Background The incidence of preterm birth and subsequent low birth weight (LBW) are vital global public health issues. It contributes to high infant and child mortality in the early stages of life and later on in adult life; it increases the risk for non-communicable diseases. The study aims to understand the socio-economic status-related inequality for LBW among children in India. It hypothesises that there is no association between the socio-economic status of the household and the newborn’s LBW in India. Methods The study utilised data from the fourth round of the National Family Health Survey, a national representative cross-sectional survey conducted in 2015-16 (N = 127,141). The concentration index (CCI) and the concentration curve (CC) measured socio-economic inequality in low birth status among newborns. Wagstaff decomposition further analysed key contributors in CCI by segregating significant covariates. Results About 18.2% of children had low birth weight status. The value of concentration was − 0.05 representing that low birth weight status is concentrated among children from lower socio-economic status. Further, the wealth quintile explained 76.6% of the SES related inequality followed by regions of India (− 44%) and the educational status of mothers (43.4%) for LBW among children in India. Additionally, the body mass index of the women (28.4%), ante-natal care (20.8%) and residential status (− 15.7%) explained SES related inequality for LBW among children in India. Conclusion Adequate attention should be given to the mother’s nutritional status. Awareness of education and usage of health services during pregnancy should be promoted. Further, there is a need to improve the coverage and awareness of the ante-natal care (ANC) program. In such cases, the role of the health workers is of utmost importance. Programs on maternal health services can be merged with maternal nutrition to bring about an overall decline in the LBW of children in India.

Background: Growing untreated morbidities among the older adults on geriatric issues especially an optimal dental treatment has become an unfinished agenda and a long-neglected area for care and management in many low and middle-income countries. There is a continuous rise in the older population in India and at the same time, the rising of co-morbidities or multi-morbidities in the aging population creates catastrophic challenges at the individuals, household, community, and country levels, and therefore, it is important to address dental health problems and related issues in the aged population in India. The study aims to understand the prevalence of dental health problems and their health-seeking behaviour among older adults in India. Further, the study determines the factors associated with low access and under-coverage of dental health care services among the elderly populations in IndiaMethods: The present research used data from Building a Knowledge Base on Population Aging in India (BKPAI) which was a national level survey and was conducted in 2011, across seven states of India. The effective sample size of this study was 9541 older adults aged 60+ years. Descriptive statistics and bivariate analysis were used to fulfill the study objectives. Additionally, the study employed the Heckprobit selection model which is a two-equation model to understand the determinants of dental health problems.Results: Older adults in the age group of 70-79 years (36.9%) and 80+ years (51.9%) reported higher dental problems compared to 60-69 years (19.9%), older women reported more dental problems (29.2%) and also used more dental aids (12.6%) compared to older men. Older adults in the age group 70-79 and 80+ years were 0.15 times and 0.40 times less likely to use dental aids respectively, as compared to 60-69 years older adults. Moreover, older women were 0.28 times more likely to use dental aids than older men. Education and wealth of older adults have a negative relationship with dental problems.Conclusion: This study clearly emphasized that awareness of smoking-related health problems should be promoted vigorously. Further, a holistic approach is needed to prevent dental diseases that occur because of other co-morbidities. For that, integration of the oral health program with programs dealing with morbidities can act as a solution to the existing problem.

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Background Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions. Methods The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran’s I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA. Results Moran’s I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%. Conclusion The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women’s education.

Geographically, Manipur is composed of two sets of landmasses known as the valley and the hills districts. As compared to the valley districts, the hilly district is largely remained undeveloped and lack basic infrastructure and services like healthcare facilities, educational institutions, public distribution system, transportation, etc. Little is known about the differentials in the utilization of maternal healthcare services between the hills and the valley of Manipur state of India. The paper tries to understand the inequalities in accessing maternal healthcare services between the hills and valleys region. Logistic regression and concentration index was adopted to assess the utilization of maternal healthcare services. Results indicate low utilization of maternal healthcare services in the hilly region, with only 19%, 22%, and 21% have access to 4+ ANC visit, institutional delivery, and PNC visits respectively. The odds of utilizing 4+ ANC visits [Odds Ratio (OR): 0.

