Validating the indicator "maternal death review coverage" to improve maternal mortality data: A retrospective analysis of district, facility, and individual medical record data.

Background: Understanding causes and contributors to maternal mortality is critical from a quality improvement perspective to inform decision making and monitor progress toward ending preventable maternal mortality. The indicator "maternal death review coverage" is defined as the percentage of maternal deaths occurring in a facility that are audited. Both the numerator and denominator of this indicator are subject to misclassification errors, underreporting, and bias.

Validating the implementation of an indicator reporting policies and laws on free public maternal health-related services in the era of universal health coverage: A multi-country cross-sectional study.

Background: The concept of universal health coverage (UHC) encompasses both access to essential health services and freedom from financial harm. The World Health Organization's Maternal Newborn Child and Adolescent Health (MNCAH) Policy Survey collects data on policies that have the potential to reduce maternal morbidity and mortality. The indicator, "Are the following health services provided free of charge at point-of-use in the public sector for women of reproductive age?", captures the free provision of 13 key categories of maternal health-related services, to measure the success of UHC implementation with respect to maternal health.

Validation of a measure to assess decision-making autonomy in family planning services in three low- and middle-income countries: The Family Planning Autonomous Decision-Making scale (FP-ADM).

Background: Integrating measures of respectful care is an important priority in family planning programs, aligned with maternal health efforts. Ensuring women can make autonomous reproductive health decisions is an important indicator of respectful care. While scales have been developed and validated in family planning for dimensions of person-centered care, none focus specifically on decision-making autonomy.

Study protocol for an individually randomized control trial for India's first roleplay-based mobile game for reproductive health for adolescent girls.

Background: Go Nisha Go™ (GNG), is a mobile game combining behavioural science, human-centric design, game-based learning, and interactive storytelling. The model uses a direct-to-consumer (DTC) approach to deliver information, products, services, interactive learning, and agency-building experiences directly to girls. The game's five episodes focus on issues of menstrual health management, fertility awareness, consent, contraception, and negotiation for delay of marriage and career.

Validating indicators for monitoring availability and geographic distribution of emergency obstetric and newborn care (EmoNC) facilities: A study triangulating health system, facility, and geospatial data.

Availability of emergency obstetric and newborn care (EmONC) is a strong supply side measure of essential health system capacity that is closely and causally linked to maternal mortality reduction and fundamentally to achieving universal health coverage. The World Health Organization's indicator "Availability of EmONC facilities" was prioritized as a core indicator to prevent maternal death. The indicator focuses on whether there are sufficient emergency care facilities to meet the population need, but not all facilities designated as providing EmONC function as such.

Interaction between micronutrients and lipid profile in prediabetes and diabetes among school-aged children (5-9 y) in India.

Objectives: Lipids and micronutrients play a major role in the pathophysiology of diabetes, and several studies have established the association between lipids and diabetes. The aim of this study was to determine the interaction between lipid profile and micronutrient status with different prediabetes and diabetes diagnosis criteria among school-aged children in India.

Methods: The data used in this study was from Comprehensive National Nutritional Survey conducted in India from 2016 to 2018.

Validating midwifery professionals' scope of practice and competency: A multi-country study comparing national data to international standards.

Background: There is a global shortage of midwives, whose services are essential to meet the healthcare needs of pregnant women and newborns. Evidence suggests that if enough midwives, trained and regulated to global standards, were deployed worldwide, maternal, and perinatal mortality would decline significantly. Health workforce planning estimates the number of midwives needed to achieve population coverage of midwifery interventions.

Authorization of midwives to perform basic emergency obstetric and newborn care signal functions in Argentina, Ghana, and India: A multi-country validation study of a key global maternal and newborn health indicator.

Background: Midwives' authorization to deliver the seven basic emergency obstetric and newborn care (BEmONC) functions is a core policy indicator in global monitoring frameworks, yet little evidence supports whether such data are captured accurately, or whether authorization demonstrates convergence with midwives' skills and actual provision of services. In this study, we aimed to validate the data reported in global monitoring frameworks (criterion validity) and to determine whether a measure of authorization is a valid indicator for BEmONC availability (construct validity).

