scholarly journals Can Health Systems Platforms Do More for Nutrition in India? Insights on Missed Opportunities from India's National Family Health Survey, 2015–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 874-874
Author(s):  
Phuong Nguyen ◽  
Purnima Menon ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Alok Kumar ◽  
...  
Keyword(s):  
Early Childhood ◽  
Health Systems ◽  
Health Survey ◽  
Scale Up ◽  
Family Health ◽  
National Family Health Survey ◽  
Nutrition Interventions ◽  
Health And Nutrition ◽  
Childhood Care ◽  
National Family

Abstract Objectives Most nutrition interventions can be delivered through health systems. However, the progress to scale up effective nutrition interventions and achieve universal health coverage has not been uniform. We aimed to 1) examine the opportunity gaps (OGs) between delivery platforms and corresponding nutrition interventions through the continuum of care (from pregnancy up to early childhood) in India between 2006 and 2016; and 2) assess inequalities in these OGs. Methods We used two rounds of National Family Health Survey data collected in 2005–06 and 2015–16 (n = 36,850 and 190,898 mother-child dyads with the last child aged of 0–5 years, respectively). We examine the OGs over time for a set of seven nutrition interventions and their associated delivery platforms during antenatal, delivery, postnatal and early childhood care at the national, state and district levels. We then assessed equality and changes in equality between 2006–2016 for the OGs by education, residence, socioeconomic status, public and private platforms. Results Coverage of nutrition interventions was consistently lower than the reach of their associated delivery platforms, with the OGs ranging from 9–32 percentage points (pp) during pregnancy, 17pp during delivery, and 9–26pp during childhood in 2006. Between 2006 and 2016, coverage improved for most indicators but the OGs became wider. The OGs were larger among women with higher education, higher SES status and living in urban areas, despite higher coverage of most interventions and the delivery platforms among these groups. Compared to private facilities, public facilities performed better in counseling/support for breastfeeding but were poorer in iron and folic acid supplementation. OGs vary tremendously by state and district, highlighting governance and implementation successes and challenges. Conclusions India's progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equity gaps must be closed by addressing policy and programmatic health systems bottlenecks to achieve universal coverage for both health and nutrition. We recommend this analytic approach to track and assess OGs in scaling up nutrition through health systems in India and worldwide. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by IFPRI.

scholarly journals Missed opportunities for delivering nutrition interventions in first 1000 days of life in India: insights from the National Family Health Survey, 2006 and 2016

2021 ◽  
Vol 6 (2) ◽  
pp. e003717
Author(s):  
Phuong Hong Nguyen ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Vani Sethi ◽  
Alok Kumar ◽  
...  
Keyword(s):  
Health Survey ◽  
Urban Areas ◽  
Family Health ◽  
Universal Coverage ◽  
National Family Health Survey ◽  
Nutrition Interventions ◽  
Missed Opportunities ◽  
Health And Nutrition ◽  
National Family ◽  
Opportunity Gaps

ObjectivesExisting health and community nutrition systems have the potential to deliver many nutrition interventions. However, the coverage of nutrition interventions across the delivery platforms of these systems has not been uniform. We (1) examined the opportunity gaps between delivery platforms and corresponding nutrition interventions through the continuum of care in India between 2006 and 2016 and and (2) assessed inequalities in these opportunity gaps.MethodsWe used two rounds of the National Family Health Survey data from 2005 to 2006 and 2015–2016 (n=36 850 and 190 898 mother–child dyads, respectively). We examine the opportunity gaps over time for seven nutrition interventions and their associated delivery platforms at national and state levels. We assessed equality and changes in equality between 2006 and 2016 for opportunity gaps by education, residence, socioeconomic status (SES), public and private platforms.ResultsCoverage of nutrition interventions was consistently lower than the reach of their associated delivery platforms; opportunity gaps ranging from 9 to 32 percentage points (pp) during the pregnancy, 17 pp during delivery and 9–26 pp during childhood in 2006. Between 2006 and 2016, coverage improved for most indicators, but coverage increases for nutrition interventions was lower than for associated delivery platforms. The opportunity gaps were larger among women with higher education (22–57 pp in 2016), higher SES status and living in urban areas (23–57 pp), despite higher coverage of most interventions and the delivery platforms among these groups. Opportunity gaps vary tremendously by state with the highest gaps observed in Tripura, Andaman and Nicobar islands, and Punjab for different indicators.ConclusionsIndia’s progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equality gaps remained. It is critical to close these gaps by addressing policy and programmatic delivery systems bottlenecks to achieve universal coverage for both health and nutrition within the delivery system.

scholarly journals Utilization of Integrated Child Development Services in India: Programmatic Insights from National Family Health Survey, 2016

2020 ◽  
Vol 17 (9) ◽  
pp. 3197 ◽  
Author(s):  
Sunil Rajpal ◽  
William Joe ◽  
Malavika A. Subramanyam ◽  
Rajan Sankar ◽  
Smriti Sharma ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Child Development ◽  
Service Utilization ◽  
Random Effects ◽  
Health Survey ◽  
Urban Areas ◽  
Family Health ◽  
National Family Health Survey ◽  
Childhood Care ◽  
National Family

The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world’s largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015–2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0–72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother–child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.

scholarly journals Correction to: Inequalities in the utilisation of maternal health Care in Rural India: Evidences from National Family Health Survey III & IV

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Survey ◽  
Family Health ◽  
Maternal Health Care ◽  
Rural India ◽  
National Family Health Survey ◽  
National Family

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Severe wasting among Indian infants <6 months: Findings from the National Family Health Survey 4

2019 ◽  
Vol 15 (4) ◽  
Author(s):  
Tarun Shankar Choudhary ◽  
Akanksha Srivastava ◽  
Ranadip Chowdhury ◽  
Sunita Taneja ◽  
Rajiv Bahl ◽  
...  
Keyword(s):  
Health Survey ◽  
Family Health ◽  
National Family Health Survey ◽  
National Family

Anemia Prevalence in India Over Two Decades: Evidence from National Family Health Survey (NFHS)

2021 ◽  
Vol 6 (4) ◽  
pp. 335-340
Author(s):  
Ekta Belwal ◽  
Shalini Pandey ◽  
Supta Sarkar
Keyword(s):  
Iron Deficiency ◽  
Health Survey ◽  
Family Health ◽  
Preschool Age ◽  
Reproductive Age ◽  
Vulnerable Groups ◽  
Quality Data ◽  
Family Welfare ◽  
National Family Health Survey ◽  
National Family

Anemia is the most prevalent deficiency disease and one among the major nutrition related goals globally. Children and women of reproductive age are the most vulnerable groups for anemia everywhere. While there are various nutritional and non-nutritional factors causing anemia, Iron deficiency is the most prominent of them. In India, more than half population of preschool age children and reproductive age women is suffering from anemia. Indian government had started anemia prophylaxis efforts a half century ago and still continuing to battle with this ever prevalent disease to bring down its occurrence. National Family Health Survey is the large-scale survey conducted in India to provide high-quality data on health and family welfare and related emerging issues. The data provided not only helps in formulation, revision and monitoring of the policies and programs but in situating the development of India globally. Studying the time trend for anemia prevalence and other related parameters reported in NFHS surveys helps how well India has performed until now and how far is from its goal to become Anemia free country. Keywords: Anemia, iron deficiency, health survey, child health, maternal health.

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