- A research professional with more than 19 years of work experience in the development sector with a unique combinatio... moreA research professional with more than 19 years of work experience in the development sector with a unique combination of analytical, management and leadership skills. Expertise in designing, executing monitoring research and evaluation studies and surveys, preparing and managing budgets, advanced data analysis using different statistical softwares (SAS, STATA and SPSS) and modelling using Treeage software. Trained in Applied Methods of Cost Effectiveness Analysis at the Health Economics Research Centre, Oxford University. Familiarity of working in seven countries of Afghanistan, Bangladesh, India, Indonesia, Nepal, Pakistan and Philippines in the Asia region with an understanding of Sustainable Development Goals, Human Development Index and other social sector statistics. Handling advanced statistical data analysis of multi-country census, Global DHS data and other large-scale data sets and publishing articles in scientific peer reviewed journals.edit
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The Weekly Iron Folic Acid (WIFA) supplementation program for school going adolescent girls has been implemented by Indonesian Government since 2016. The objective of this study was to assess the coverage and adherence toward the WIFAS... more
The Weekly Iron Folic Acid (WIFA) supplementation program for school going adolescent girls has been implemented by Indonesian Government since 2016. The objective of this study was to assess the coverage and adherence toward the WIFAS among school going adolescent girls, as part of a baseline assessment of the new intervention. Methods: A cross-sectional survey was conducted in East Java (EJ) and East Nusa Tenggara (ENT) in year 2018. The samples were drawn from 60 high schools from 20 districts. The data collection was done by using a semi-structured, self-administered questionnaire. Results: The total number of respondents in EJ and ENT was 934 and 922 adolescent girls respectively, with a mean age of 17 y. The percentage of girls who reported to have received WIFAS tablet in the last six months was only 10% in ENT and 31% in EJ. The average number of WIFA tablet received was only 0.4-1.4 tablets and the average number of tablets consumed was only 0.4-0.7 tablet in the last 6 mo. Adolescent girls, who consumed at least 1 tablet was only 9% in ENT and 18% in EJ. The frequently causes of not consuming WIFA were that they forgot; did not think it was necessary; and were scared side effects. Conclusion: The coverage and adherence to WIFA program among school going adolescent girls in EJ and ENT provinces were low.
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Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in... more
Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-forage z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively.
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Background: Vitamin A deficiency is a common form of micronutrient malnutrition. The estimated relative risks associated with vitamin A deficiency in children were 1.86 (95% CI 1.32–2.59) for measles mortality, 2.15 (95% CI 1.83–2.58) for... more
Background: Vitamin A deficiency is a common form of micronutrient malnutrition. The estimated relative risks associated with vitamin A deficiency in children were 1.86 (95% CI 1.32–2.59) for measles mortality, 2.15 (95% CI 1.83–2.58) for diarrhoea mortality, 1.78 (95% CI 1.43–2.19) for malaria mortality, 1.13 (95% CI 1.01–1.32) for other
infectious disease mortality. Vitamin A supplementation reduces night blindness, child morbidity and mortality.
Methods: This paper tries to explore the socio-demographic causes of receipt of vitamin A in selected lower-middleincome and low income countries by analysing the data of the demographic and health surveys from 2012 and 2016 using PASW 18.0 software. Multivariate binary logistic regressions were conducted to explore the role of sociodemographic covariates in the receipt of vitamin A supplementation. In addition, random forest (RF) analyses were
conducted using Python 3.6.
Results: After adjusting for related socio-economic and demographic factors, mother’s work status and education and among mass media channels, exposure to television seems to play an important role in predicting receipt of vitamin A in the selected countries in Asia, while education of the mother was significantly associated with the receipt of
vitamin A in the selected countries of Africa. In all the selected countries, the RF analyses revealed mother’s education followed by wealth index and mass media (TV), as the variable of most importance.
Conclusions: It can be concluded that mother’s education and mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. It also figures in the variable importance matrix in addition to wealth index.
infectious disease mortality. Vitamin A supplementation reduces night blindness, child morbidity and mortality.
Methods: This paper tries to explore the socio-demographic causes of receipt of vitamin A in selected lower-middleincome and low income countries by analysing the data of the demographic and health surveys from 2012 and 2016 using PASW 18.0 software. Multivariate binary logistic regressions were conducted to explore the role of sociodemographic covariates in the receipt of vitamin A supplementation. In addition, random forest (RF) analyses were
conducted using Python 3.6.