Methods: We conducted a validation study in Argentina, Ghana, and India.

National guidelines for data quality in surveys: An overview.

Good quality health, nutrition and demographic survey data are vital for evidence-based decision-making. Existing literature indicates system specific, data collection and reporting gaps that affect quality of health, nutrition and demographic survey data, thereby affecting its usability and relevance. To mitigate these, the National Data Quality Forum (NDQF), under the Indian Council of Medical Research (ICMR) - National Institute of Medical Statistics (NIMS) developed the National Guidelines for Data Quality in Surveys delineating assurance mechanisms to generate standard quality data in surveys.

Measuring adequacy of the midwifery workforce using standards of competency and scope of work: Exploring the density and distribution of midwives in three low- and middle-income countries using cross-sectional and geospatial data.

Background: A global midwifery shortage hampers the goal of ending preventable maternal/newborn mortality and stillbirths. Whether current measures of midwifery workforce adequacy are valid is unknown. We compare two measures of density and distribution of midwifery professionals to assess their consistency, and explore how incorporating midwifery scope, competency, and the adjusting reference population impacts this critical metric.

Improving measures of access to legal abortion: A validation study triangulating multiple data sources to assess a global indicator.

Background: Global mechanisms have been established to monitor and facilitate state accountability regarding the legal status of abortion. However, there is little evidence describing whether these mechanisms capture accurate data. Moreover, it is uncertain whether the "legal status of abortion" is a valid proxy measure for access to safe abortion, pursuant to the global goals of reducing preventable maternal mortality and advancing reproductive rights.

Prevalence and Correlates of Vitamin D Deficiency Among Children and Adolescents From a Nationally Representative Survey in India.

Objective: To evaluate the prevalence of vitamin D deficiency (VDD) and its correlates among apparently healthy children and adolescents.

Methods: We carried out a secondary analysis of data of Comprehensive National Nutrition Survey 2016-18 to analyze the pre-valence and predictors of VDD among Indian children and adolescents.

Results: The over-all prevalence of VDD in preschool children (1-4 years), school age (5-9 years) children, and adolescents (10-19 years) was 13.

Prevalence of metabolic syndrome among adolescents in India: a population-based study.

Background: In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India.

Methods: A nationally representative data of adolescents (10-19 years) from the Comprehensive National Nutrition Survey was used.

Multisite, mixed methods study to validate 10 maternal health system and policy indicators in Argentina, Ghana and India: a research protocol.

Introduction: Most efforts to assess maternal health indicator validity focus on measures of service coverage. Fewer measures focus on the upstream enabling environment, and such measures are typically not research validated. Thus, methods for validating system and policy-level indicators are not well described.

Association of maternal height and body mass index with nutrition of children under 5 years of age in India: Evidence from Comprehensive National Nutrition Survey 2016-18.

Background And Objectives: Child undernutrition remains an area of public health concern across the globe, particularly in developing countries like India. Previous studies have focused on the association of maternal nutrition with premature pregnancy and birthweight of child, with few establishing the intergenerational effect but limited to select populations and geography.

Methods And Study Design: This study used data from 35,452 children aged under 5 years and their biological mother from nationally representative Comprehensive National Nutrition Survey (CNNS) in India.

Waist circumference, waist-to-height ratio and BMI percentiles in children aged 5 to 19 years in India: A population-based study.

Objective: Nationally representative percentiles for waist circumference (WC), waist-to-height-ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India.

Methods: Using LMS method, age- and gender-specific reference growth charts were constructed for WC ( = 68,261), WHtR ( = 68,261), and BMI ( = 67,741) from children/adolescents aged 5-19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age-sex-specific BMI -scores ≥ 95th percentile.

Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016-18.

Background: Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF.

The Effects of a Single Freeze-Thaw Cycle on Concentrations of Nutritional, Noncommunicable Disease, and Inflammatory Biomarkers in Serum Samples.

