Background: As per statistics on infant mortality, the State of Maharashtra has done well in bringing down IMR from 33 to 21 per 1000 live births. However a lot needs to be achieved still. Various child health programs like home based new born care and others have improved child survival. But the analysis of cases will throw light on actionable points for policy change. Methods: Keeping in mind mortality statistics of the State, an analysis was done on causes of neonatal deaths and social determinants. A retrospective study was done on causes of death from birth to 28 days during 2015-2016 in the State of Maharashtra. 6 deaths per block were reviewed by a committee that included a pediatrician. Verbal autopsy was done and all factors like social, cultural, behavioral as well as factors that resulted in delay in deciding to take the baby to health facility, delay in transport and delay at health facility were studied in details. Results: Latur circle had the highest deaths i.e. 70%, Nashik and Gadchiroli had 62 and 63% respectively. Males were more than females (55.7%). ^0.6% of deaths occurred in babies weighing less than 2500 gms. Delay in deciding to take the baby to the health facility and getting treatment was important (41.4% cases). In 40.8% cases delay in receiving treatment at health facility was observed. Major causes were infections, prematurity and asphyxia. Conclusions: Various causes of neonatal deaths are studied. Delay in deciding to take the baby to the health facility was one of the major factors. Majority of deaths were due to infection prematurity and asphyxia.
The present paper describes the significance of anthropometric measurements in detecting nutritional status of individuals, specially children. It highlights evolution of anthropometry, discusses importance of various measurements & their role in determining undernutrition & obesity. There is a need to have one measurement to detect obesity & undernutrition both. An ideal such measure is yet to be established.
BackgroundMalnutrition in children is widely prevalent around the world. It has been observed that malnourished children with multiple anthropometric deficits have higher mortality. However, adequate studies are not available on the outcome and recovery of these children.Nandurbar, a tribal district from Maharashtra, India, shows high prevalence of all three forms of malnutrition, often occurring simultaneously. A project previously undertaken in Nandurbar from July 2014 to June 2016 studied the effect of various therapeutic feeds in treatment of children with uncomplicated severe acute malnutrition (SAM). In this study, we analyse secondary data from it to correlate effects of stunting, wasting and underweight on treatment recovery.MethodsAnalysis was done on 5979 children with SAM using linear and logistic regression on R software for recovery rates and weight gain in children with SAM with single versus multiple anthropometric deficits, their relation to age, sex, and recovery from severe stunting by gain in height.ResultsThe mean age of children was 35 months and 53.1% of the children were males. 2346 (39.2%) children recovered at the end of the 8-week treatment. 454 (7.6%) had single anthropometric deficit (SAM only), 3164 (52.9%) had two anthropometric deficits (SAM and severe underweight (SUW)) and 2355 (39.4%) children had three anthropometric deficits (SAM, SUW and severe stunting). Out of the 5979 children with SAM, only 52 (0.9%) of children were not underweight (severe or moderate).44.94% of children with SAM who were severely stunted recovered, compared with 35.52% of children who were not (p<0.001). After controlling for confounders, severe stunting was found to increase the odds of recovery by 1.49. Severely stunted children with SAM also showed faster recovery and weight gain by 1.93 days (p<0.012) and 0.29 g/kg/day (p<0.001), respectively. Recovery was higher in females and younger age group. Recovery was also found to depend on the therapeutic feed, with children receiving medical nutrition therapy showing better recovery for severely stunted children.ConclusionOur findings corroborate previous literature that stunting is a way for the body to deal with chronic stress of nutritional deprivation and provides a survival advantage to a child.
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