This analysis on key nutrition indicators from successive rounds of the NFHS (4 and 5) is based on all-India and State/UT level factsheet released by Ministry of Health and Family Welfare (MoHFW). The analysis includes: 1. National level trends from NFHS-3 (2005-06), NFHS-4 (2015-16) and NFHS-5 (2019-21) data for 44 indicators including outcomes, service delivery and key determinants of nutrition. 2. State level trends of same indicators- number of states showing improvement / worsening (± 0.1 percent point change), /no change for these indicators, spatial maps based on change in prevalence for these indicators; and charting State performance with respect to achieving Sustainable Development Goals (SDG 2030) targets. This presentation will be useful for policy makers, State administrators, public health experts, research scholars and research institutes in the area of maternal and child health & Nutrition.
This paper answers research questions on screening and management of severe thinness in pregnancy, approaches that may potentially work in India, and what more is needed for implementing these approaches at scale. A desk review of studies in the last decade in South Asian countries was carried out collating evidence on six sets of strategies like balanced energy supplementation (BEP) alone and in combination with other interventions like nutrition education. Policies and guidelines from South Asian countries were reviewed to understand the approaches being used. A 10‐point grid covering public health dimensions covered by World Health Organization and others was created for discussion with policymakers and implementers, and review of government documents sourced from Ministry of Health and Family Welfare. Eighteen studies were shortlisted covering Bangladesh, India, Nepal, and Pakistan. BEP for longer duration, preconception initiation of supplementation, and better pre‐supplementation body mass index (BMI) positively influenced birthweight. Multiple micronutrient supplementation was more effective in improving gestational weight gain among women with better pre‐supplementation BMI. Behavior change communication and nutrition education showed positive outcomes on dietary practices like higher dietary diversity. Among South Asian countries, Sri Lanka and Nepal are the only two countries to have management of maternal thinness in their country guidelines. India has at least nine variations of supplementary foods and three variations of full meals for pregnant women, which can be modified to meet additional nutritional needs of those severely thin. Under the National Nutrition Mission, almost all of the globally recommended maternal nutrition interventions are covered, but the challenge of reaching, identifying, and managing cases of maternal severe thinness persists. This paper provides four actions for addressing maternal severe thinness through available public health programs, infrastructure, and human resources.
Objective To examine prevalence, risk factors, and consequences of maternal severe thinness in India. Methods This mixed methods study analyzed data from the Indian National Family Health Survey (NFHS)‐4 (2015–2016) to estimate the prevalence of and risk factors for severe thinness, followed by a desk review of literature from India. Results Prevalence of severe thinness (defined by World Health Organization as body mass index [BMI] <16 in adult and BMI for age Z score < –2 SD in adolescents) was higher among pregnant adolescents (4.3%) compared with pregnant adult women (1.9%) and among postpartum adolescent women (6.3%) than postpartum adult women (2.4%) 2–6 months after delivery. Identified research studies showed prevalence of 4%–12% in pregnant women. Only 13/640 districts had at least three cases of severely thin pregnant women; others had lower numbers. Three or more postpartum women aged ≥20 years were severely thin in 32 districts. Among pregnant adolescents, earlier parity increased odds (OR 1.96; 95% CI, 1.18–3.27) of severe thinness. Access to household toilet facility reduced odds (OR 0.72; 95% CI, 0.52–0.99]. Among mothers aged ≥20 years, increasing education level was associated with decreasing odds of severe thinness (secondary: OR 0.74; 95% CI, 0.57–0.96 and Higher: OR 0.54; 95% CI, 0.32–0.91, compared with no education); household wealth and caste were also associated with severe thinness. Conclusion This paper reveals the geographic pockets that need priority focus for managing severe thinness among pregnant women and mothers in India to limit the immediate and intergenerational adverse consequences emanating from these deprivations.
Pregnancy is a period of major physiologic, hormonal, and psychological change, increasing the risk of nutritional deficiencies and mental disorders. Mental disorders and malnutrition are associated with adverse pregnancy and child outcomes, with potential long‐standing impact. Common mental disorders during pregnancy are more prevalent in low‐ and middle‐income countries (LMICs). In India, studies suggest the prevalence of depression is 9.8%–36.7% and of anxiety is 55.7%. India has seen some promising developments in recent years such as increased coverage of the District Mental Health Program; integration of maternal mental health into the Reproductive and Child Health Program in Kerala; and the Mental Health Care Act 2017. However, mental health screening and management protocols have not yet been established and integrated into routine prenatal care in India. A five‐action maternal nutrition algorithm was developed and tested for the Ministry of Health and Family Welfare, aiming to strengthen nutrition services for pregnant women in routine prenatal care facilities. In this paper, we present opportunities and challenges for integration of maternal nutrition and mental health screening and a management protocol at routine prenatal care in India, discuss evidence‐based interventions in other LMICs including India, and make recommendations for public healthcare providers.
Objectives Thinness and overweight/obesity are prevalent among women of reproductive age in India but there is limited evidence on the burden and predictors of this during pregnancy and post-partum. We estimated prevalence and risk factors for thinness and overweight among pregnant and recently delivered women (RDW). Methods We used India's National Family Health Survey (2015–2016), including 16,153 pregnant women <20 weeks of gestation and 19,430 RDW of 2–6-month-old infants. All women were classified as severe thin (ST), thin (TH), overweight (OV) or obese (OB) (body mass index, BMI <16, <18.5, ≥23 and ≥25 kg/m2, respectively), using cutoffs for Asian populations. Logistic regression was used to examine associated factors (including socio-demography, hygiene and sanitation, antenatal health services and diet) with those outcomes. Results Barely 40% of women were of normal BMI. ST, TH, OV/OB and OB were seen in 2%, 20%, 25% and 13% respectively among pregnant women, and for RDW, they were 2%, 21%, 24% and 13%. Factors associated with a lower odds of ST and TH among pregnant women and RDW included higher wealth quintile (adjusted odds ratios, AORs ranging from 0.58–0.63 for highest quintile), higher education (AORs: 0.64–0.81), age group ≥25 y (AORs: 0.58–0.83), and improved toilet facility (AOR 0.81). Multiparous pregnant women had higher odds of TH compared to primiparas (AORs: 1.24–1.31). Factors associated with OV and OB among pregnant women and RDW were belonging in higher socio-economic group (AORs: 1.34–1.53), higher wealth quintile (AORs: 1.56–8.49), age group ≥25 y (AORs: 2.73–5.09), urban residence (AOR 1.16–1.36), and having higher education (AORs: 1.44–1.60). Among RDW, receiving supplementary food and health and nutrition education increased odds of TH (AORs: 1.15) and reduced odds of OV and OB (AORs: 0.83–0.87), but this is likely attributable to selection bias in program use. Conclusions TN and OV/OB affect 1 in 5 pregnant women and 1 in 4 RDW in India. Socio-economic factors, sanitation, parity, education and age influence TN and OV/OB. Better diet and physical activity estimates are needed to understand OV and OB in this population. Given the high burden of both forms of malnutrition, a policy focus on healthy weight gain is essential. Funding Sources UNICEF; Bill & Melinda Gates Foundation (via POSHAN).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.