Susmita Bharati

Prevalence of Anemia and Its Determinants Among Nonpregnant and Pregnant Women in India

This study investigates the severity and distribution of anemia among nonpregnant and pregnant women aged 15 to 49 years in urban and rural sectors of 26 states in India and its association with certain economic and biosocial factors. A national survey was conducted to collect data on hemoglobin, height, weight, and certain economic and biosocial factors of 72 660 nonpregnant and 5619 pregnant women. Nonpregnant women aged less than 25 years are most affected by anemia. Womens education and standard of living in the households have a vital role in reducing anemia. Urban and well-nourished women also suffer less from anemia. The severity of anemia is higher among pregnant than nonpregnant women. Efforts must be made to educate women and enhance their level of economic status so that the prevalence of anemia can be reduced substantially.

Determinants of nutritional status of pre-school children in india

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.

SOCIOECONOMIC DIFFERENTIALS IN NUTRITIONAL STATUS OF CHILDREN IN THE STATES OF WEST BENGAL AND ASSAM, INDIA

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998-99 (NFHS-2). The three indices of malnutrition taken for analysis are weight-for-height (WHZ), height-for-age (HAZ) and weight-for-age (WAZ). These are assumed to depend on birth order, preceding birth interval, parents educational status, working status of the mother, mothers age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age.

Prevalence and causes of chronic energy deficiency and obesity in Indian women.

ABSTRACT We investigate the nutritional status of women in India and its relation to the prevalence of chronic energy deficiency (CED) and obesity. To do this, we have used the data from the Indian National Family Health Survey, 1998–1999, on body mass index (BMI) of ever-married women, ages 15–49 years, along with several socioeconomic factors, such as level of education, religion or caste, occupational status, and standard of living index. The study was based on 81,712 women from 26 states and 6 zones, which were grouped according to geographic proximity of the states of India. A multiple linear regression analysis was done to see the relation between nutritional status of women and different socioeconomic factors. The data reveal that the prevalences of CED, overweight, and obesity in India are 31.2%, 9.4%, and 2.6%, respectively. The incidences of CED and obesity are negatively related. The prevalence of CED is the lowest in Arunachal Pradesh and highest in Orissa. Punjab has the highest prevalence of obesity, and Bihar has the lowest. For the zonewise distribution the Northeast zone has the lowest degree of prevalence of CED and the East zone is at the bottom of the list with the highest degree of malnutrition. We also found that the nutritional status of women goes together with the enhancement of their educational status, standard of living, and so on. There are also significant differences between rural and urban sectors and among castes, religions, and occupations. Furthermore, regression analysis shows that all the socioeconomic variables considered here significantly affect BMI in Indian women.

Body Mass Index and Chronic Energy Deficiency of Adult Males of Central Indian Populations

ABSTRACT Data on body weight, height, and sitting height from 11,496 adult males, age 18–62 years, belonging to 38 different populations of five major social groups (scheduled tribes, scheduled castes, “other backward castes,” general castes, and Muslims) of Central India were taken for our analysis to assess the nutritional status of these groups. Cormic index and body mass index (BMI) were computed, and an analysis of variance (ANOVA) was carried out among different populations as well as among social groups separately on Cormic index and BMI. Shape, size, and generalized distances among the different social groups were computed and dendro-grams were drawn. The level of malnutrition is the lowest among the general castes. The opposite is the case with the scheduled castes and scheduled tribes. Comparison of the coefficient of variation shows that there is variation in weight and BMI but that there is no marked variation in the other anthropometric variables. The ANOVA on Cormic index and BMI suggests that the people within a population are more homogeneous than the people between populations. There is a positive but statistically insignificant correlation between Cormic index and BMI. The five social groups differ more in size distance than in shape distance. According to the dendrogram of generalized distance values, the Muslims and the general castes can be grouped into one cluster and the scheduled castes, scheduled tribes, and other backward castes can be grouped into another cluster.

Spatial patterns of anthropometric variation in India with reference to geographic, climatic, ethnic and linguistic backgrounds.

Background: Anthropometric variation can be fruitfully utilized to investigate microevolutionary processes. Anthropometric variations in the Indian subcontinent based on stature and three indices (Cephalic Index, Nasal Index, and Total Facial Index) are highly variable and discriminative among populations across geographical regions. Aims: Anthropometric variation in stature, Cephalic Index (CI), Nasal Index (NI) and Total Facial Index (TFI) were investigated with respect to ethnic, linguistic, geographical and climatic affiliation, across the Indian subcontinent. Subjects and methods: Published data on anthropometric variations of 531 populations from the Indian subcontinent were analysed using discriminant analysis and spatial autocorrelation analysis. Results: Discriminant analysis of the four anthropometric variables shows that stature and NI are good discriminators for populations of different languages. Stature, NI and CI discriminate well among populations of diverse ethnic origin and climatic conditions in different regions. TFI is not a good discriminator for populations of diverse ethnic, linguistic and climatic attributes. Spatial autocorrelation analysis showed significant departure from randomness, suggesting geographic structuring. The Morans I estimate is positive and statistically significant for the four variables at low distances but exhibits significant negative association at higher values. Conclusion: The results suggest geographical clines for the four anthropometric variables and indicate the influence of population structure on the studied variables.

