strengthening food security enhancement intervention should be based on the assessment of household food security and its correlates. OBJECTIVES The objective was to find out the prevalence and factors contributing to household food security in a tribal population in Bankura. METHODS A cross-sectional study was conducted among 267 tribal households in Bankura-I CD Block selected through cluster random sampling. Household food security was assessed using a validated Bengali version of Household Food Security Scale-Short Form along with the collection of information regarding the monthly per capita expenditure (MPCE), total to earning member ratio, BPL card holding, utilization of the public distribution system (PDS) and receipt of any social assistance through a house-to-house survey. RESULT AND CONCLUSION Overall, 47.2% of study households were food secure whereas 29.6% and 23.2% were low and very low food secure, respectively. MPCE ≥ Rs. 356, total to earning member ratio ≤ 4:1, regular utilization of PDS, and nonholding of the BPL card were significantly related with household food security.

Birth preparedness and complication readiness among women of Bankura District, West Bengal

Background: Birth preparedness and complication readiness (BPCR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency which is critical in averting maternal morbidity and mortality. Objectives: To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Bankura, West Bengal. Materials and Methods: A cross-sectional, community-based study was carried out among 120 pregnant women and 235 recently delivered women. Information on sociodemographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. For statistical analysis Z-test was used. Results: The majority of respondents (69.3%) had registered for antenatal care within the first 12 weeks of their pregnancy and 74.0% of the recently delivered women had four or more antenatal check-ups and 81.3% had institutional delivery. The BPCR index of pregnant women and recently delivered women was 45.2 and 59.0, respectively, whereas BPCR index of the total was 52.1. Conclusion: Although the BPCR indicators are satisfying, the health system should use the opportunity during visits to health institutions to increase awareness among the pregnant women and her family on how to plan for the pregnancy and identify danger signs.

A study on utilization of Janani Suraksha Yojana and its association with institutional delivery in the state of West Bengal, India

Background: India launched the Janani Suraksha Yojana (JSY) on the principles of conditional cash transfer providing monetary incentive to needy women to improve access to institutional childbirth. Objectives: This study was conducted among JSY-eligible women who delivered between April 2012 and June 2012 to assess the utilization of cash incentives toward institutional delivery, along with other associated factors influencing institutional delivery. Methods: It was a cross-sectional, descriptive study conducted between July 2012 and May 2013 on 946 women selected through stratified random sampling of subcentres from better and worse performing districts of West Bengal. Results: 74.7% of the study population was JSY-eligible. 90.2% of those who took three antenatal check-ups (ANCs) and 36.8% JSY-noneligible women received cash. Government institutions were preferred for childbirth among all groups irrespective of JSY eligibility, receipt of cash, and number of antenatal visits. Overall, 78.8% opted for institutional delivery if they had received cash, which was significantly more than those who did not (64.5%). JSY-eligible women were 1.5 times more likely to deliver in government institutions compared to JSY-noneligible women. With no incentive, the likelihood of institutional delivery was halved. The distance of a 24 Χ 7 delivery hub beyond 5 km (74.8% vs. 81.8%), the religion of Islam (62.7% vs. 83.2%), and multiparity (63.9% vs. 83.6%) were significant deterring factors. Conclusion: Despite some inclusion and exclusion errors, cash incentive under JSY was associated with increased institutional delivery, especially in government institutions though there were other factors influencing the decision as well.