a b s t r a c tBackground: Despite the health system effort s, health disparities exist across sub-populations in India. We assessed the effects of health behaviour change interventions through women's self-help groups (SHGs) on maternal and newborn health (MNH) behaviours and socio-economic inequalities. Methods: We did a quasi-experimental study of a large-scale SHG program in Uttar Pradesh, India, where 120 geographic blocks received, and 83 blocks did not receive health intervention. Data comes from two cross-sectional surveys with 4,615 recently delivered women in 2015, and 4,250 women in 2017. The intervention included MNH discussions in SHG meetings and community outreach activities. The outcomes included antenatal, natal and postnatal care, contraceptive use, cord care, skin-to-skin care, and breastfeeding practices. Effects were assessed using multilevel mixed-effects regression adjusted differencein-differences (DID) analysis adjusting for geographic clustering and potential covariates, for all, mostmarginalised and least-marginalised women. Concentration indices examined the socio-economic inequality in health practices over time. Findings: The net improvements (5-11 percentage points [pp]) in correct MNH practices were significant in the intervention areas. The improvements over time were higher among the most-marginalised than least-marginalised for antenatal check-ups (DID: 20pp, p < 0 • 001 versus DID: 6pp, p = 0 • 093), consumption of iron folic acid tablets for 100 days (DID: 7pp, p = 0 • 036 versus DID: -1pp, p = 0 • 671), current use of contraception (DID: 12pp, p = 0 • 046 versus DID: 10pp, p = 0 • 021), cord care (DID: 12pp, p = 0 • 051 versus DID: 7pp, p = 0 • 210), and timely initiation of breastfeeding (DID: 29pp, p = 0 • 001 versus DID: 1pp, p = 0 • 933). Lorenz curves and concentration indices indicated reduction in rich-poor gap in health practices over time in the intervention areas. Interpretation: Disparities in MNH behaviours declined with the effort s by SHGs through behaviour change communication intervention.
Even after enactment of the Protection of Women From Domestic Violence Act 2005, over the last 10 years, the rate of decline of prevalence of spousal violence against women has remained low in India. This study attempts to explain the experience of spousal violence using a social–ecological framework. We analyzed the National Family Health Survey 2015 to 2016 (NFHS-4) data of 66,013 ever-married women aged 15 to 49 years. Participants in the domestic violence module of the NFHS-4 reported their experience of violence committed by their husband within the 12 months preceding the survey. Multilevel logistic regression analyses were done to determine the association between spousal violence and different explanatory variables of various levels of social ecology including variables on women’s empowerment. About one fourth of ever-married women reported experiencing any form of violence during the last year. The experience of spousal violence was significantly associated with social ecology at multiple levels. At the individual level, the odds of experiencing physical violence were higher among younger women, who married at a younger age, had an age gap of 3 to 4 years with her husband, and had more children. Women in vulnerable groups, with poor economic status, and members of marginalized communities had higher odds of experiencing spousal violence. Women had high odds of experiencing spousal violence if living in a social ecology with unfavorable social norms, higher rates of domestic crimes, and a higher prevalence of underage marriage. The association of spousal violence with women’s empowerment remained inconclusive. The results argue for manipulating contextual factors to empower women to challenge gender-related equations and investing in education for gender sensitization at the higher level social ecologies.
Wireless video sensor networks are anticipated to be deployed to monitor remote geographical areas. To save energy in bit transmissions/receptions over a video sensor network, the captured video content needs to be encoded before its transmission to the base station. However, video encoding is an inherently complex operation that can cause a major energy drain at battery-constrained sensors. Thus a systematic evaluation of different video encoding options is required to allow a designer to choose the most energy-efficient compression technique for a given video sensing application scenario. In this paper, we empirically evaluate the energy efficiencies of predictive and distributed video coding paradigms for deployment on real-life sensor motes. For predictive video coding, our results show that despite its higher compression efficiency, inter video coding always depletes much more energy than intra coding. Therefore, we propose to use image compression based intra coding to improve energy efficiency in the predictive video coding paradigm. For distributed video coding, our results show that the Wyner-Ziv encoder has consistently better energy efficiency than the PRISM encoder. We propose minor modifications to PRISM and Wyner-Ziv encoders which significantly reduce the energy consumption of these encoders. For all the video encoding configurations evaluated in this paper, our results reveal the counter-intuitive and important finding that the major source of energy drain in WSNs is local computations performed for video compression and not video transmission.
BackgroundAppropriate immediate newborn care is vital for neonatal survival. Antenatal period is a crucial time to impart knowledge and awareness to mothers regarding newborn care, either during facility visits or during home visits by community health workers (CHWs) especially in the rural context. In this paper, we report newborn care practices in rural Uttar Pradesh (UP) and have explored association between newborn care practices with antenatal care, contact with community health workers during pregnancy and place of childbirth.MethodsWe use cross-sectional baseline data (which is part of a larger intervention project) collected from 129 gram panchayats (GPs) from 15 administrative blocks spread over five districts of UP in 2013. From currently married women (n = 2208) of 15–49 years, who delivered 15 months prior to the survey, we collected information on women’s demographic and socio-economic characteristics, knowledge and practice of reproductive, maternal, newborn, child health and nutrition behaviours. Association of newborn practices with antenatal care, contacts by community health worker during pregnancy and place of childbirth were tested using random intercept logistic regression, adjusting for socio-economic and demographic factors and accounting for clustering at the GP and block levels.ResultsEighty-three percent of 2208 mothers received ANC, but only half of the respondents received a minimum of three ANC visits. More than two thirds of respondents delivered at a health facility. Practice of newborn care was poor: merely one fourth of women practised clean cord care, one third of women followed good breastfeeding practices (initiation with an hour of birth, fed colostrum and did not give pre-lacteal feeds) and one third provided adequate thermal care (kept baby warm and delayed bathing). Only 5% followed all above practices with evidence of clustering of newborn care practices at the block and GP levels. While facility-based childbirth was strongly associated with appropriate newborn care practices, ANC visits and contacts with CHWs was not associated with all newborn care practices.ConclusionThe quality of ANC care provided needs to be improved to have an impact on newborn care practices. Our finding emphasizes the importance of facility-based birthing. There is a need for training CHWs to strengthen their counselling skills on newborn care. Variation of newborn care practices between communities should be taken into consideration while implementing any intervention to optimize benefits.
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