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Takum T.,National Institute of Epidemiology | Padung D.,National Rural Health Mission | Joshua V.,National Institute of Epidemiology | Manickam P.,National Institute of Epidemiology | Murhekar M.V.,National Institute of Epidemiology
Journal of Tropical Pediatrics | Year: 2011

Vaccination coverage in Papum Pare district, Arunachal Pradesh was observed to be low. We evaluated the universal immunization programme (UIP) through survey of health facilities in the district and collected data about inputs and processes for childhood vaccination, cold-chain maintenance, supervision and monitoring. Using cluster sampling methodology, we selected 697 children aged 12-23 months from 41 clusters and interviewed their mothers to collect information about vaccination status, socio-demographic factors, knowledge, attitude and practices. Only 50% health facilities in the district were conducting fixed-day immunizations. Of the children surveyed, 55% were fully vaccinated. Mothers who were informed about next due date by health workers, possessed immunization card, attended antenatal clinics, or who delivered in hospital were likely to complete the vaccination schedule of their children. In order to increase the vaccination coverage, all health facilities in the district need to be made functional for conducting immunization. Educating health workers to remind mothers about due date of vaccination will also help increasing the vaccination coverage. © The Author [2010].


Singh K.,Child Nutrition and Development Programme | Badgaiyan N.,Child Nutrition and Development Programme | Ranjan A.,Child Nutrition and Development Programme | Dixit H.O.,National Rural Health Mission | And 3 more authors.
Indian Pediatrics | Year: 2014

Objective: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC). Design: Review of data. Setting: 12 NRCs in Uttar Pradesh, India. Participants: Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011). Intervention: Detection and treatment of SAM with locally-adapted protocols. Outcomes: Survival, default, discharge, and recovery rates. Results: 54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3) g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain ≥15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%) Conclusions: NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted. © 2014 Indian Academy of Pediatrics.


Dare A.J.,University of Toronto | Ng-Kamstra J.S.,University of Toronto | Patra J.,University of Toronto | Fu S.H.,University of Toronto | And 6 more authors.
The Lancet Global Health | Year: 2015

Background: Few population-based studies quantify mortality from surgical conditions and relate mortality to access to surgical care in low-income and middle-income countries. Methods: We linked deaths from acute abdominal conditions within a nationally representative, population-based mortality survey of 1·1 million households in India to nationally representative facility data. We calculated total and age-standardised death rates for acute abdominal conditions. Using 4064 postal codes, we undertook a spatial clustering analysis to compare geographical access to well-resourced government district hospitals (24 h surgical and anaesthesia services, blood bank, critical care beds, basic laboratory, and radiology) in high-mortality or low-mortality clusters from acute abdominal conditions. Findings: 923 (1·1%) of 86 806 study deaths at ages 0-69 years were identified as deaths from acute abdominal conditions, corresponding to 72 000 deaths nationally in 2010 in India. Most deaths occurred at home (71%) and in rural areas (87%). Compared with 567 low-mortality geographical clusters, the 393 high-mortality clusters had a nine times higher age-standardised acute abdominal mortality rate and significantly greater distance to a well-resourced hospital. The odds ratio (OR) of being a high-mortality cluster was 4·4 (99% CI 3·2-6·0) for living 50 km or more from well-resourced district hospitals (rising to an OR of 16·1 [95% CI 7·9-32·8] for >100 km). No such relation was seen for deaths from non-acute surgical conditions (ie, oral, breast, and uterine cancer). Interpretation: Improvements in human and physical resources at existing government hospitals are needed to reduce deaths from acute abdominal conditions in India. Full access to well-resourced hospitals within 50 km by all of India's population could have avoided about 50 000 deaths from acute abdominal conditions, and probably more from other emergency surgical conditions. Funding: Bill & Melinda Gates Foundation, Dalla Lana School of Public Health, Canadian Institute of Health Research. © 2015 Dare et al.


Ryman T.K.,Centers for Disease Control and Prevention | Trakroo A.,The United Nations Childrens Fund | Ekka J.B.,National Rural Health Mission | Watkins M.,Centers for Disease Control and Prevention
Vaccine | Year: 2012

Recommended childhood vaccines have typically been provided through routine immunization programs. Recently, implementation of strategies that use campaign-like features for providing all the recommended childhood immunizations have been utilized to increase vaccination coverage. Between January 2006 and January 2008, Assam, India, conducted Immunization Weeks (IWs), a periodic campaign-like approach for providing the recommended childhood vaccines generally administered through the routine Universal Immunization Program (UIP). Using data from a household vaccination coverage survey conducted in 5 districts of Assam in late-2007/early-2008 among children 12-28 months of age, a secondary analysis was conducted for a subset of children with vaccination cards to assess the impacts of implementing the IW-strategy. Sixty-five percent of the 3310 surveyed children received at least one vaccine dose through an IW. Without IWs, coverage would likely have been lower for all vaccines (e.g., 75% measles vaccine coverage including IWs doses and an estimated 61% without IWs). The proportion of children receiving at least one IW dose was significantly different depending on the child's residence; 72% in hard-to-reach char areas, 66% in rural areas and 53% in urban areas (p=0.01). Overall, 2085 (63%) of children were fully vaccinated; of these 60% received a combination of IW and UIP doses, 35% received doses only through the UIP, and 5% received doses only through IWs. A delay in administration later than the recommended ages was found for both UIP doses and for IW doses (e.g., for measles vaccine, UIP doses were 6.9 weeks delayed and IW doses 13.6 weeks delayed). Among this sample of vaccinated children, IWs appeared to increase vaccination coverage and improve access to services in hard-to-reach areas. However, the UIP appeared to be a better system for ensuring that children received all doses in the recommended vaccination series. © 2012.


Choudhury M.,National Rural Health Mission | Das P.,Assam Agricultural University | Baroova B.,Assam Agricultural University
Journal of Food Science and Technology | Year: 2011

For better utilization of millets, two processing techniques, viz., popping and malting were standardized using two local varieties of foxtail millet (Setaria italica). In popped samples, crude fat and crude fibre contents were significantly lower than raw millet in both the yellow and purple varieties, while the carbohydrate and energy values were significantly higher. In malted samples, crude protein and fat contents were significantly lower than in raw millet in both the varieties, whereas the carbohydrate contents were higher. Starch digestibility was highest (42.4%) in yellow popped samples and lowest in yellow malted samples (21.8%). Protein digestibility was highest (13.2%) in purple popped and lowest (2.4%) in yellow malted samples. © 2010 Association of Food Scientists & Technologists (India).

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