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To determine the extent of exclusive breastfeeding practices among mothers of 4 and 6 month old infants whose fathers received breastfeeding education materials and counseling services. A quasi-experimental design was used. At the baseline, 251 and 241 couples were recruited into the intervention and control sites respectively. Fathers in the intervention area received breastfeeding education materials, counseling services at commune health centers and household visits. In the control site, where mothers routinely receive services on antenatal and postpartum care, fathers did not receive any intervention services on promoting breastfeeding. Primary indicators were exclusive breastfeeding at 4 and 6 months. At 6 months of age, based on 24-hour recall, 16.0% (38/ 238) of mothers in the intervention group were exclusively breastfeeding their children, compared to 3.9% (10/230) of those mothers in the control group (p < 0.001). Significant differences were found based on last-week recall (8.8% in the intervention group vs. 1.3% in the control group, p < 0.001) and since-birth recall (6.7% in the intervention group vs. 0.9% in the control group, p < 0.01). At 4 months of age, based on since birth recall, the breastfeeding proportion was significantly higher in the intervention group than in control group (20.6% in the intervention group vs. 11.3% in the control group, p < 0.01). An intervention targeting fathers might be effective in increasing exclusive breastfeeding practices at 4 and 6 months. To improve exclusive breastfeeding, health care staff working in maternal and child health units, should consider integrating fathers with services delivered to mothers and children. Keywords Exclusive breastfeeding * Health promotion * Fathers * Viet Nam, Introduction Breastfeeding is strongly associated with decreasing infant mortality, especially from infectious diseases [1, 2]. Exclusive breastfeeding (EBF) during the first 6 months of life brings benefits to both maternal [...]

Support from family is critical for the success of breastfeeding: if fathers and family members are supportive of breastfeeding, the mother is more likely to initiate breastfeeding and to breastfeed for longer. [ABSTRACT FROM AUTHOR]

Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices in developing countries. A community‐based education intervention was designed to mobilize fathers' support for early breastfeeding. This study aimed to evaluate an education intervention targeting fathers to increase the proportion of early breastfeeding initiation and to reduce prelacteal feeding. Quasi‐experimental study design was used to compare intervention and control areas located in two non‐adjacent rural districts that shared similar demographic and health service characteristics in northern Viet Nam. Fathers and expectant fathers with pregnant wives from 7 to 30 weeks gestational age were recruited. Fathers in the intervention area received breastfeeding education materials, counselling services at a commune health centre and household visits. They were also invited to participate in a breastfeeding promotion social event. After intervention, early breastfeeding initiation rate was 81.2% in the intervention area and 39.6% in the control area (P < 0.001). Babies in the intervention area were more likely to be breastfed within the first hour after birth [odds ratio (OR) 7.64, 95% confidence interval (CI) 4.81–12.12] and not to receive any prelacteal feeding (OR 4.43, 95% CI 2.88–6.82) compared with those in the control area. Fathers may positively influence the breastfeeding practices of mothers, and as a resource for early childcare, they can be mobilized in programmes aimed at improving the early initiation of breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is the most preventable cause of premature death and disability. Even though tobacco use is common in many Asian countries, reliable and comparable data on the burden imposed by tobacco use in this region are sparse, and surveillance systems to track trends are in their infancy. Objective: To assess and compare the prevalence of tobacco use and its associated factors in nine selected rural sites in five Asian countries. Methods: Tobacco use among 9,208 men and 9,221 women aged 25-64 years in nine Health and Demographic Surveillance System (HDSS) sites in five Asian countries of the INDEPTH Network were examined in 2005 as part of a broader survey of the major chronic non-communicable disease risk factors. All sites used a standardised protocol based on the WHO STEPS approach to risk factor surveillance; expanded questions of local relevance, including chewing tobacco, were also included. Multivariable logistic regression was used to assess demographic factors associated with tobacco use. Results: Tobacco use, whether smoked or chewed, was common across all sites with some notable variations. More than 50% of men smoked daily; this applied to almost all age groups. Few women smoked daily in any of the sites. However, women were more likely to chew tobacco than men in all sites except Vadu in India. Tobacco use in men began in late adolescence in most of the sites and the number of cigarettes smoked daily ranged from three to 15. Use of both forms of tobacco, smoked and chewed, was associated with age, gender and education. Men were more likely to smoke compared to women, smoking increased with age in the four sites in Bangladesh but not in other sites and with low level of education in all the sites. Conclusion: The prevalence of tobacco use, regardless of the type of tobacco, was high among men in all of these rural populations with tobacco use started during adolescence in all HDSS sites. Innovative communication strategies for behaviour change targeting adolescents in schools and adult men and women at work or at home, may create a mass awareness about adverse health consequences of tobacco smoking or chewing tobacco. Such efforts, to be effective, however, need to be supported by strong legislation and leadership. Only four of the five countries involved in this multi-site study have ratified the Framework Convention on Tobacco Control, and even where it has been ratified, implementation is uneven. [ABSTRACT FROM AUTHOR]

