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Background It is thought that there is a high risk of zinc deficiency in India, but there are no representative national estimates. Objectives We aimed to evaluate the national and state-level prevalence of low serum zinc concentrations (SZCs) in Indian children from the nationally representative Comprehensive National Nutrition Survey. Methods Prevalence of low SZC, adjusted for C-reactive protein, was estimated among preschool (1–4 y; n  = 7874) and school-age children (5–9 y; n  = 10,430) and adolescents (10–19 y; n  = 10,140), using SZC cutoffs defined by the International Zinc Nutrition Consultative Group. Results Prevalence of low SZC was high among adolescents (31.1%; 95% CI: 29.8%, 32.4%), compared with school-age (15.8%; 95% CI: 15.3%, 16.3%) or preschool children (17.4%; 95% CI: 16.7%, 18.0%). However, stratification of prevalence by fasting status or using an alternative lower SZC cutoff independent of fasting status led to a reduction in prevalence by 3.7% or 7.8% in children <10 y, respectively. The prevalence of low SZC was higher among rural preschool children, those belonging to households with poor socioeconomic status, and those with severe stunting or underweight. Preschool children with diarrhea (22.6%; 95% CI: 20.8%, 24.4%), productive cough (22.7%; 95% CI: 18.5%, 27.5%), or malaria/dengue (38.5%; 95% CI: 29.4%, 48.2%) in the 2 wk preceding the survey had a higher prevalence of low SZC than those without morbidity (16.5%; 95% CI: 15.9%, 17.2%; 17.6%; 95% CI: 16.9%, 18.2%; and 17.5%; 95% CI: 16.8%, 18.1%, respectively). Conclusions The national prevalence of low SZC among preschool (17%) or school-age children (16%) was <20%, which is considered the cutoff indicating a problem of public health significance; but there were variations by state and socioeconomic status. In adolescents, however, the prevalence of low SZC was 31%, which warrants further investigation. The association of low SZC with diarrhea in preschool children necessitates better coverage of Zn administration in the management of diarrhea. [ABSTRACT FROM AUTHOR]

• Multidimensional child poverty is notably more prevalent among STs and SCs. • Standard of living, ECD, and WASH are the dimensions that need committed thrust. • STs and SCs contribute more to the national MCP than their share of the population. • Head of household characterised by female gender, older age, and higher level of education is associated with a lower likelihood of MCP. • MCP tends to be more pronounced in nuclear families, households with 7+ members, rural areas, and central and eastern regions. Children are among the most vulnerable groups worldwide, bearing a disproportionate share of the burden of poverty. One-third of children, compared to one-sixth of adults, are multidimensionally poor. Experiencing poverty in childhood can have long-term negative consequences across generations. As a result, multidimensional poverty measures have recently been investigated in the child poverty literature. This study analysed multidimensional poverty among children (0–59 months) in India using the Alkire-Foster's counting approach and looked into how it differs across the country's well-known social stratification, the Caste system. The determinants of multidimensional child poverty (MCP) have been determined using multiple logistic regression. By using National Family Health Survey, 2019–21 data, the study revealed that the incidence of MCP in India is 32 %; highest among Scheduled Tribes (STs) (50 %), followed by Scheduled Castes (SCs) (37 %), Other Backward Classes (OBCs) (30 %) and 'Others' (22 %). Across all the Castes highest rates of deprivation were recorded in the indicators of standard of living and early childhood development (ECD) dimensions; together, they contribute more than 50 % to the MCP index (MCPI). The contribution of the water, sanitation, and hygiene (WASH) dimension in MCPI of STs is also noticeably higher (20.2 %). Of the 15 indicators considered, availability of TV/Radio, followed by immunisation, sanitation, cooking fuel, housing condition, and stunting, are the leading contributors with a combined contribution of more than 55 %. A child being a male, of higher birth order and born to a mother with higher years of schooling was more likely to experience multidimensional poverty. The household head's sex, age, and years of schooling were significantly associated with MCP. Across all castes, children from nuclear families, 7 + household members, higher number of children per woman, rural areas, central, eastern and north-eastern (except STs) regions were more likely to experience multidimensional poverty. [ABSTRACT FROM AUTHOR]

