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Sharma A, Chanda S, Porwal A, Wadhwa N, Santhanam D, Ranjan R, Shah H, Adyanthaya S, Meena R. Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India. BMC Nutr 2024; 10:82. [PMID: 38845052 PMCID: PMC11154971 DOI: 10.1186/s40795-024-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups. OBJECTIVE To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy. METHODS Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives. RESULTS Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1-1.4), community motivators (aOR = 1.9, CI: 1.7-2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women. CONCLUSION Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.
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Affiliation(s)
- Anshita Sharma
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India.
| | - Srei Chanda
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Akash Porwal
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Namita Wadhwa
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Divya Santhanam
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Raghwesh Ranjan
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Hemang Shah
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Shachi Adyanthaya
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Ramavatar Meena
- Directorate of Integrated Child Development Services, Jaipur, Rajasthan, India
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Wang Z, Chaudhry M, Mistry R, Needham BL, Baylin A, Mancuso P, Singh K, Khandelwal S. A mixed-methods study on the dietary practices of early postpartum women during the summer rainy season in Belgaum, Karnataka, India. Ecol Food Nutr 2022; 61:728-752. [PMID: 36268551 DOI: 10.1080/03670244.2022.2136171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The current mixed-method study uses Food Frequency Questionnaires and 24-hour dietary recalls (n = 41) to assess the food/nutrient intake; and qualitative interviews to identify local perceptions of food among 41 early postpartum women in Belgaum, India. The results show that total energy, protein, and most micronutrient intake were significantly lower than the Recommended Dietary Allowance of India (p < .05 individually); ninety percent of mothers restricted the consumption of some specific fruits, vegetables, and other foods during postpartum due to their perceptions of foods, folk medicines, and health beliefs. Culturally sensitive programs relevant to postpartum diet practices for women should be implemented.
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Affiliation(s)
- Zeyuan Wang
- Nutritional Science, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Monica Chaudhry
- Department of Public Health Nutrition, Public Health Foundation of India (PHFI), Delhi, India
| | - Ritesh Mistry
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Belinda L Needham
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Ana Baylin
- Nutritional Science, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Peter Mancuso
- Nutritional Science, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kalpana Singh
- Department of Public Health Nutrition, Public Health Foundation of India (PHFI), Delhi, India
| | - Shweta Khandelwal
- Department of Public Health Nutrition, Public Health Foundation of India (PHFI), Delhi, India
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Locks LM, Shah M, Bhaise S, Hibberd PL, Patel A. Assessing the Diets of Young Children and Adolescents in India: Challenges and Opportunities. Front Pediatr 2022; 10:725812. [PMID: 35656376 PMCID: PMC9152162 DOI: 10.3389/fped.2022.725812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Sustainably addressing the crisis of undernutrition for children and adolescents in underserved and resource-limited communities will require, among other investments, interventions aimed at optimizing the diets of these vulnerable populations. However, to date, there are substantial global gaps in the collection of dietary data in children and adolescents. This review article summarizes the challenges and opportunities in assessing diet among children and adolescents in India. National surveys in India identify the scale of the triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in children and adolescents and assess key nutrition and food security indicators for making informed policy decisions. However, national surveys do not collect data on diet, instead relying on anthropometry, biomarkers of micronutrient deficiencies, and summary measures of diet, such as the WHO infant and young child feeding summary indicators. Sub-national surveys and the scientific literature thus fill important gaps in describing the nutrient intakes of children and adolescents in India; however large gaps remain. Future research can be improved by investments in infrastructure to streamline the assessment of diet in India. The current challenges confronting the collection and analysis of high-quality dietary data occur in both the data collection and data analysis phases. Common methods for assessing diets in low-resource settings-such as 24 h recalls and food frequency questionnaires are particularly challenging to implement well in young children and adolescents due to motivation and memory issues in young respondents. Additionally, there are challenges with parental recall including children having multiple caretakers and meals outside the home. Furthermore, analysis of dietary data is hindered by the lack of affordable, accessible software for dietary data analysis relevant to the diversity in Indian diets. New technologies can address some of the challenges in dietary data collection and analysis, but to date, there are no platforms designed for population-level dietary assessment in India. Public and private sector investment in dietary assessment, as well as collaboration of researchers and the creation of open-source platforms for the sharing of data inputs (local food lists, recipe databases, etc.) will be essential to build infrastructure to better understand the diets of children and adolescents in India and improve dietary interventions in these target groups.
