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Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. Sample: This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Measurement: Random blood glucose was assessed for each participant using a finger prick test. Results: The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. Conclusion: The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden. [ABSTRACT FROM AUTHOR]

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems ( CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. Methods CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. Results CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing ( MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. Conclusions CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India. [ABSTRACT FROM AUTHOR]

Age-appropriate infant and young child feeding (IYCF) practices are critical to child nutrition.The objective of this paper was to examine the associations between age-appropriate IYCF practices and child nutrition outcomes in India using data from ~18 463 children of 0-23.9 months old from India's National Family Health Survey, 2005-06-3. The outcome measures were child height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-height z-score, stunting, underweight and wasting. Linear and logistic regression analyses were used, accounting for the clustered survey data. Regression models were adjusted for child, maternal, and household characteristics, and state and urban/rural residence. The analyses indicate that in India suboptimal IYCF practices are associated with poor nutrition outcomes in children. Early initiation of breastfeeding and exclusive breastfeeding were not associated with any of the nutrition outcomes considered. Not consuming any solid or semi-solid foods at 6-8.9 months was associated with being underweight (P < 0.05). The diet diversity score and achieving minimum diet diversity (⩾4 food groups) for children 6-23 months of age were most strongly and significantly associated with HAZ, WAZ, stunting and underweight (P < 0.05). Maternal characteristics were also strongly associated with child undernutrition. In summary, poor IYCF practices, particularly poor complementary foods and feeding practices, are associated with poor child nutrition outcomes in India, particularly linear growth. [ABSTRACT FROM AUTHOR]

In India, poor feeding practices in early childhood contribute to the burden of malnutrition as well as infant and child mortality. This paper aims to use the newly developed World Health Organization (WHO) infant feeding indicators to determine the prevalence of complementary feeding indicators among children of 6-23 months of age and to identify the determinants of inappropriate complementary feeding practices in India. The study data on 15 028 last-born children aged 6-23 months was obtained from the National Family Health Survey 2005-2006. Inappropriate complementary feeding indicators were examined against a set of child, parental, household, health service and community level characteristics. The prevalence of timely introduction of complementary feeding among infants aged 6-8 months was 55%. Among children aged 6-23 months, minimum dietary diversity rate was 15.2%, minimum meal frequency 41.5% and minimum acceptable diet 9.2%. Children in northern and western geographical regions of India had higher odds for inappropriate complementary feeding indicators than in other geographical regions. Richest households were less likely to delay introduction of complementary foods than other households. Other determinants of not meeting minimum dietary diversity and minimum acceptable diet were: no maternal education, lower maternal Body Mass Index (BMI) (<18.5 kg/m2), lower wealth index, less frequent (<7) antenatal clinic visits, lack of post-natal visits and poor exposure to media. A very low proportion of children aged 6-23 months in India received adequate complementary foods as measured by the WHO indicators. [ABSTRACT FROM AUTHOR]