Public Health Interventions, Barriers, and Opportunities for Improving Maternal Nutrition in India

2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S71-S92 ◽  
Author(s):  
Usha Ramakrishnan ◽  
Alyssa Lowe ◽  
Sheila Vir ◽  
Shuba Kumar ◽  
Rani Mohanraj ◽  
...  
Keyword(s):  
Public Health ◽  
Program Implementation ◽  
Tamil Nadu ◽  
Maternal Nutrition ◽  
Phase 1 ◽  
National Level ◽  
Monitoring And Evaluation ◽  
Resource Scarcity ◽  
Maternal Undernutrition ◽  
Nutrition Programs

Background Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. Objective To evaluate the implementation of maternal nutrition programs in India. Methods The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. Results India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Conclusions Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.

Participatory Poverty Assessment Effort in Food Security and Extension Policy

2020 ◽  
pp. 481-499 ◽  
Author(s):  
Muhamad Rusliyadi ◽  
Azaharaini Bin Hj. Mohd. Jamil
Keyword(s):  
Human Resources ◽  
Program Implementation ◽  
National Level ◽  
Development Program ◽  
Monitoring And Evaluation ◽  
Participatory Approach ◽  
Policy Model ◽  
Poverty Assessment ◽  
Grassroots Level ◽  
The Impact

The impact study assessment aims to evaluate policies and monitor the achievement of targets and the results of a development program such as DMP. The output obtained is information that is an evaluation of how the policy was planned, initiated, and implemented. Participatory monitoring and evaluation analyze the outcome and impact of the DMP Program. PPA seeks to answer the question of whether or not the policy or program is working properly. A participatory approach may improve the outcomes in the form of a new policy model for the future. The output of the PPA process from this study is the agricultural policy formulated in terms of practical ways of approaching poverty problems from a local perspective. The success of alternative policy options applied by local government such as physical, human resources, and institution development at the grassroots level should be adopted at the national level. It should represent the best example of a case of successful program implementation at the grassroots level which can then be used in formulating national policies and strategies.

A Situation Analysis of Public Health Interventions, Barriers, and Opportunities for Improving Maternal Nutrition in Bihar, India

2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S93-S103 ◽  
Author(s):  
Elizabeth A. Noznesky ◽  
Usha Ramakrishnan ◽  
Reynaldo Martorell
Keyword(s):  
Public Health ◽  
Low Birthweight ◽  
Maternal Nutrition ◽  
New Technologies ◽  
Service Providers ◽  
Secondary Data ◽  
New Delhi ◽  
Maternal Undernutrition ◽  
Barriers And Opportunities ◽  
The Government

Background Maternal underweight and anemia are highly prevalent in Bihar, especially among adolescent girls aged 15 to 19 years. Although numerous programs and platforms exist for delivering efficacious interventions for improving maternal nutrition, the coverage and quality of these interventions are low. Objective To examine existing interventions for reducing maternal undernutrition in Bihar and identify barriers to and opportunities for expanding their coverage and quality. Methods The research was conducted in New Delhi and Bihar between May and August 2010. Forty-eight key informant interviews were conducted with policy makers, program managers, and service providers at multiple levels. Secondary data were collected from survey reports and program documents. All data were analyzed thematically. Results Barriers to the delivery and uptake of interventions to improve maternal nutrition include the shortage of essential inputs, low prioritization of maternal undernutrition, sterilization bias within the family planning program, weak management systems, poverty, gender inequality, caste discrimination, and flooding. In order to overcome barriers and improve service delivery, the current government and its partners have introduced structural reforms within the public health system, launched new programs for underserved groups, developed innovative approaches, and experimented with new technologies. Conclusions Since coming to power, the Government of Bihar has achieved impressive increases in the coverage of prioritized health services, such as institutional deliveries and immunization. This success presents it with an excellent opportunity to further reduce maternal and infant mortality by turning its attention to the serious problem of maternal undernutrition and low birthweight.