Results: After adjusting for related socio-economic and demographic factors, mother’s work status and education and among mass media channels, exposure to television seems to play an important role in predicting receipt of vitamin A in the selected countries in Asia, while education of the mother was significantly associated with the receipt of
vitamin A in the selected countries of Africa. In all the selected countries, the RF analyses revealed mother’s education followed by wealth index and mass media (TV), as the variable of most importance.
Conclusions: It can be concluded that mother’s education and mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. It also figures in the variable importance matrix in addition to wealth index.
Background: The success of any program is measured by continuous monitoring through service statistics for a periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of activities in... more
Background: The success of any program is measured by continuous monitoring through service statistics for a
periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of
activities in the light of specified objectives. Service statistics need a lot of indicators to be tracked on a regular basis.
The service statistics provide us with numerators. To understand the numerators more meaningfully, we need to
standardize them by using specific denominators. So, denominators have to be estimated, which can enable
computation of indicators for monitoring purposes. Census and Large scale sample surveys provide proportions to
calculate denominators for program monitoring purposes.
Methods: This paper uses demographic techniques to estimate denominators for all the countries for which data from
the world population prospects is available.
Results: The denominators have been estimated for number of infants, children and women of reproductive age and
elderly in the age group of 60+ years.
Conclusions: The estimations of denominators at the sub-national levels becomes quite challenging due to the scarce
availability of data to be used as proportions for different population groups. But, once, the methodology is improved
with appropriate data, it could serve as a boon for annual program monitoring process at multiple data time points
between two national surveys.
periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of
activities in the light of specified objectives. Service statistics need a lot of indicators to be tracked on a regular basis.
The service statistics provide us with numerators. To understand the numerators more meaningfully, we need to
standardize them by using specific denominators. So, denominators have to be estimated, which can enable
computation of indicators for monitoring purposes. Census and Large scale sample surveys provide proportions to
calculate denominators for program monitoring purposes.
Methods: This paper uses demographic techniques to estimate denominators for all the countries for which data from
the world population prospects is available.
Results: The denominators have been estimated for number of infants, children and women of reproductive age and
elderly in the age group of 60+ years.
Conclusions: The estimations of denominators at the sub-national levels becomes quite challenging due to the scarce
availability of data to be used as proportions for different population groups. But, once, the methodology is improved
with appropriate data, it could serve as a boon for annual program monitoring process at multiple data time points
between two national surveys.
Background: As per NNS 2013, about 58% of the infants aged 0-5 months were exclusively breastfed. The data also shows that only 41% infants 6-8 months of age were introduced solid, semi-solid and soft foods. Further only 28% of children... more
Background: As per NNS 2013, about 58% of the infants aged 0-5 months were exclusively breastfed. The data also shows that only 41% infants 6-8 months of age were introduced solid, semi-solid and soft foods. Further only 28% of children aged 6-23 months received foods from four or more food groups during last 24 hours preceding the survey. Suboptimal IYCF practices are therefore considered to be an important contributor to the high rates of under nutrition in Afghanistan. The program monitoring at two time points was conducted to inform the program about the current status of the program activities and any course correction required. It was also meant to inform the government and other stakeholders on the feasibility of program strategies in improving IYCF practices and recommendations for scale-up programs.
Methods: The program monitoring was performed before and after the (IYCN) program roll out in Wardak and Laghman provinces of Afghanistan. To understand and monitor the status of process and program indicators, a Large Country-Lot Quality Assurance Sampling (LC-LQAS) study design was adopted.
Results: Minimum acceptable diet was observed to be 54% (95% CI: 46%, 61%) in the second round, which was 44% (95% CI: 35%, 53%) in the first round.
Conclusions: Minimum acceptable diet among the children of age group 6-23 months was found to be consistently doing well in both the rounds. LC-LQAS was found to be an apt method to estimate the IYCN indicators at time points with low resource use.
Methods: The program monitoring was performed before and after the (IYCN) program roll out in Wardak and Laghman provinces of Afghanistan. To understand and monitor the status of process and program indicators, a Large Country-Lot Quality Assurance Sampling (LC-LQAS) study design was adopted.