Background: Indoor Residual Spraying (IRS) and Insecticide Treated Nets (ITNs) are important tools in the fight against insect vectors of important diseases. In spite of having operational and logistic limitation(s), IRS and ITN are still in practice as conventional tools with mixed results for controlling Phlebotomus argentipes, the vector of Visceral Leishmaniasis (VL) in the Indian subcontinent. A combination of both tools might results better for reducing VL vector densities during the attack phase of the VL elimination initiative. Methods: A comparison-based study was designed for analyzing the field efficacy of a combination strategy of IRS+ITN (PermaNet 3.0 ®) versus single interventions with IRS and ITNs alone comparing with control respectively. The study was conducted at the villages of Samastipur district of Bihar (India) using aspiration and light traps techniques (i.e., AT and LTT respectively) for collecting sand fly. The numbers of all types of sand flies (male, unfed, fed and gravid female) were recorded during a period of 12 months after the intervention in the three study arms. The bioavailability of insecticide for IRS as well as ITN was also observed at the interval of 3 months with the help of cone bioassay technique established by World Health Organization (WHO). Results: The observed highest percent-reduction of sand flies (93.59%-100%) at the sites with combined intervention of IRS+ITN, as compared to the sites without any intervention at control (with 0% reduction) or with single control intervention either with IRS (4.29%-86.77%) or with ITN (60.18%-97.07%) followed by the reduction in bioavailability of insecticide in IRS (i.e., 52.38%, 58.33%, 45.45% & 50.00%) and ITN (84.44%, 82.50%, 77.78% & 83.33%) over the period of 12 months since intervention, establishes the success of IRS plus ITN as a combined approach for contaminating vector population. Also, through the house-to-house survey at the end of study period, the acceptance of combined approach for IRS plus ITN by the community was accessed to be highest i.e., 100% as compared to the single-intervention approaches for IRS (87%) and ITN (100%). Conclusions: Study results advocate the use of the combined strategy during the attack phase of the VL elimination initiative in order to reduce or interrupt disease transmission. It may also be a valid approach during the maintenance phase in hot-spots of VL transmission.

Background Although existing research supports the correlation of hereditary and psychological factors with an adolescent’s deliberate self-harm, there is a dearth of research that focus on their socio-economic characteristics. This paper intends to identity the potential risk factors that influence an adolescent’s deliberate self-harm. Methods Data for this study was obtained from Understanding the Lives of Adolescents and Young Adults (UDAYA) study conducted in 2015–16 with sample of 5,969 adolescent boys and 9,419 girls aged 10–19 years. The outcome variable was deliberate self-harm among adolescents. The explanatory variables added in the study were age, current schooling status, working status, media exposure, access to internet, parental abuse, involvement in fights, substance use, depressive symptoms, caste, religion, wealth index, residence and states. Bivariate analysis along with binary logistic regression analysis was done to fulfill the study objectives. Results About 4.5% and 3.2% of adolescent boys and girls, respectively had deliberate self-harm. The odds of deliberate self-harm were 50 per cent more likely among adolescent girls who had internet access [OR 1.50; CI 1.05–2.16]. The likelihood of deliberate self-harm was 49 per cent and 61 per cent significantly more likely among adolescent boys [OR 1.49; CI 1.11–2.0] and girls [OR 1.61; CI 1.27–2.04] who experienced parental physical abuse respectively. With reference to minimal/mild depressive symptoms, adolescents who had moderate [boys-OR 2.10; CI 1.29–3.4 and girls-OR 2.50; CI 1.774–3.59] or moderately high/severe [boys-OR 4.58; CI 2.88–7.29 and girls-OR 4.18; CI 3.1–5.63] depressive symptoms had significantly higher odds of deliberate self-harm. Conclusions Internet access, parental abuse, involvement in fights, and depressive symptoms emerged as significant predictors of deliberate self-harm among adolescent boys and girls. Results suggest that an early identification of the predictors and intervention might prevent deliberate self-harm among adolescents. Since parents play a major role in the lives and development of adolescents, it is highly recommended that they initiate open and supportive communication with their children.

Background The International Diabetes Federation (IDF) estimated that 1.1 million children and adolescents aged 14–19 years are living with diabetes. Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose. It is also recognized as a complex disease that affects people of different ages due to different causes. The present study aims to estimate the prevalence of pre-diabetes/diabetes at the national level. Additionally, the respective study determines the factors associated with pre-diabetes/diabetes conditions among adolescents at the national level. Methods The data for this study was carried out from the Comprehensive National Nutrition Survey (CNNS), the first-ever nationally representative nutrition survey of children and adolescents in India. The study used a sample size of 17,865 adolescent boys and 17,965 adolescent girls for the analysis. Descriptive statistics, bivariate analysis, and logistic regression analysis were done to carve out the results. Results The prevalence of pre-diabetes/diabetes was 12.3% and 8.4% among adolescent boys and girls in India, respectively. Body mass index and Subscapular skinfold thickness were the two most important predictors of pre-diabetes/diabetes among adolescents. Further, physical activities show a negative association with pre-diabetes/diabetes. Moreover, interaction models in the present study clearly reveal the fact that adolescent girls were less likely to suffer from pre-diabetes/diabetes than adolescent boys. Additionally, it was found that the prevalence of pre-diabetes/diabetes was high among adolescent girls from lower socio-economic strata. Conclusion The high prevalence of pre-diabetes and diabetes among adolescents portrayed serious public health concern in India. As body mass index and Subscapular skinfold thickness were positively associated with pre-diabetes/diabetes conditions among adolescents. Therefore, effective approaches are needed to be taken to tackle these pre-diabetes/diabetes conditions among adolescents and especially among adolescent boys.