Public Health Interventions, Barriers, and Opportunities for Improving Maternal Nutrition in Northeast Nigeria

2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S51-S70 ◽  
Author(s):  
Amy Webb Girard ◽  
Cynthia Dzingina ◽  
Oladele Akogun ◽  
John B. Mason ◽  
Deborah A. McFarland
Keyword(s):  
Economic Development ◽  
Nongovernmental Organizations ◽  
Maternal Nutrition ◽  
Phase 1 ◽  
Maternal Undernutrition ◽  
Health And Economic Development ◽  
Barriers And Opportunities ◽  
State And Local ◽  
Depth Interviews ◽  
Northeast Nigeria

Background Efficacious strategies to improve maternal nutrition and subsequent maternal, neonatal, and child health exist, but their utilization and application at scale is limited. Objective This study explored the gaps, barriers, and opportunities for maternal nutrition policy and programming in Nigeria, a country with a disproportionate share of the global burden of maternal and child mortality Methods Research was conducted in three phases in four Local Government Authorities in Taraba State. Phase 1 consisted of a desk review of policies, programs, and sociodemographic and health indicators pertinent to maternal nutrition. In-depth interviews were conducted with key informants in state and local ministries of health as well as international nongovernmental organizations and community- and faith-based organizations. Phase 2 utilized in-depth interviews and focus group discussions with community leaders, health promoters, and mothers. Phase 3 consisted of key informant interviews with federal policy and program leaders in government ministries and nongovernmental organizations. Results Nutrition, especially maternal nutrition, is not prioritized and is poorly funded in both the governmental and the nongovernmental systems. Perceived weak advocacy for nutrition and its role in economic development and the lack of coordination among governmental and nongovernmental actors were said to contribute to low prioritization. Dependence on health facilities as the primary platform for delivering maternal nutrition is problematic, given severe resource constraints and perceived community barriers, including cost, distance, and poor quality of care. Conclusions Advocacy for maternal nutrition that improves understanding of its consequences for health and economic development could hasten prioritization, coordination, and investment in maternal nutrition at the national, state, and local levels. Innovative, multisectoral strategies that move beyond facility-based platforms are needed to reduce the burden of maternal undernutrition in Northeast Nigeria.

scholarly journals The Role of Mosquito Surveillance in Monitoring Arboviral Infections in Croatia

2020 ◽  
Vol 39 (1) ◽  
pp. 15-22
Author(s):  
Nataša Janev Holcer ◽  
Krunoslav Capak ◽  
Tatjana Vilibić-Čavlek ◽  
Pavle Jeličić ◽  
Lovro Bucić
Keyword(s):  
Public Health ◽  
Detection System ◽  
Mosquito Species ◽  
National Level ◽  
Virus Detection ◽  
Monitoring And Evaluation ◽  
Legal Framework ◽  
Vector Surveillance ◽  
Vector Borne Diseases ◽  
Vector Borne

In accordance with the noticed growing trend in the number of vector-borne disease cases, the extent of public health significance of this problem is also increasing. However, the strengthening of capacities for suppression of these outbreaks is present. With the aim of protecting population from arbovirus infections, there is a need for continuous monitoring and evaluation of risk factors related to vectors and vector borne diseases and human health, for which data is acquired through monitoring programs. In order to address these issues, several activities must be integrated and taken into consideration: vector surveillance, entomological activity, early detection system, preventive measures, counter-epidemic measures and virus detection in vectors, reservoirs or infected animals. There is a legal framework regarding mosquito monitoring on a local, as well as national level. Additionally, at the initiative of the Croatian Institute of Public Health, invasive mosquito species monitoring is being implemented and continuously conducted since 2016.

scholarly journals Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259708
Author(s):  
Gallican N. Rwibasira ◽  
Samuel S. Malamba ◽  
Gentille Musengimana ◽  
Richard C. M. Nkunda ◽  
Jared Omolo ◽  
...  
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
National Level ◽  
Age Groups ◽  
Monitoring And Evaluation ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Epidemic Control ◽  
Hiv Diagnosis ◽  
Recent Infection

Background Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. Methods We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. Results Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). Conclusion Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.

Policies and Program Implementation Experience to Improve Maternal Nutrition in Ethiopia

2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S27-S50 ◽  
Author(s):  
Lisa S. Saldanha ◽  
Laura Buback ◽  
Jessica M. White ◽  
Afework Mulugeta ◽  
Solomon G. Mariam ◽  
...  
Keyword(s):  
Program Implementation ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Background Information ◽  
Nutrition Interventions ◽  
District Health ◽  
Community Based ◽  
Maternal Undernutrition ◽  
Health And Nutrition ◽  
Nutrition Service

