Objective: To assess the level, pattern and determinants of minimum acceptable diet (MAD) feeding in Odisha, India. Design: Utilizing cross-sectional data, the MAD was estimated through a dietary assessment method wherein the child’s mother was asked to recall all the food intake of the youngest child the previous day and night of the surveyed date. Setting: National Family Health Survey (NFHS–4) 2015–16 Participants: Children age 6-23 months, living with mother and for whom complete information on MAD was available (n=3073). Results: Only 8.4% of the children aged 6-23 months were fed MAD, and the MAD feeding varies considerably by socio-demographic characteristics. Children aged 12-17 months had two times (OR: 2.51, 95% CI: 1.48-4.26), and those aged 18-23 months had three times (OR: 3.77, 95% CI: 2.25-6.30) higher odds of having a MAD than their counterparts aged 6-8 months. Children whose mother was exposed to any mass media had a higher chance of MAD feeding (OR: 1.46, 95% CI:1.01-2.11). Conclusions: The children of higher age, second or higher-order births, with mother exposed to mass media are significantly more likely to be fed a MAD. At the same time, children from scheduled caste households have a lower probability of MAD feeding. The lower MAD feeding among the scheduled caste households suggests strengthening the ongoing programmes with a higher emphasis on the inclusion of this disadvantaged and marginalized group. Findings from this study would assist policymakers, and public health managers improve MAD feeding practices in Odisha, India, in a targeted manner.

Background:As a part of a larger study for evaluating the effectiveness of a community-based family welfare program, this study assessed the contraceptive behavior of couples preceding sterilization and termination of pregnancies, if any during the interim period.Methods:During May–June 2013, a cross-sectional study was undertaken in three districts of Odisha, an eastern state of India with poor maternal health indicators. Using a 15 × 14 cluster design with probability proportionate to size sampling 15 village clusters from each district were selected. Seven beneficiaries from the catchment area of two Accredited Social Health Activist of the selected villages were interviewed (14 respondents from each village) using a pretested predesigned questionnaire.Results:A total of 630 clients with either of the partner having undergone sterilization were interviewed. Male partner having undergone vasectomy was < 1% (n = 3). The mean age (standard error mean [SEM]) of the respondent women was 34.54 ± 0.26 years. The mean age of the women at the time of sterilization was 27.12 (standard deviation [SD], 3.8, SEM 0.15 and median 26.83 years) years. Women as young as 22 years had undergone sterilization. Average family size was 2.81 with about 29 respondents (4.5%) having 5 or more children. The average duration between the last childbirth (LCB) to the date of sterilization was 18.37 months (range: 1–142 months, SD: 24 months, SE: 10 months). Seventy-two percent of the respondents did not use any method of contraception during this period. Methods adopted for contraception among the users was pill (20%) followed by condom (7%), and intrauterine contraceptive device (IUCD) was least used (0.2%). Ten percent of the women had undergone abortion before sterilization either once (7.9%) or more than once (2.1%).Conclusion:There was a gross delay in sterilization after LCB. Postpartum sterilization or IUCD were also not used frequently.

Purpose Changing demographic trends in India have resulted in a growing ageing population, and this poses many health challenges for older people. Lack of formal care institutions and social security nets further aggravate the situation. Living arrangements are, thus, expected to play a significant role in determining the healthcare needs of older people. The purpose of this paper is to examine the association of living arrangements with health among older people in India. Design/methodology/approach Data for the study were drawn from the Building Knowledge Base on Population Ageing in India (2011). The health status of older people was measured by assessing chronic illness, self-rated health and limitations in activities of daily living. Logistic regression was used to examine the influence of living arrangements on health outcomes. Further, a structural equation model was employed to observe whether poor health preceded co-residence. Findings Older people living in co-residential arrangements report more health disadvantages and older people with poor health prefer co-residence with their offspring. Perhaps the support, care and health awareness in co-residential arrangements helps older people obtain the healthcare interventions they require for the various illnesses they have had, and enable them to improve their ongoing health status. Originality/value The present study has extended the research on the relationship between health and living arrangements, and has also addressed the case of older people with poor health who prefer to stay in co-residential arrangements which has been taken up by limited studies.

Good nutrition is the foundation of human well-being that leads to better health, effective engagement of the workforce, and productive lifestyle, resulting in higher income and an integrated development trajectory. This paper attempts to comprehend the impact of climate vulnerability on household nutrition status through agriculture production systems in Odisha, India. This study using secondary data estimates a composite index of climate vulnerability on the agriculture ecosystem in Odisha at the district scale. Results suggest that among all the districts in Odisha, Bhadrak (0.193) is the most vulnerable district followed by Sonepur (0.191) and Baudh (0.190). On the other hand, Mayurbhanj (0.099) is the least vulnerable district followed by Ganjam (0.103) and Sundargarh (0.105). The fi ndings also suggest that there is a wide variation in vulnerability indicators among the districts in Odisha (0.099 – the lowest district value vs. 0.193 – the highest). The results of multivariate analysis evince that in households (both women and children) nutritional status, the composite value of “climate vulnerability” has a greater role in predicting the predictors in Odisha through the agriculture production system. The climate vulnerability has a positive and signifi cant relationship with forest area (r=0.403*), gross cropped area (r=0.489**), percent of scheduled caste population (r=0.510**), percent of urban area (r=0.427*), and per-capita income (r=0.712**). The fi ndings also signify that district-wise gross cropped area (t=3.01), average annual rainfall (t=4.05), area under irrigation (t=3.36), cropping intensity (t=3.60), and forest areas (t=1.81) play a more predictive role to determine the household nutritional status along with socioeconomic and health factors such as per-capita income (t=1.8), urbanization (t=1.91), and women’s anemic status (t=2.74). Drawing inferences from the empirical evidence, the study suggests that climate vulnerability has a much greater role in influencing household nutrition status, particularly with women and child nutrition through the agriculture production system. Appropriate policy level measures for climate-sensitive and adaptive action are the need of the hour to make agriculture production ecosystem contributes positively to nutrition status.