Results: Minimum acceptable diet was observed to be 54% (95% CI: 46%, 61%) in the second round, which was 44% (95% CI: 35%, 53%) in the first round.
Conclusions: Minimum acceptable diet among the children of age group 6-23 months was found to be consistently doing well in both the rounds. LC-LQAS was found to be an apt method to estimate the IYCN indicators at time points with low resource use.
Background : In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified a set of six global nutrition targets that by 2025. The goals were... more
Background : In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified a set of six global nutrition targets that by 2025. The goals were aimed at reducing stunting, anaemia, low birth weight, no increase in childhood overweight, increase rates of exclusive breastfeeding and reduce and maintain wasting. Out of these an average annual rate of reduction(AARR) of 3.9% for a 40% reduction in reduction in the number of children under five years of age who are stunted and an average annual rate of reduction of 5.2% has been estimated for a 50% reduction in anaemia among women of reproductive age.
Methods: This paper uses demographic techniques to project the number of stunted children under five years and anaemic women for the thirteen 100 million plus countries as of UN population projections, 2017 of Philippines, Ethiopia, Japan, Mexico, Russian Federation, Bangladesh, Nigeria, Pakistan, Brazil, Indonesia, United States of America, India and China using average annual rate of reduction recommended in the world health assembly.
Results: The number of stunted children under five years of age is estimated to be reduced by 27% by 2025, 40% by 2030 and 72% by 2050. The number of anaemic women of reproductive age is estimated to be reduced by 32% by 2025, 46% by 2030 and 85% by 2050.
Conclusions : There is a dire need for accelerating the progress of reduction in stunting prevalence among children under five years and anaemia among women of reproductive age to achieve the global targets in selected high burden countries of India and Nigeria.
Methods: This paper uses demographic techniques to project the number of stunted children under five years and anaemic women for the thirteen 100 million plus countries as of UN population projections, 2017 of Philippines, Ethiopia, Japan, Mexico, Russian Federation, Bangladesh, Nigeria, Pakistan, Brazil, Indonesia, United States of America, India and China using average annual rate of reduction recommended in the world health assembly.
Results: The number of stunted children under five years of age is estimated to be reduced by 27% by 2025, 40% by 2030 and 72% by 2050. The number of anaemic women of reproductive age is estimated to be reduced by 32% by 2025, 46% by 2030 and 85% by 2050.
Conclusions : There is a dire need for accelerating the progress of reduction in stunting prevalence among children under five years and anaemia among women of reproductive age to achieve the global targets in selected high burden countries of India and Nigeria.
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Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child... more
Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child morbidity and mortality, impaired mental development, impaired immune competence, increased susceptibility to lead poisoning, and decreased performance at work. Methods: This paper attempts to understand the determinants underlying iron and folic acid intake and correlates of anaemia prevalence in two countries in the Asia region using multivariate binary logistic regression analyses of recent data from the Demographic and Health Surveys of Cambodia and India. The individual level data was analysed, using Predictive Analytics Software for Windows (PASW) 18.0 release. Results: After adjusting for standard co-variates, reading newspaper and watching television was significantly associated with coverage, while reading newspaper and listening to radio was significantly associated with adherence to iron tablets or syrup in India. In case of both Cambodia and India, those who received at least three antenatal care visits were much more likely to adhere to at least 90 days of iron tablet or syrup or iron and folic acid tablets, more so in Cambodia compared to India. Those who reported to have adhered to at least 90 days of iron and folic acid tablets in India were more likely to be not anaemic unlike in case of Cambodia. Conclusions: Antenatal care-seeking visits seem to be a particularly effective ways of reaching women and in increasing the likelihood of intake of iron only or iron and folic acid supplements.
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Background: Anaemia has been a long standing public health problem in Bangladesh, particularly amongst the children and women. BDHS, 2011 showed that 42% of the women aged 15-49 years (pregnant women 49.6% and 48% lactating women) were... more
Background: Anaemia has been a long standing public health problem in Bangladesh, particularly amongst the children and women. BDHS, 2011 showed that 42% of the women aged 15-49 years (pregnant women 49.6% and 48% lactating women) were anaemic. Nutrition International (Formerly known as Micronutrient Initiative) supported Government of Bangladesh in revitalising IFA as a key component of the ANC package through demonstration of strategies to improve the coverage and adherence of IFA among pregnant women in selected districts with the objective of reducing iron deficiency anaemia.