Background Maternal undernutrition persists as a serious problem in Ethiopia. Although there are maternal nutrition interventions that are efficacious and effective in improving maternal, neonatal, and child health (MNCH) outcomes, implementation has been limited. Objective This study explored needs, perceptions, priorities, facilitating factors and barriers to implementation of relevant policies and programs to find opportunities to improve maternal nutrition in Ethiopia Methods Background information was compiled and synthesized for a situation analysis. This informed focus group discussions and in-depth interviews with mothers, community leaders, health workers, and district health officials in four woredas (districts) in Tigray and Southern Nations, Nationalities and Peoples Region. Results Findings focused on three priority issues: maternal anemia, intrauterine growth retardation (IUGR), and maternal thinness and stunting. Community-level investigations found that women's low status, food insecurity and poverty, and workload were key factors perceived to contribute to women's undernutrition. Awareness of and demand for services to improve women's nutrition were low, except for high demand for supplementary food. On the supply side, barriers included low prioritization of maternal nutrition in health and nutrition service delivery and weak technical capacity to deliver context-sensitive maternal nutrition interventions at all levels. Conclusions Community-based health and nutrition services were promising platforms for expanding access to interventions such as micronutrient supplements and social and behavior change communication. Investments are needed to support these community-based programs, including training, supplies, supervision and monitoring. To address IUGR at scale, increased access to cash or food transfers could be explored.

scholarly journals Implementing Multisector Nutrition Programs in Ethiopia and Nepal

2016 ◽  
Vol 37 (4_suppl) ◽  
pp. S115-S123 ◽  
Author(s):  
Eileen Kennedy ◽  
Habtamu Fekadu ◽  
Shibani Ghosh ◽  
Kedar Baral ◽  
Dale Davis ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Food Insecurity ◽  
Program Implementation ◽  
National Level ◽  
Nutrition Program ◽  
Effective Governance ◽  
Nutrition Programs ◽  
Key Stakeholders ◽  
Challenges And Opportunities ◽  
Micronutrient Malnutrition

Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The main challenges identified included the need for more specificity in the roles of agencies/individuals in program implementation, more effective mechanisms for linking national to subnational officials, methods for creating awareness of the plans, and a dedicated line item in the budgets of each agency. The level of enthusiasm was high in both countries. Respondents in both countries highlighted the need to identify a “champion” at the highest level who would keep the momentum for the respective plans alive.

scholarly journals The European Association for the Study of Obesity (EASO) Endorses the Milan Charter on Urban Obesity

Obesity Facts ◽  
2021 ◽  
pp. 1-6
Author(s):  
Michele O. Carruba ◽  
Luca Busetto ◽  
Sheree Bryant ◽  
Antonio Caretto ◽  
Nathalie J. Farpour-Lambert ◽  
...  
Keyword(s):  
Public Health ◽  
Social Stigma ◽  
National Level ◽  
Well Being ◽  
Communicable Diseases ◽  
Urban Environments ◽  
Shared Responsibility ◽  
Access To Treatment ◽  
Non Communicable Diseases ◽  
Health Goals

The Milan Charter on Urban Obesity highlights the challenges of urban environments as a battleground for human health, as cities are often organized to subvert public health goals, and promote rather than prevent the development of obesity and consequent non-communicable diseases. The Charter articulates ten principles which detail actions and strategies through which general practitioners, diverse medical specialists, related healthcare professionals, administrators and healthcare practice managers, policy actors – within health systems and at a national level – along with experts across disciplines, and citizens, can work in cooperation to meet this challenge and improve public health. The Charter urges the adoption of decisions that deliver the following: (i) policies which enable our cities to become healthier and less obesogenic, more supportive of well-being and less health-disruptive in general, and (ii) policies that fully support primary prevention strategies, that address social stigma, and that ensure fair access to treatment for people living with obesity. The Milan Charter on Urban Obesity aims to raise awareness of our shared responsibility for the health of all citizens, and focuses on addressing the health of people living with obesity – not only as a challenge in its own right, but a gateway to other major non-communicable diseases, including cardiovascular diseases, type 2 diabetes, and some cancers.

Capacity building in the public health field in the Tunisian medical faculties

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Coman ◽  
O Oltean ◽  
M Palianopoulou ◽  
D Plancikova ◽  
C Zedini ◽  
...  
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Knowledge ◽  
National Level ◽  
Training Programme ◽  
Local Health ◽  
The Public ◽  
Public Health Training ◽  
Medical Faculties ◽  
Health Field

Abstract Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained. The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties. Key messages Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.

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