 The stability of biological samples is vital for reliable measurements of biomarkers in large-scale survey settings, which may be affected by freeze-thaw procedures. We examined the effect of a single freeze-thaw cycle on 13 nutritional, noncommunicable diseases (NCD), and inflammatory bioanalytes in serum samples.  Blood samples were collected from 70 subjects centrifuged after 30 minutes and aliquoted immediately.

Haemoglobin thresholds to define anaemia in a national sample of healthy children and adolescents aged 1-19 years in India: a population-based study.

Background: WHO's haemoglobin cutoffs to define anemia were based on five studies of predominantly White adult populations, done over 50 years ago. Therefore, a general re-examination of the existing haemoglobin cutoffs is warranted for global application, in representative healthy populations of children and adults. Such data are scarce in low-income and middle-income countries; however, a 2019, large-scale, nationally representative survey of children and adolescents aged 0-19 years in India (Comprehensive National Nutrition Survey [CNNS]) offered an opportunity for this re-examination.

Prevalence of low serum zinc concentrations in Indian children and adolescents: findings from the Comprehensive National Nutrition Survey 2016-18.

Background: It is thought that there is a high risk of zinc deficiency in India, but there are no representative national estimates.

Objectives: We aimed to evaluate the national and state-level prevalence of low serum zinc concentrations (SZCs) in Indian children from the nationally representative Comprehensive National Nutrition Survey.

Methods: Prevalence of low SZC, adjusted for C-reactive protein, was estimated among preschool (1-4 y; n = 7874) and school-age children (5-9 y; n = 10,430) and adolescents (10-19 y; n = 10,140), using SZC cutoffs defined by the International Zinc Nutrition Consultative Group.

Characterisation of the types of anaemia prevalent among children and adolescents aged 1-19 years in India: a population-based study.

Background: Anaemia is a serious public health concern in India. However, national estimates for its prevalence are not available for the 5-14 years age group, nor are estimates available for the types of anaemia among children and adolescents (1-19 years). We aimed to assess the prevalence of anaemia among children and adolescents in India and to categorise types of anaemia on the basis of micronutrient deficiencies.

Socioeconomic inequality trends in childhood vaccination coverage in India: Findings from multiple rounds of National Family Health Survey.

Objectives: This article examines the inequality patterns in childhood vaccination coverage at various socio-economic levels using all four rounds of nationally representative National Family Health Surveys (NFHS) in India.

Methods: The analytic sample restricted to the most recent singleton surviving children aged 12-23 months in each survey, was 11,599 in NFHS-1 (1992-93); 10,209 in NFHS-2 (1998-99); 9582 in NFHS-3 (2005-06) and 49,284 in NFHS-4 (2015-16). Complete childhood vaccination is defined as a child aged 12-23 months who received one dose of BCG (Bacille Calmette Guerin), one dose of measles, and three doses each of DPT (Diphtheria, Pertussis, Tetanus), and polio vaccine (excluding the polio vaccine given at birth) at any time before the survey-according to the vaccination card or the mother's recall.

Determinants of low birth weight in India: An investigation from the National Family Health Survey.

Objective: This study aimed to estimate the change in prevalence of low birth weight (LBW) over the last decade in India and to identify its associated factors-biological, demographic, socio-economic, and programmatic.

Methods: We used the data from the National Family Health Survey of 2005-2006 (NFHS-3) and 2015-2016 (NFHS-4). The sample of this study included 11 300 children from NFHS-3 and 99 894 from NFHS-4 data; all these children were the last full-term singleton live-births, born within the last 3 years prior to the survey.

Spousal Violence Against Women in India: A Social-Ecological Analysis Using Data From the National Family Health Survey 2015 to 2016.

Even after enactment of the Protection of Women From Domestic Violence Act 2005, over the last 10 years, the rate of decline of prevalence of spousal violence against women has remained low in India. This study attempts to explain the experience of spousal violence using a social-ecological framework. We analyzed the National Family Health Survey 2015 to 2016 (NFHS-4) data of 66,013 ever-married women aged 15 to 49 years.