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Affiliation(s)
- Lindsey M. Locks
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
| | - Miloni Shah
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
| | | | - Patricia L. Hibberd
- Department of Global Health, School of Public Health, Boston University, Boston, MA, United States
- Department of Infectious Diseases, School of Medicine, Boston University, Boston, MA, United States
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, India
- Datta Meghe Institute of Medical Sciences, Sawangi, India
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Cervera‐Mata A, Sahu PK, Chakradhari S, Sahu YK, Patel KS, Singh S, Towett EK, Martín‐Ramos P, Quesada‐Granados JJ, Rufián‐Henares JA. Plant seeds as source of nutrients and phytochemicals for the Indian population. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ana Cervera‐Mata
- Departamento de Edafología y Química Agrícola Facultad de Farmacia Universidad de Granada Granada Spain
| | - Pravin Kumar Sahu
- School of Studies in Environmental Science Ravishankar Shukla University Raipur India
| | - Suryakant Chakradhari
- School of Studies in Environmental Science Ravishankar Shukla University Raipur India
| | - Yaman Kumar Sahu
- School of Studies in Chemistry Ravishankar Shukla University Raipur India
| | | | - Samarendra Singh
- Department of Higher Education Government of Chhattisgarh New Raipur India
| | | | - Pablo Martín‐Ramos
- Department of Agricultural and Environmental Sciences Instituto de Investigación en Ciencias Ambientales de Aragón University of Zaragoza Huesca Spain
| | - José Javier Quesada‐Granados
- Departamento de Nutrición y Bromatología Centro de Investigación Biomédica Instituto de Nutrición y Tecnología de los Alimentos Universidad de Granada Granada Spain
| | - José A. Rufián‐Henares
- Departamento de Nutrición y Bromatología Centro de Investigación Biomédica Instituto de Nutrición y Tecnología de los Alimentos Universidad de Granada Granada Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA Universidad de Granada Granada Spain
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Sharma S, Akhtar F, Singh RK, Mehra S. Comparing Reproductive Health Awareness, Nutrition, and Hygiene among Early and Late Adolescents from Marginalized Populations of India: A Community-Based Cross-Sectional Survey. Healthcare (Basel) 2021; 9:healthcare9080980. [PMID: 34442117 PMCID: PMC8394421 DOI: 10.3390/healthcare9080980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 11/16/2022] Open
Abstract
Adolescence (10–19 years) is marked by many physiological changes and is vulnerable to health and nutritional problems. Adolescence, particularly, early adolescence is inadequately addressed in our national surveys. The present study aimed to assess the reproductive health awareness, nutrition, and hygiene of marginalized adolescent girls and boys and compare them among early and late adolescents. Our cross-sectional study was a part of a community-based project across India’s five zones, namely North, East, West, Central, and South. Unadjusted and adjusted logistic regression was performed to compare awareness about HIV/AIDS, or Sexually Transmitted Infections (STI), consumption of Iron Folic Acid (IFA) tablets and three meals in a day, safe menstrual hygiene practices, history of anemia, and open defecation practice among early and late adolescents. Data were reported as unadjusted and adjusted odds ratio (aOR) with a 95% confidence interval (95% CI). Among early adolescents, around 58% of girls and boys did not consume IFA tablets, and 28% of girls and 24% of boys defecated in the open. Compared to late adolescents, early adolescent girls had lower odds of awareness about HIV/AIDS (aOR (95% CI): 0.50 (0.47–0.54)) and open defecation (aOR (95% CI): 0.90 (0.83–0.98)) and higher odds of hand hygiene after defecation (aOR (95% CI): 1.52 (1.37–1.68)) and safe menstrual practices (aOR (95% CI): 1.42 (1.23–1.64)). There is a dire need to start public health interventions from early adolescence for long-term benefits throughout adolescence.
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Affiliation(s)
- Shantanu Sharma
- Department of Clinical Sciences, Lund University, Skåne University Hospital, S-20502 Malmö, Sweden
- MAMTA Health Institute for Mother and Child, Delhi 110048, India; (F.A.); (R.K.S.); (S.M.)
- Correspondence:
| | - Faiyaz Akhtar
- MAMTA Health Institute for Mother and Child, Delhi 110048, India; (F.A.); (R.K.S.); (S.M.)
| | - Rajesh Kumar Singh
- MAMTA Health Institute for Mother and Child, Delhi 110048, India; (F.A.); (R.K.S.); (S.M.)
| | - Sunil Mehra
- MAMTA Health Institute for Mother and Child, Delhi 110048, India; (F.A.); (R.K.S.); (S.M.)
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Association between Maternal Dietary Diversity and Low Birth Weight in Central India: A Case-Control Study. J Nutr Metab 2021; 2021:6667608. [PMID: 34194827 PMCID: PMC8181120 DOI: 10.1155/2021/6667608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/25/2021] [Indexed: 11/28/2022] Open
Abstract
Low birth weight (LBW) is one of the major public health challenges in India. LBW etiology is multifactorial and linked to multiple determinants, including maternal undernutrition and sociodemographic characteristics. The objective of the present endeavor was to assess how maternal dietary diversity and other sociodemographic factors among marginalized populations are associated with the incidence of LBW. The study was a part of the community-based intervention that aimed to improve maternal and child health in the Morena district of Madhya Pradesh, a state in central India. In this case-control study, cases were defined as mothers with an LBW child (<2500 grams) and controls as mothers without an LBW child. A quantitative survey was done with women of reproductive age, having at least one child aged 0–24 months. We calculated the dietary diversity based on the number of food groups consumed during pregnancy by women on a daily basis. Stepwise logistic regression models were built to test for associations between sociodemographic and dietary diversity variables and LBW incidence. There were 157 mothers with and 214 without an LBW child. Women's diets mainly consisted of grains, such as wheat, rice, maize, and roots and tubers. Eggs and meat were consumed by less than 1% of the women. There were 20% lesser chances of an LBW child with increasing maternal dietary diversity scores (odds ratio: 0.79; 95% CI: 0.65, 0.96). The poor maternal diet quality during pregnancy may result in adverse birth outcomes with long-term consequences in a child.
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