Trends in Socioeconomic and Nutritional Status of Children Younger Than 6 Years in India

The main aims of this study are to find out the trends in the (a) prevalence of undernutrition and severe anemia and (b) degree of association of undernutrition and severe anemia in children younger than 6 years in India with some socioeconomic variables. Using the Reproductive and Child Health Survey data, z score of weight for age and hemoglobin status were analyzed to understand the state and agewise variation and their association with the sociodemographic variables through logistic regression. The prevalence of malnutrition according to both the criteria was first seen to increase, attain a maximum value at some age between 12 and 48 months, and then decrease. Statewise distribution showed a close link between the stage of development and the prevalence of malnutrition—prevalence rate being less for developed states. The rates were also less for the Northeastern states of India. The regression analysis clearly points out that children with illiterate mothers, of lower age groups, or from low standard of living households are more prone to become malnourished. The economic growth alone is not sufficient for substantially reducing malnutrition. It is necessary to improve the rate of literacy, especially of women, to reduce the prevalence of malnutrition and anemia among children. It is not only economic development but also overall human development that is needed in India.

Burden of Anemia and its Socioeconomic Determinants among Adolescent Girls in India

Background Anemia is still one of Indias major public health problems, especially among adolescent girls. Objective To investigate the severity and distribution of anemia among Indian adolescent girls aged 10 to 19 years and its association with socioeconomic and sociodemographic factors. Methods The study used data from the District Level Household Survey, round II, 2002–04, conducted under the Reproductive and Child Health Project. Data were collected on hemoglobin along with socioeconomic and sociodemographic factors of the households. The survey covered rural and urban areas of 35 states or union territories. Data from 177,670 adolescent girls were analyzed. Results The highest prevalence of anemia (99.9%) was observed in Jharkhand in eastern India. The prevalence in the northeastern states was relatively low. The highest prevalence rates were observed among older girls (15 to 19 years), illiterate girls living in rural areas, girls in illiterate households, girls from households with a low standard of living, non-Christian girls, girls from Scheduled Tribes, girls living in west India, and married girls. The highest percentages of girls with normal hemoglobin were reported among Christian Scheduled Tribes (39.4%) and among girls in northeastern India (40.1%). Analysis by binary ordered logistic regression showed that anemia status did not depend on urban or rural residence or on age. Conclusions Enhancement of the economic status of families, especially poor families, is a prerequisite to the amelioration of anemia among adolescent girls. The level of education of the girls is also a major factor.

Socioeconomic determinants of iron-deficiency anemia among children aged 6 to 59 months in India.

The extent of anemia and its socioeconomic determinants among the preschool children (6-59 months old) in India have been studied in this article. Relevant data are taken from the third round of the National Family Health Survey. The initial analysis reveals some interesting features. The most affected children are in the age-group of 6 to 23 months. Beyond this age a decreasing trend is observed up to the age of 48 to 59 months. The highest and the lowest prevalence of anemia have been found to be in the central and the northeast zones, respectively. The vulnerable groups are the children of illiterate parents and those belonging to the poor families in the rural areas. Categorical logistic regression also confirms that status of literacy and wealth of parents have strong negative association with the status of anemia of the children.

Growth and nutritional status of Bengali adolescent girls

ObjectiveAssessment of the growth and nutritional status among healthy Bengali adolescent schoolgirls at peri-urban area.MethodsIn this cross sectional study, sample consists of 527 school going adolescent girls, aged 10 to 18 years. The sample of the present study was collected from a peri-urban area (Duttapukur) of north 24 parganas district of West Bengal, India. Standard anthropometric measurements including linear, curvilinear and skinfold thickness were collected from each subject. Percentile curves and nutritional indices were used to determine the growth and nutritional status respectively.ResultsThe nature of distance curves and percentile curves of the body measurements showed a high rate of increase in 10–11 years of age group corresponding to an earlier adolescent growth spurt than average Indian girls. The adolescent girls in the current study were found to be significantly (p<0.0001) taller than Indian girls and heavier than both Indian and urban Bengali girls but slightly shorter than urban Bengali girls. They are significantly (p<0.0001) shorter and lighter than American girls, which also corresponded to 50th percentile curves. Age specific nutritional assessment shows different grades of malnutrition among them. Gomez’s classification indicates about 60 % to 70 % adolescent girls show either moderate to mild malnutrition during their growth period. Both the indices of Waterlow’s classification show least percentage of least malnutrition among the girls.ConclusionThe growth pattern and nutritional status observed among adolescent girls in peri-urban situation show heterogeneity with respect to some anthropometric traits and in conformity with the growth pattern and nutritional status of urban girls.