Search

This study reviews the performance of a community-based nutrition programme in preventing and treating wasting without complications among children under age three in urban informal settlements of India. Implemented by a non-profit organization, with national (Integrated Child Development Services [ICDS]) and city-level (Municipal Corporation of Greater Mumbai [MCGM]) government partners, the programme screened 7,759 children between May 2014 and April 2015. During this period, the programme admitted 705 moderately wasted and 189 severely wasted children into the treatment group and 6,820 not wasted children into the prevention group. Both prevention and treatment groups received growth monitoring, referrals to public health facilities, and home-based counselling (if <6 months) by community health workers. Treatment groups received additional home-based counselling and access to medical screenings. Severely wasted children also received access to ready-to-use therapeutic food. The study assessed default rates, wasting status, and average weight gain 3 months after admission. Factors associated with growth faltering in the prevention group were explored using logistic regression. Default rates for the severely wasted, moderately wasted, and prevention group were 12.7%, 20.4%, and 22.1%, respectively. Recovery rate was 42.4% for the severely wasted and 61.3% for the moderately wasted. For the moderately wasted, mean weight gain was 2.1 g/kg/day, 95% confidence interval (CI) [1.6, 2.6], and 4.5 g/kg/day for the severely wasted, 95% CI [3.1, 5.9]. Among prevention group children, 3.6% faltered into wasting-3.2% into moderate and 0.4% into severe. The paper gives insights into ways in which ICDS and MCGM can successfully integrate large-scale community-based acute malnutrition programming., (© 2019 John Wiley & Sons Ltd.)

This paper attempts a sub-state level analysis of health system efficiency, focusing on West Bengal, a low income Indian state. Using a stochastic frontier model, it provides an idealized yardstick for evaluation. Our results suggest that overall efficiency of the public health delivery system remains low due to considerable disparities across districts. This is owing to differentials in availability and utilization of inputs such as the per capita availability of hospitals, beds, and manpower, and adversely affects life expectancy. Overcoming these factoral disparities may help the deficient districts to improve life expectancy. It may require a considerable increase in medical and public health expenditure in rural areas in the state and especially calls for resource mobilization to improve infrastructure facilities and maintain essential supplies at primary health centers. This could be attempted partly through funds from the National Rural Health Mission (NRHM) and by improving rural sanitation in poorer districts. [ABSTRACT FROM AUTHOR]

Ethno-racial minority families who come in contact with child protection services face unique challenges that include different ideas about appropriate child rearing practices, possibly different definitions of child maltreatment, the possibility of racial biases and service provision that does not address their particular needs. Ethno-racial minority immigrants encounter additional barriers to services associated with the challenges of settlement in a new cultural environment. Although considerable research has explored these issues, knowledge of the experiences of ethno-racial families who have been in contact with child protection is limited. The current paper provides insights from a qualitative study that explored the experiences of one ethno-racial group (South Asians) in Canada. Findings suggest a variety of reasons that families come into contact with the child protection system, and the characteristics of the sample highlight their difficult financial and employment circumstances. Themes include participants' desire to be better informed about the reasons for child protection involvement and about what they can expect from the worker and the agency. They also identified a wish for services that not only recognize their cultural diversity but also respond to the needs of the whole family. In-home services were especially appreciated. The findings reveal the resilience and personal agency among participants that can be enhanced through strength-based approaches to practice. Helping others, establishing community networks and developing needed services were avenues of resilience identified. [ABSTRACT FROM AUTHOR]

The purpose of this study is to identify the structure of marriage, with regional and local variations, in a Kuwaiti tribal community and an Indian village. It provides a rich description of life and culture of the study area in which it highlights the cultural differences between these areas. As the study progresses, it gives a comparative account of marriage and attempts to explain how the structure of marriage is shaped according to the culture. It also sheds light on how the empowerment of women has affected the institution of marriage and family. Finally, the paper shows that marriage is the basic institution in any society, regardless of the cultural variation. 2004) have convincingly argued that these challenges have their roots in the societal norms and values that concurrently developed throughout the unfolding history of the meaning of MR. As Priestly (1998) noted, although people with differences have existed in all societies, the degree to which they were integrated or excluded varied according to predominant cultural perceptions. Yazbeck, McVilly and Parmenter (2004) suggested that people's attitudes toward individuals with MR are socially constructed and are acquired through experience over time. Individuals with MR are often judged by people based on their disability instead of their whole lives and what they may accomplish and experience during their life (Blatt,987). Consequently, People may rely on false generalization and develop negative attitudes towards individuals with MR. Makas, Finnerty-Fried, Sugafoos, and Reiss (1988) noted that for nondisabled persons, positive attitude toward people with disability is usually conceptualized as being 'nice' and 'helpful', whereas for a person with a disability, the attitude would be dispensing with the category of disability entirely. A study of community attitudes in one state of Australia found that up to 86% of respondents reported feeling 'uncomfortable' when interacting with individuals with disabilities (Enhance Management, 999). Another study (European Commission, 2001) found that 40% of Europeans reported feeling 'uneasy' in the presence of people with disabilities. Attitudes manifest themselves as positive or negative reactions toward an object, driven by beliefs that impel individuals to behave in a particular way (Yuker, 1988). They comprise a complex of feelings, desires, fears, convictions, prejudices, or other tendencies learned through varied experiences that give rise to a set or readiness to act toward a person in a certain way (Chaiken & Stangor,987). This means that attitude is not behavior, but the precondition of behavior. In addition, Myers, Ager, Kerr, and Myles (1998) identified three types of attitudes that influence how non-disabled people interact with, and include or exclude people with disabilities: (1) A preparedness to engage with people as consumers, neighbors, or friends; (2) a lack of awareness about individuals with MR; and (3) a wariness or hostility regarding the idea of community integration. Research has shown that the third type of attitudes, which represents negative and non-acceptance of individuals with MR is commonly observed (Gething, 1994; Schwartz & Armony-Sivan, 2001 ). Such negative attitudes in a society may present people with MR as a burden on the welfare system. Moreover, people might not see individuals with disabilities as possessing a valuable social role or possessing the same abilities and characteristics that the majority of people possess. Thus, individuals with MR may not be accepted or included in society and may often be treated badly. In turn, Wolfensberger (1988) indicated that individuals with MR, being in a devalued position, would behave badly as they think that this is what is expected of them.… [ABSTRACT FROM AUTHOR]