Methods and Materials: The program package consisted of strengthening the supply chain of the IFA supplements; capacity building of health staff in estimation of IFA requirements, monitoring and tracking adherence, behavior Change interventions for increasing adherence with a focus on improved interpersonal counselling, modifying monitoring system to track coverage and improving supportive supervision. The demonstration projects were implemented in Narsinghdi and Satkhira districts of Bangladesh. The program was assessed by a pre-post intervention study design with intervention and comparison areas in the country. Socio-demographically similar districts were considered as comparison areas.
Results: In the intervention areas, adherence to 90+ IFA tablets was found to be more than 50% and binary logistic regression revealed that among all women interviewed, those who were exposed to improved interpersonal counseling were 7 times more likely to consume 90+ IFA in the most recent end-line survey undertaken [UOR: 7.560 (95% CI: 3.850-14.486, p=0.000)].
Conclusions: Considering the positive results of the program package, as demonstrated by the program evaluation findings, it is being scaled up in 10 low performing districts of Bangladesh with a focus on improved inter-personal counselling.
Methods and Materials: The program package consisted of strengthening the supply chain of the IFA supplements; capacity building of health staff in estimation of IFA requirements, monitoring and tracking adherence, behavior Change interventions for increasing adherence with a focus on improved interpersonal counselling, modifying monitoring system to track coverage and improving supportive supervision. The demonstration projects were implemented in Narsinghdi and Satkhira districts of Bangladesh. The program was assessed by a pre-post intervention study design with intervention and comparison areas in the country. Socio-demographically similar districts were considered as comparison areas.
Results: In the intervention areas, adherence to 90+ IFA tablets was found to be more than 50% and binary logistic regression revealed that among all women interviewed, those who were exposed to improved interpersonal counseling were 7 times more likely to consume 90+ IFA in the most recent end-line survey undertaken [UOR: 7.560 (95% CI: 3.850-14.486, p=0.000)].
Conclusions: Considering the positive results of the program package, as demonstrated by the program evaluation findings, it is being scaled up in 10 low performing districts of Bangladesh with a focus on improved inter-personal counselling.
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Background: The success of any program is measured by continuous monitoring through service statistics for a periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of activities in... more
Background: The success of any program is measured by continuous monitoring through service statistics for a periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of activities in the light of specified objectives. Service statistics need a lot of indicators to be tracked on a regular basis. The service statistics provide us with numerators. To understand the numerators more meaningfully, we need to standardize them by using specific denominators. So, denominators have to be estimated, which can enable computation of indicators for monitoring purposes. Census and large scale sample surveys provide proportions to calculate denominators for program monitoring purposes.
Methods: This paper uses demographic techniques to estimate denominators for the thirteen 100 million plus countries as of UN projections, 2017 of Philippines, Ethiopia, Japan, Mexico, Russian Federation, Bangladesh, Nigeria, Pakistan, Brazil, Indonesia, United States of America, India and China.
Results: The denominators have been estimated for number of live births, number of annual pregnancies, the first 1,000 days, children and women of reproductive age (15 to 49 years), pregnant, lactating, non-pregnant and non-lactating women, elderly in the age group of 60+ years.
Conclusions: The estimations of denominators at the sub-national levels becomes quite challenging due to the scarce availability of data to be used as proportions for different population groups. But, once, the methodology is improved with appropriate data, it could serve as a boon for annual program monitoring process at multiple data time points between two national surveys and between two consecutive censuses.
Methods: This paper uses demographic techniques to estimate denominators for the thirteen 100 million plus countries as of UN projections, 2017 of Philippines, Ethiopia, Japan, Mexico, Russian Federation, Bangladesh, Nigeria, Pakistan, Brazil, Indonesia, United States of America, India and China.
Results: The denominators have been estimated for number of live births, number of annual pregnancies, the first 1,000 days, children and women of reproductive age (15 to 49 years), pregnant, lactating, non-pregnant and non-lactating women, elderly in the age group of 60+ years.
Conclusions: The estimations of denominators at the sub-national levels becomes quite challenging due to the scarce availability of data to be used as proportions for different population groups. But, once, the methodology is improved with appropriate data, it could serve as a boon for annual program monitoring process at multiple data time points between two national surveys and between two consecutive censuses.
Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child... more
Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child morbidity and mortality, impaired mental development, impaired immune competence, increased susceptibility to lead poisoning, and decreased performance at work. Methods: This paper attempts to understand the determinants underlying iron intake in select countries in Asia using multivariate regression analyses of recent data from the Demographic and Health Surveys of eight countries of Afghanistan, Cambodia, India, Indonesia, Myanmar, Nepal, Pakistan, and the Philippines. The individual level data was analysed, using Predictive Analytics Software for Windows (PASW) 18.0 release. Results: After adjusting for standard co-variates, exposure to newspaper was found to be associated with increased adherence to iron tablets or syrup, in five of the eight countries (India, Indonesia, Nepal, Pakistan, and the Philippines). Exposure to television was significantly associated with coverage and adherence to iron tablets or syrup in Afghanistan, India, Indonesia and Myanmar. Those who received at least three antenatal care visits were much more likely to adhere to at least 90 days of iron tablet or syrup or iron and folic acid tablets supplementation. Conclusions: Based on insights from eight demographic and health surveys, mass media (including print and TV), as well as antenatal care-seeking visits seem to be a particularly effective ways of reaching women and in increasing the likelihood of uptake of iron only or iron and folic acid supplements.
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Background: Vitamin A supplementation reduces night blindness, child morbidity and mortality. In Bangladesh, Vitamin A deficiency among children 6-59 months has remained just about stagnant at 20.5 per cent as per the latest Bangladesh... more
Background: Vitamin A supplementation reduces night blindness, child morbidity and mortality. In Bangladesh, Vitamin A deficiency among children 6-59 months has remained just about stagnant at 20.5 per cent as per the latest Bangladesh National Micronutrient Status Survey 2011-12 declining by a meagre 1.2 per cent from 21.7 per cent in 1997 (IPHN/HKI, 1997). Alarmingly, there is an absolute decline of 24 percentage points in VAS supplementation from 2007 to 2011 according to the Bangladesh Demographic & Health Surveys (BDHS). The current status of vitamin A supplementation raises concern because the Ministry of Health and Family Welfare (MoHFW)’s Health, Population and Nutrition Sector Development Program (HPNSDP) 2011-2016 target of 90 per cent needs to be achieved by 2016. Methods: This paper tries to explore the socio-demographic causes of receipt of Vitamin A in Bangladesh by analysing the data of the demographic and health surveys for 2007 and 2011 using SAS software. A log binomial regression was conducted to explore the effect of education and exposure to mass media on receipt of vitamin A supplementation. Results: After adjusting for related socio-economic and demographic factors, parent’s education and among mass media channels, television seems to play an important role in predicting receipt of Vitamin A, (Prevalence Ratio [PR]: 1.0973, 95% Confidence Interval [CI] 1.0499-1.1469) in BDHS 2011. Similarly, also those who watched television were more likely to have received vitamin A (Prevalence Ratio [PR]: 1.0542, 95% Confidence Interval [CI] 1.0304-1.0784). Conclusions: It can be concluded that mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. Though mother’s education was not associated in the 2007 survey, but it was significantly associated with the receipt of vitamin A in the 2011 survey.
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Background: Motivation is a force that initiates, guides and maintains goal-oriented behaviors. There are different theories which have been proposed to describe the various aspects of motivation as well as job satisfaction of workers.... more
Background: Motivation is a force that initiates, guides and maintains goal-oriented behaviors. There are different theories which have been proposed to describe the various aspects of motivation as well as job satisfaction of workers. Health worker motivation and work performance are closely related.
