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Problems of Low Birth Weight: A community based monitoring surveillance system in West Bengal. By Pandey CS, R. Anuradha, Jana Laboni Child In Need Institute February 2004. About CINI. Thrust Areas Safe motherhood. Child survival, growth & development. Nutrition for vulnerable groups.

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problems of low birth weight a community based monitoring surveillance system in west bengal

Problems of Low Birth Weight: A community based monitoring surveillance system in West Bengal.

By

Pandey CS, R. Anuradha, Jana Laboni

Child In Need Institute

February 2004

about cini
About CINI
  • Thrust Areas
  • Safe motherhood.
  • Child survival, growth & development.
  • Nutrition for vulnerable groups.
  • Reproductive and sexual health of young people
  • Prevention of RTI/STI/HIV/AIDS
  • Area & Population
  • CINI reaches out to more than 700,000 rural and urban poor population in 4 districts of West Bengal.
  • 5,000 street children in Kolkata
  • 5,000 sex workers in four rural red light areas.
  • Many other population groups through its collaborative work with government agencies and NGOs in other states of India.
institute based activities
Institute based activities
  • Out Patient Department
  • Thursday Clinic
  • Reproductive Health Clinic
  • Adolescent Health Clinic
  • Nutrition Rehabilitation Center
  • Lactation Management Unit
  • Emergency Ward
major national priorities
~ Major National Priorities ~
  • Reduce Maternal Mortality Ratio.
  • Reduce Infant and Child Mortality rates.
  • Reduce Proportion of Low Birth Weight babies.
  • Reduce Severe and Moderate Malnutrition in U5 children.
  • Reduce Unmet Need for contraception.
  • Reduce Anaemia prevalence among women and adolescent girls.
  • Complete Primary Immunization of all children aged 11-23 months.
  • Reduce spread of HIV infection.
  • Source: NPP 2000, NHP 2001, 10th 5YP, NACO 2002
slide6

Lifecycle Approach to bring about ‘Sustainable Health & Nutrition Development for Women & Children’

slide7

LCA: A Package of interventions organised to

address risks and opportunities during critical stages of lifecycle, starting with pregnancy and moving through birth, infancy, early childhood and adolescence.

Pregnancy

  • Early registration
  • Ensure adequate weight gain
  • Ensure TT , IFA, 3 or more ANC
  • Attended delivery

Adolescence

Early childhood

  • Adequate nutrition
  • Reduce anaemia among girls
  • Awareness regarding pubertal changes
  • Develop life skills
  • Birth weight above 2500 gm
  • Proper feeding as well as weaning
  • Early stimulation
  • Timely immunization
  • Prevent frequent illness
  • Reduce incidence of death
translating medico social factors into doables
Translating Medico-Social Factors Into Doables
  • ·Energy expenditure (rest and workload)
  • Diet during pregnancy
  • ·Inter-pregnancy Interval
  • ·Anaemia
  • ·Previous Pregnancy history
  • ·Mental stress
  • ·Maternal Chronic diseases (Heart, TB, respiratory illness)
  • ·Maternal problem during 3rd trimester (eclampsia, antepartum haemorrhage)
  • ·Substance abuse (tobacco, alcohol)
  • Maternal Infection (malaria, diarrhoea, RTI/ STI/HIV/AIDS)

Contextual Factors

Maternal Anthropometric measures

Gestational Weight Gain

Familial Factors

Low birth weight

Pre-pregnancy BMI

Individual Factors

Access to health services

strategies

Strategies

  • Case Management
  • Behaviour change and communication
  • Linkage, convergence and partnership
slide12

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)

normal curve distribution of birth weight

October 2001 – September 2002

Mean = 2.66 kgs, SD=430 grams N=784

Normal curve distribution 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

maternal anthropometric measures

Maternal weight in 1st Trimester

Maternal height

Maternal Anthropometric measures

2 = 21.9 , df =1, p < 0.0001

2 = 8.9 , df =1, p = 0.002

maternal age
Maternal Age

2 = 20.8 , df =3, p = 0.0001

pregnancy characteristics

Complication in previous pregnancy

2 = 3.9, df =1, p=0.04

Pregnancy characteristics

Gravida and birth weight

2 = 33.6, df =1, p< 0.0001

slide18

Consequences

of

Low Birth Weight

changes in nutritional status of lbw children at first 3 6 and 12 months of life
Changes in Nutritional status of LBW children at first 3, 6 and 12 months of life

Cohort of 700 children born before Oct’ 2002

infant deaths in lbw babies
Infant deaths in LBW babies

2 = 17.7, df =2, p= 0.0001

slide22

MIS Information Flow

Mother & Child Protection Card

Cohort Register (health worker wise)

Information Sheet

(one time only)

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

limitations
Limitations
  • Field based routine monitoring data
  • Validation of birth weight
  • Differences in birth weight - home & institution