Background: Chronic non-communicable diseases (NCDs) are the leading cause of morbidity, mortality, and disability worldwide. More than 80% of chronic disease deaths occur in low-income and middle-income countries. Epidemiological data on the burden of chronic NCD and the risk factors which predict them are lacking in most low-income countries. The INDEPTH Network (http://www.indepth-network.org) which includes the Health and Demographic Surveillance System (HDSS) with many surveillance sites in lowmiddle income countries provided an opportunity to establish surveillance of the major chronic NCD risk factors in 2005 using a standardised approach. Objective: This paper presents the conceptual framework and research design of the chronic NCD risk factor surveillance within nine rural INDEPTH HDSS settings in Asia. Methods: This multi-site study was designed as a baseline cross-sectional survey with sufficient sample size to measure trends over time. In each of nine HDSS sites in five Asian countries, a sample of 2,000 men and women aged 25-64 years, using the WHO STEPwise approach to Surveillance (http://who.int/chp/steps), was selected using stratified random sampling (in each 10-year interval) from the HDSS sampling frame. Results: A total of 18,494 men and women from the nine sites were interviewed with an overall response rate of 98%. The major NCDs risk factors included self-reported information on tobacco and alcohol consumption, fruit and vegetable intake, physical activity patterns, and measured body weight, height, waist circumference, and blood pressure. A series of training sessions were conducted for research scientists, supervisors, and surveyors in each site. Data quality was ensured through spot check, re-check, and data validation procedures, including accuracy and completeness of data obtained. Standardised data entry programme, created using the EPIDATA software, was used to ensure uniform database structure across sites. The data merging and analysis were done using STATAVersion 10. Conclusion: This multi-site study confirmed the feasibility of conducting chronic NCD risk factor surveillance in the low and middle-income settings by integrating the chronic NCDs risk factor surveillance into an existing HDSS data collection and management setting. This collaborative work has provided reliable epidemiological data as a basis for developing chronic NCD prevention and control activities. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity leads to higher morbidity and mortality from chronic non-communicable diseases (NCDs) such as stroke and heart disease. In high income countries, studies have measured the population level of physical activity, but comparable data are lacking from most low and middle-income countries. Objective: To assess the level of physical inactivity and its associated factors in selected rural sites in five Asian countries. Methods: The multi-site cross-sectional study was conducted in nine rural Health and Demographic Surveillance System (HDSS) sites within the INDEPTH Network in Bangladesh, India, Indonesia, Thailand, and Vietnam. Using the methodology from the WHO STEPwise approach to Surveillance (STEPS), about 2,000 men and women aged 25-64 years were selected randomly from each HDSS sampling frame. Physical activity at work and during leisure time, and on travel to and from places, was measured using the Global Physical Activity Questionnaire version 2 (GPAQ2). The total activity was calculated as the sum of the time spent in each domain of activities in metabolic equivalent-minutes per week, and was used to determine the level of physical activity. Multivariable logistic regression was used to assess demographic factors associated with a low level of physical activity. Results: The prevalence of physical inactivity ranged from 13% in Chililab HDSS in Vietnam to 58% in Filabavi HDSS in Vietnam. The majority of men were physically active, except in the two sites in Vietnam. Most of the respondents walked or cycled for at least 10 minutes to get from place to place, with some exceptions in the HDSSs in Indonesia and Thailand. The majority of respondents, both men and women, were inactive during their leisure time. Women, older age, and high level of education were significantly associated with physical inactivity. Conclusion: This study showed that over 1/4 men and 1/3 women in Asian HDSSs within the INDEPTH Network are physically inactive. The wide fluctuations between the two HDSS in Vietnam offer an opportunity to explore further urbanisation and environmental impacts on physical activity. Considering the importance of physical activity in improving health and preventing chronic NCDs, efforts need to be made to promote physical activity particularly among women, older people, and high education groups in these settings. [ABSTRACT FROM AUTHOR]

Introduction: Lack of reliable population-based data, especially morbidity data, is a barrier to preventing and controlling chronic diseases in developing countries. We report the self-reported prevalences of major chronic diseases in Southeast Asia and examine their relation to selected sociodemographic variables in adults., Methods: Data are from a 2005 cross-site study of 8 sites in 5 Asian countries that surveyed 18,484 people aged 25-64 years. Respondents were asked whether they had been told by a health care worker that they had any of 7 chronic health conditions: joint problems, stroke, heart disease, diabetes, pulmonary disease, hypertension, or cancer. Information about participants' sex, age, and educational level was also obtained., Results: We found that 22.7% of men and 31.6% of women reported having at least 1 of the chronic health conditions of interest, and 5.1% of men and 9.2% of women reported having 2 or more chronic conditions. Multivariate regression analyses showed that women had more chronic conditions than men, the prevalence of chronic conditions increased with age, and people with the least education were more likely to have chronic conditions., Conclusion: Chronic conditions are commonly reported among adults in Asian countries. Disparities in the prevalence of chronic conditions by sex and education are evident.