In India, Civil registration was initiated under the registration of births and deaths act, 1969 to give reliable estimates of fertility and mortality situation for the nation up to the lowest administrative levels, but due to its... more
In India, Civil registration was initiated under the registration of births and deaths act, 1969 to give reliable estimates of fertility and mortality situation for the nation up to the lowest administrative levels, but due to its inadequate and underreporting, still the Sample Registration System is used to generate reliable indicators of fertility and mortality. In this paper, an attempt is made to compute certain indicators from the civil registration system for the period of 2001-14 in the State of Rajasthan, India. The major SDG indicators of goal 3 of ensuring healthy lives and promoting well-being for all at all ages; targets 3.1 (By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births) and 3.2 (By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births) with indicators of Under-five Mortality Rate (indicator 3.2.1) and Maternal Mortality Ratio (indicator 3.1.1) and other fertility and mortality indicators can be computed, if certain denominator bases are available every year. As the civil registration data has not been classified by the place of residence, it is not strictly comparable to SRS figures. But it has been presented here so as to serve as an indication and for the improvement of the system for generation of reliable vital rates at sub-national levels using civil registration data, which is the need of the day for planning purposes for programme managers and policy makers
India is the second most populous country in the world characterized by regional imbalances like a large north–south divide in health and development. The National Population Policy, 2000 focuses on 'Decentralised Planning and Programme... more
India is the second most populous country in the world characterized by regional imbalances like a large north–south divide in health and development. The National Population Policy, 2000 focuses on 'Decentralised Planning and Programme Implementation'. The 73rd Constitutional Amendment Act, 1992, made health, family welfare, and education a responsibility of village panchayats. The panchayati raj institutions are an important means of furthering decentralized planning and programme implementation. The National Rural Health Mission (NRHM) also clearly spells out this by recognizing the importance of decentralization and district management of health programmes. In this direction, the concepts of Village Health Plan and Fund, Village Health and Sanitation Committees and Rogi Kalyan Samities are inbuilt in this programme to decentralize the powers, functions and funds to the local frontline health functionaries and to empower them to take decision and utilize the funds for the welfare of the patients. The present study focuses on the decentralization of healthcare systems in Indian context and its relationship with improvement in healthcare service delivery, utilization and outcomes in rural areas. This study was carried out in two districts of Vadodara and Khurdha in the states of Gujarat and Odisha respectively. The data includes both primary and secondary sources. The primary quantitative survey includes data collected through a questionnaire for 480 women (15–49 years of age) and 480 men (15–54 years of age) from 480 households. The primary qualitative data includes data collected from in-depth interviews, focus group discussions and case studies. The secondary source includes the data from the health facility survey of the DLHS-3. The study was carried out during 2009–2010. In this paper, an attempt has also been made to construct an index of health systems decentralization using secondary data with inputs from the field from the primary study in the two states of Gujarat and Odisha, which revealed that Gujarat fared higher in terms of health system decentralization compared to its counterpart.
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Background: Medical Certification of Cause of Death (MCCD) scheme is imperative tool to obtain scientific and reliable information in terms causes of mortality. The Office of the Registrar General of India (ORGI) initiated the scheme on... more
Background: Medical Certification of Cause of Death (MCCD) scheme is imperative tool to obtain scientific and reliable information in terms causes of mortality. The Office of the Registrar General of India (ORGI) initiated the scheme on Medical Certification of Cause of Deaths (MCCD) under Civil Registration System (CRS), during the Third Five Year Plan.
Methods: This paper analyzes the data for the last 16 years for MCCD in Rajasthan from 1999 to 2015. The findings are based on more than half a million deaths, for which cause of death data is reported. The per cent of cause of deaths have been computed and the curve estimation method has been used to project the cause of death due to circulatory diseases.
Results: The data reveals that the percentage of medically certified deaths hovers around 10 to 13 percent during 1999 to 2015 of the total deaths registered under the civil registration system, which is about 5 million deaths. The highest percentage of deaths that has been medically certified is due to circulatory diseases as seen for the combined period of sixteen years (1999-2015) (21 percent) followed by deaths due to certain infectious and parasitic diseases (16 percent). This has increased from 13.8 per cent in 1999 to 20.2 per cent in 2015. This proportion has been projected upto 2030, the target year of achievement of Sustainable Development Goals (SDGs).
Conclusion: Addressing this cause, could help in the achievement of indicator of 3.4.1, mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease under the target of reducing by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being by 2030 subsumed under the SDG 3 of ensuring healthy lives and promote well-being for all at all ages.
Methods: This paper analyzes the data for the last 16 years for MCCD in Rajasthan from 1999 to 2015. The findings are based on more than half a million deaths, for which cause of death data is reported. The per cent of cause of deaths have been computed and the curve estimation method has been used to project the cause of death due to circulatory diseases.
