Issues of Low Birth Weight: A group based observing observation framework in West Bengal.

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Issues of Low Birth Weight: A people group based observing reconnaissance framework in West Bengal. By Pandey CS, R. Anuradha, Jana Laboni Child In Need Institute February 2004

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About CINI Thrust Areas Safe parenthood. Youngster survival, development & advancement. Nourishment for defenseless gatherings. Conceptive and sexual soundness of youngsters Prevention of RTI/STI/HIV/AIDS Area & Population CINI contacts more than 700,000 provincial and urban poor populace in 4 regions of West Bengal. 5,000 road kids in Kolkata 5,000 sex laborers in four rustic red light regions. Numerous other populace bunches through its community oriented work with government organizations and NGOs in different conditions of India .

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LCA Implementing Units

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Institute based exercises Out Patient Department Thursday Clinic Reproductive Health Clinic Adolescent Health Clinic Nutrition Rehabilitation Center Lactation Management Unit Emergency Ward

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~ Major National Priorities ~ Reduce Maternal Mortality Ratio. Lessen Infant and Child Mortality rates. Decrease Proportion of Low Birth Weight babies. Lessen Severe and Moderate Malnutrition in U5 kids. Lessen Unmet Need for contraception. Diminish Anemia predominance among ladies and pre-adult young ladies. Finish Primary Immunization of all youngsters matured 11-23 months. Lessen spread of HIV disease. Source: NPP 2000, NHP 2001, 10 th 5YP, NACO 2002

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Lifecycle Approach to realize 'Manageable Health & Nutrition Development for Women & Children'

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LCA: A Package of intercessions sorted out to address dangers and openings amid basic phases of lifecycle, beginning with pregnancy and traveling through birth, early stages, early youth and immaturity. Pregnancy Early enlistment Ensure satisfactory weight pick up Ensure TT , IFA, at least 3 ANC Attended conveyance Adolescence Early youth Adequate sustenance Reduce paleness among young ladies Awareness with respect to pubertal changes Develop life aptitudes Birth weight above 2500 gm Proper bolstering and in addition weaning Early incitement Timely inoculation Prevent visit sickness Reduce occurrence of death

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Translating Medico-Social Factors Into Doables · Energy use (rest and workload) Diet amid pregnancy · Inter-pregnancy Interval · Anemia · Previous Pregnancy history · Mental stretch · Maternal Chronic ailments (Heart, TB, respiratory ailment) · Maternal issue amid 3 rd trimester (eclampsia, antepartum drain) · Substance mishandle (tobacco, liquor) Maternal Infection (intestinal sickness, looseness of the bowels, RTI/STI/HIV/AIDS) Contextual Factors Maternal Anthropometric measures Gestational Weight Gain Familial Factors Low birth weight Pre-pregnancy BMI Individual Factors Access to wellbeing administrations

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Strategies Case Management Behavior change and correspondence Linkage, meeting and organization

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Existing Scenario: Global & Developing nations

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Indian Scenario: LBW pervasiveness in chose condition of India

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Case Management Activities from October 2001 to September 2003 Low Birth Weight 554 (20.9%) Normal Birth Weight 1966 (74.3%) Abortions 117 Live Born 2645 (97.5%) Still Alive 2563 Pregnancies 3819 Stillborn 69 (25/1000) Deliveries 2714 Died 0-7 days 46 (17.4/1000) Died 8-28 days 19 (7.2/1000) Died 29 days – 1 yr 17 (6.4/1000)

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October 2001 – September 2002 Mean = 2.66 kgs, SD=430 grams N=784 Normal bend dispersion of birth weight October 2002 – September 2003 Mean = 2.7 kg SD = 455 grams N= 2510 Mean = 2.72 kgs, SD=464 grams N=1726

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Correlates of Low Birth Weight

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Maternal weight in 1 st Trimester Maternal stature Maternal Anthropometric measures  2 = 21.9 , df =1, p < 0.0001  2 = 8.9 , df =1, p = 0.002

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Maternal Age  2 = 20.8 , df =3, p = 0.0001

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Complication in past pregnancy  2 = 3.9, df =1, p=0.04 Pregnancy attributes Gravida and birth weight  2 = 33.6, df =1, p< 0.0001

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Consequences of Low Birth Weight

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Changes in Nutritional status of LBW youngsters at initial 3, 6 and 12 months of life Cohort of 700 kids conceived before Oct' 2002

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Infant passings in LBW babies  2 = 17.7, df =2, p= 0.0001

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Database Management AND Field MIS

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MIS Information Flow Mother & Child Protection Card Cohort Register (wellbeing laborer astute) Information Sheet (one time just) Village Census Supervisor's Visit Household Census Referral Slip Database Follow up List for Supervisor Vital Events Sponsor Report One time Monthly Report Monthly At A Glance Report Annually Supervisor's Report Annual Report

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Limitations Field based routine observing information Validation of birth weight Differences in birth weight - home & establishment

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Thank you!