• Around 59% of the children are suffering from anaemia in India. • Overall, 36.8% of mother–child pairs are suffering from anaemia. • In India, higher double burden of anaemia is seen in Jharkhand and Haryana states and lowest in Mizoram state. • After controlling for significant background factors, poor household at higher risk of double burden of anaemia in India. The prevalence of anaemia among pregnant women in India continues to be high despite efforts to address the issue through iron-folic acid supplements under the national health program. It is estimated that about 50% of pregnant women, adolescent girls and children are anaemic. Anaemic women are at a significantly higher risk of morbidity, mortality, postpartum haemorrhage, and low birth outcomes, in addition to low birth weight and preterm birth of their babies due to poor intrauterine growth. The purpose of this study is to investigate anaemia among mother–child pairs — known as a double burden — in poor and non-poor households in India. The study uses data from the fourth round of the National Family Health Survey (NFHS). The survey collects information on the haemoglobin levels in mothers and children. Bivariate and multivariate analyses were used to determine the risk of anaemia in mother–child pairs among poor and non-poor households. Our survey found that, respectively, 57.1% and 58.7% of the mothers and children were suffering from anaemia; and the double burden was 36.8%. The double burden of anaemia was much higher among poor households (41.0%) as compared to the prevalence in non-poor households (33.1%). This pattern was observed across the background characteristics of the mothers, such as age, place of residence, education, caste, religion, Body Mass Index (BMI) and selected child factors. The adjusted odds for poor households, after controlling for significant background factors of the mothers and children, was found to 11% (OR:1.11, p-value:<0.001; 95%, CI:1.09–1.14) with higher odds of double burden as compared to non-poor households. The findings of the study point to the need for policies that are targeted at addressing the double burden of anaemia in poor households in India. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance In order to explore the traditional medicine practised by the ethnic communities residing in the topographically and climatically challenged Purulia, an underprivileged district of West Bengal, India, a quantitative ethnobiological approach was adopted to document the folkloric use of ethnomedicinals against different sexual, gynaecological and related ailments. Materials and methods Ethnobiological surveys were conducted during 2012–2015 by interviewing 82 informants or traditional healers with the help of a semi-structured questionnaire. The survey included questions on botanical and non-botanical ingredients and additives mixed with monoherbal and polyherbal formulations, vernacular names of the plants and animals, methods of preparation and administration and restrictions during medications. Additional quantitative indices such as use value, informant׳s consensus factor and fidelity level were used for data analysis. Results Twenty eight sexual and gynaecological disorders were found to be treated with 18 monoherbal and 31 polyherbal formulations consisting of a total number of 96 plant species from 86 genera and 47 families and four animal species. A variety of additives, either botanicals or non-botanicals were used with the formulations for higher efficacy and taste enhancement. Fabaceae (16 species) was found to be the most common family of medicinal plants whereas herbs (42.7%) and roots (32%) were the most common habit type and plant part used respectively. Use value, informant׳s consensus factor and fidelity level indicate frequency and coherence of citations. Conclusion Age old belief on traditional medicine prevails in the studied area due to its efficacy, inexpensive price and the remoteness of tribal villages from conventional medical centres. Traditional healers had detailed knowledge of preparations, doses, methods of administration, restrictions during medications, safety and efficacy of using folkloric therapeutics against sexual and gynaecological disorders. Possible synergistic interactions among phytochemicals and additives were indicated to explain enhanced therapeutic efficacy of mixed herbal formulations. [ABSTRACT FROM AUTHOR]

In India, “non-notified” slums are not officially recognized by city governments; they suffer from insecure tenure and poorer access to basic services than “notified” (government-recognized) slums. We conducted a study in a non-notified slum of about 12,000 people in Mumbai to determine the prevalence of individuals at high risk for having a common mental disorder (i.e., depression and anxiety), to ascertain the impact of mental health on the burden of functional impairment, and to assess the influence of the slum environment on mental health. We gathered qualitative data (six focus group discussions and 40 individual interviews in July–November 2011), with purposively sampled participants, and quantitative data (521 structured surveys in February 2012), with respondents selected using community-level random sampling. For the surveys, we administered the General Health Questionnaire-12 (GHQ) to screen for common mental disorders (CMDs), the WHO Disability Assessment Schedule 2.0 (WHO DAS) to screen for functional impairment, and a slum adversity questionnaire, which we used to create a composite Slum Adversity Index (SAI) score. Twenty-three percent of individuals have a GHQ score ≥5, suggesting they are at high risk for having a CMD. Psychological distress is a major contributor to the slum's overall burden of functional impairment. In a multivariable logistic regression model, household income, poverty-related factors, and the SAI score all have strong independent associations with CMD risk. The qualitative findings suggest that non-notified status plays a central role in creating psychological distress—by creating and exacerbating deprivations that serve as sources of stress, by placing slum residents in an inherently antagonistic relationship with the government through the criminalization of basic needs, and by shaping a community identity built on a feeling of social exclusion from the rest of the city. [ABSTRACT FROM AUTHOR]

Abstract: Community-Based Health Insurance (CBHI) (a.k.a. micro health insurance) is a contributory health insurance among rural poor in developing countries. As CBHI schemes typically function with no subsidy income, the schemes'' expenditures cannot exceed their premium income. A good estimate of Willingness-To-Pay (WTP) among the target population affiliating on a voluntary basis is therefore essential for package design. Previous estimates of WTP reported materially and significantly different WTP levels across locations (even within one state), making it necessity to base estimates on household surveys. This is time-consuming and expensive. This study seeks to identify a coherent anchor for local estimation of WTP without having to rely on household surveys in each CBHI implementation. Using data collected in 2008–2010 among rural poor households in six locations in India (total 7874 households), we found that in all locations WTP expressed as percentage of income decreases with household income. This reminds of Engel''s law on food expenditures. We checked several possible anchors: overall income, discretionary income and food expenditures. We compared WTP expressed as percentage of these anchors, by calculating the Coefficient of Variation (for inter-community variation) and Concentration indices (for intra-community variation). The Coefficient of variation was 0.36, 0.43 and 0.50 for WTP as percent of food expenditures, overall income and discretionary income, respectively. In all locations the concentration index for WTP as percentage of food expenditures was the lowest. Thus, food expenditures had the most consistent relationship with WTP within each location and across the six locations. These findings indicate that like food, health insurance is considered a necessity good even by people with very low income and no prior experience with health insurance. We conclude that the level of WTP could be estimated based on each community''s food expenditures, and that this information can be obtained everywhere without having to conduct household surveys. [Copyright &y& Elsevier]

Objective To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods. Design Cross-sectional. Setting Two low-income villages in Haryana and an urban slum in Delhi. Participants Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed. Main Outcome Measures Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks. Analysis Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks. Results A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids). Conclusions and Implications Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India. [ABSTRACT FROM AUTHOR]