Results: The data reveals that the percentage of medically certified deaths hovers around 10 to 13 percent during 1999 to 2015 of the total deaths registered under the civil registration system, which is about 5 million deaths. The highest percentage of deaths that has been medically certified is due to circulatory diseases as seen for the combined period of sixteen years (1999-2015) (21 percent) followed by deaths due to certain infectious and parasitic diseases (16 percent). This has increased from 13.8 per cent in 1999 to 20.2 per cent in 2015. This proportion has been projected upto 2030, the target year of achievement of Sustainable Development Goals (SDGs).
Conclusion: Addressing this cause, could help in the achievement of indicator of 3.4.1, mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease under the target of reducing by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being by 2030 subsumed under the SDG 3 of ensuring healthy lives and promote well-being for all at all ages.
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Objectives: This study tries to explore the role of exposure to mass media and interpersonal communication in predicting current use of contraception in Bangladesh. Materials & Methods: Bivariate and Multivariate analyses were carried out... more
Objectives: This study tries to explore the role of exposure to mass media and interpersonal communication in predicting current use of contraception in Bangladesh.
Materials & Methods: Bivariate and Multivariate analyses were carried out on the Bangladesh Demographic Health Survey, 2011 data using SAS software to explore the association between communication and current use of contraception.
Results: After adjusting for related socio-economic and demographic factors, mass media does not seem to have any role in predicting contraceptive use behavior, while the findings show that interpersonal communication (Prevalence Ratio [PR]: 1.0984, 95% Confidence Interval [CI] 1.0801-1.1170) is a strong positive predictor of current contraceptive use.
Conclusions: It is a well-known fact that mass media performs only the knowledge function, while interpersonal communication performs an additional function of persuasion (Rogers, 1971). This analysis corroborates this statement that the role of interpersonal communication is quite important in predicting contraceptive use.
Materials & Methods: Bivariate and Multivariate analyses were carried out on the Bangladesh Demographic Health Survey, 2011 data using SAS software to explore the association between communication and current use of contraception.
Results: After adjusting for related socio-economic and demographic factors, mass media does not seem to have any role in predicting contraceptive use behavior, while the findings show that interpersonal communication (Prevalence Ratio [PR]: 1.0984, 95% Confidence Interval [CI] 1.0801-1.1170) is a strong positive predictor of current contraceptive use.
Conclusions: It is a well-known fact that mass media performs only the knowledge function, while interpersonal communication performs an additional function of persuasion (Rogers, 1971). This analysis corroborates this statement that the role of interpersonal communication is quite important in predicting contraceptive use.
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India is the one of the first countries in the world to adopt a family planning programme way back in 1951. But it has yet to achieve net replacement levels of fertility in all states. Family planning in India has also undergone several... more
India is the one of the first countries in the world to adopt a family planning programme way back in 1951. But it has yet to achieve net replacement levels of fertility in all states. Family planning in India has also undergone several transformations. In the 1980s, though, the efforts to encourage the use of reversible methods were initiated, the trend and pace of spacing methods over terminal methods has been quite gradual. This paper uses NFHS-3, (2005-06) data to understand the enabling factors responsible to increase condom use as a birth spacing method. The use of any family planning method in India has risen from 40.7 percent during NFHS-1 to 48.2 in NFHS-2 to 56.3 percent in the recently concluded NFHS-3. The method-mix has shown a gradual shift in favour of spacing methods over terminal methods. As a spacing method, condom use in India has risen from 2.4 percent during NFHS-1 to 3.1 in NFHS-2 to 5.2 percent in the recently concluded NFHS-3. Among the states, though Uttarakhand has been carved out of Uttar Pradesh, there is a lot of variation in the level of condom use among these two states. According to NFHS-3, the condom use in Uttar Pradesh is 8.6 percent, which is about the double in case of Uttarakhand, which stands at 15.7 percent. So, this paper tries to understand the factors enabling higher condom use in Uttarakhand in comparison to Uttar Pradesh. This may offer some insights to the programme planners and implementers to achieve improvement in condom use considering the striking difference in the level of TFR in both these states. With regards to the level of TFR, Uttarakhand stands at 2.5 compared to the Uttar Pradesh, which stands at 3.8 only second in position to Bihar with a TFR of 4. It is a well-known fact that mass media performs only the knowledge function, while interpersonal communication performs an additional function of persuasion (Rogers, 1971). The results reveal that Mass media is an important factor explaining the higher condom use in Uttarakhand, while in case of Uttar Pradesh, accessibility in buying condoms from pharmacies and drug stores is significant as a factor in explaining condom use.