Despite strong policy and program commitment, essential maternal nutrition services are not reaching enough women in many countries. This paper examined multifactorial determinants (personal, family, community, and health services) associated with maternal nutrition practices in Uttar Pradesh, India. Data were from a household survey of pregnant (n = 667) and recently delivered women (n = 1,835). Multivariable regression analyses were conducted to examine the determinants of four outcomes: consumption of diverse diets, consumption of iron folic acid (IFA) and calcium tablets, and weight monitoring during pregnancy. Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal program implementation. During pregnancy, women consumed 28 IFA and 8 calcium tablets, 18% consumed diverse diet, and 17% were weighed ≥3 times. Nutrition knowledge was associated with consumption of diverse diet (odds ratio [OR] = 2.2 times), IFA (2.3 times), calcium (11.7 times), and weight monitoring (1.3 times). Beliefs and self‐efficacy were associated with IFA (OR = 2.0) and calcium consumption (OR = 4.6). Family support and adequate health services were also associated with better nutrition practices. Under optimal program implementation, we estimate that 51% of women would have adequate diet diversity, an average consumption of 98 IFA, and 106 calcium tablets, and women would be weighed 4.9 times during pregnancy. Strengthening existing program operations and increasing demand for services has the potential to result in large improvements in maternal nutrition practices from current baseline levels but may not be sufficient to meet World Health Organization‐recommended levels without creating an enabling environment including improvements in education and income levels to support behaviour change. [ABSTRACT FROM AUTHOR]

The 'Dissertations into practice' feature began life in March 2012 with a dual aim: to encourage students and new professionals to write for publication and to highlight the impact of student research on policy and practice. This article reflects on the initiative and to summarise what has been achieved so far. It highlights the diverse range of contributions to the feature so far and proves that student research can and does influence policy and practice. It also demonstrates that, with a bit of encouragement and support, students are willing and able to write for academic publication. AM [ABSTRACT FROM AUTHOR]

Aim To study the frequency of islet antibodies in a large cohort of clinic- and community-based patients with Type 2 diabetes in northern India. Methods We measured glutamic acid decarboxylase ( GAD) antibodies in 618 adults with Type 2 diabetes (378 patients with diabetes attending a hospital clinic, 240 patients diagnosed in a community survey) and in 192 healthy subjects residing in north India. Islet antigen 2 ( IA2) antibodies were also studied in a proportion of the patients with diabetes ( n = 492) and in a control population ( n = 191). GAD and IA2 antibodies were measured by immunoprecipitation of the respective 35S-labelled recombinant antigen. Results We found that GAD antibodies were present in nine (1.5%) patients with diabetes (clinic population: 0.8%, community study: 2.5%), a prevalence similar to that among the subjects without diabetes ( n = 2; 1%). IA2 antibodies were detected in seven patients with Type 2 diabetes (1.4%) and in two healthy control subjects (1.0%). The frequency of either GAD or IA2 antibodies was similar in people with and without diabetes (3.2 vs 2.1%). No subject was found to have both antibodies. Insulin requirement was higher among antibody-positive than among antibody-negative patients ( GAD antibody: 33 vs 6.3%; P = 0.001; GAD or IA2 antibody: 23.1 vs 6.4%; P = 0.02); however, other clinical features were similar in the two groups. Conclusions In the present north-Indian population with Type 2 diabetes, the overall prevalence of GAD antibodies and the prevalence of either GAD or IA2 antibodies were considerably lower than those reported in white European populations. [ABSTRACT FROM AUTHOR]