Effectiveness of a Quality Improvement Program Using Difference-in-Difference Analysis for Home Based Newborn Care - Results of a Community Intervention Trial.

Objective: To present evaluation of a quality improvement program for Accredited Social Health Activists (ASHAs).

Methods: This community intervention trial was conducted in Ballabgarh, India during 2012-2014 with two Primary Health Center (PHC) areas being the intervention areas and two PHC areas being non-intervention areas receiving standard care. Interventions included two-day training in technical and communication skills of ASHAs followed by supportive supervision in the field.

Challenges in conducting a community-based influenza vaccine trial in a rural community in northern India.

Evidence on influenza vaccine effectiveness from low and middle countries (LMICs) is limited due to limited institutional capacities; lack of adequate resources; and lack of interest by ministries of health for influenza vaccine introduction. There are concerns that the highest ethical standards will be compromised during trials in LMICs leading to mistrust of clinical trials. These factors pose regulatory and operational challenges to researchers in these countries.

Epidemiology of acute respiratory infections in children - preliminary results of a cohort in a rural north Indian community.

Background: Despite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology.

Methods: A dynamic cohort of children aged 0-10 years was established in four villages in a north Indian state of Haryana from August 2012 onwards. Trained health workers conducted weekly home visits to screen children for acute respiratory infection (ARI) defined as one of the following: cough, sore throat, nasal congestion, earache/discharge, or breathing difficulty.

Home based care to multi-drug resistant tuberculosis patients: A pilot study.

Background: India is a high tuberculosis burden and large population setting country. Multidrug-resistant tuberculosis patient has to undergo 24-27 months treatment and is expected to adhere to it. There is a need to increase compliance of MDR Regimen in MDR-TB cases, to prevent its further spread.

A community based study to test the reliability and validity of physical activity measurement techniques.

Introduction: Physical activity (PA) is protective against non-communicable diseases and it can reduce premature mortality. However, it is difficult to assess the frequency, duration, type and intensity of PA. The global physical activity questionnaire (GPAQ) has been developed by World Health Organization with the aim of having valid and reliable estimates of PA.

Effectiveness of a school based intervention for prevention of non-communicable diseases in middle school children of rural North India: a randomized controlled trial.

Objective: To assess the effectiveness of a multi-component school based intervention in improving knowledge and behavioral practices regarding diet, physical activity and tobacco use in middle schoolchildren of rural-Ballabgarh, North-India.

Methods: A total of 40 middle schools were grouped into two, based on geographic proximity and randomly assigned to the intervention or control group in a cluster randomized controlled trial. The target population consisted of 2,348 children studying in 6th and 7th grades in these schools.

Sex-specific trends in under-five mortality in rural Ballabgarh.

Objective: To assess sex-specific differentials in child survival from 1992-2011.

Methods: We analyzed data from the electronic database of Health and Demographic Surveillance System (HDSS) site in Ballabgarh in North India.

Results: Sex ratio at birth was adverse for girls throughout the study period (821 to 866 girls per 1,000 boys) and was lowest in the period 2004-2006 at 821 girls per 1,000 boys.

Temporal trends and gender differentials in causes of childhood deaths at Ballabgarh, India - need for revisiting child survival strategies.

Background: Relating Information on causes of deaths to implementation of health interventions provides vital information for program planning and evaluation. This paper from Ballabgarh Health and Demographic Surveillance System (HDSS) site in north India looks at temporal trends and gender differentials in the causes of death among under-five children.

Methods: Data on causes of death for 1972-74, 1982-84, 1992-94, 2002-04 were taken from existing HDSS publications and database.

A systematic review of school-based interventions to prevent risk factors associated with noncommunicable diseases.

Noncommunicable diseases (NCDs) are emerging as an important public health problem in developing countries. The risk factors for NCDs are initiated during childhood and adolescence. The aim of this review was to assess the effectiveness of school-based interventions for prevention of NCD risk factors (physical inactivity, diet, and tobacco consumption), and identify processes that affect the main outcome.

Performance of cause-specific childhood mortality surveillance by health workers using a short verbal autopsy tool.

Background: The routine use of verbal autopsy in health-care delivery settings has been limited. Hence, the performance of neonatal and postneonatal verbal autopsy (VA) tools developed at the Comprehensive Rural Health Services Project (CRHSP), Ballabgarh (India), were assessed.

Methods: Short VA tools developed by CRHSP were filled by health workers during their routine house visits while standard VA tools of the International Network of Field Sites with continuous Demographic Evaluation (INDEPTH) were filled by trained research workers for all 143 under-five-children deaths that occurred in 2008.

Adult mortality surveillance by routine health workers using a short verbal autopsy tool in rural north India.

Background: Most of the standard verbal autopsy tools are long and are used in a research setting. This study aims to compare a short verbal autopsy (VA) tool developed at Ballabgarh, India to be used by health workers for routine mortality surveillance with a standard tool.

Methods: A short VA tool was developed which was used by health workers during their routine house visits while a standard International Network of Field Sites with continuous Demographic Evaluation (INDEPTH) VA tool was filled by trained research workers for all adult deaths that occurred in 2008.

A role for INDEPTH Asian sites in translating research to action for non-communicable disease prevention and control: a case study from Ballabgarh, India.

Background: The International Network of field sites with continuous Demographic Evaluation of Populations and Their Health (INDEPTH) has 34 Health and Demographic Surveillance System (HDSS) in 17 different low and middle-income countries. Of these, 23 sites are in Africa, 10 sites are in Asia, and one in Oceania. The INDEPTH HDSS sites in Asia identified chronic non-communicable diseases (NCDs) as a neglected area of attention.

A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India.

Background: Acute respiratory infection (ARI) is a major killer of children in developing countries. Although the frequency of ARI is similar in both developed and developing countries, mortality due to ARI is 10-50 times higher in developing countries. Viruses are common causes of ARI among such children, yet the disease burden of these infections in rural communities is unknown.

Genetic variability in the G protein gene of group A and B respiratory syncytial viruses from India.

Respiratory syncytial virus (RSV) is the most commonly identified viral agent of acute respiratory tract infection (ARI) of young children and causes repeat infections throughout life. Limited data are available on the molecular epidemiology of RSV from developing countries, including India. This study reports on the genetic variability in the glycoprotein G gene among RSV isolates from India.

Genetic diversity among respiratory syncytial viruses that have caused repeated infections in children from rural India.

Respiratory syncytial virus (RSV) causes repeat infections throughout life. Antigenic variability in the RSV G protein may play a significant role in reinfections. A variable region of the RSV G gene was analyzed for 14 viruses from seven children who experienced initial and repeat infections.

Cost of curative pediatric services in a public sector setting.

Objective: To estimate the cost of ambulatory (out-patient) and in-patient pediatric health services for the year 1999 provided by All India Institute of Medical Sciences (AIIMS) at all the three levels-primary, secondary and tertiary level.

Methods: The costing module developed by Children's Vaccines Initiative (CVI) was used. This rapid assessment tool focuses on collection of data at macro level by using key informants like doctors, nursing staff, accountant, store keeper, engineer etc.

Breastfeeding practices and health-seeking behavior for neonatal sickness in a rural community.

The aim of the study was to evaluate the knowledge of mothers and grandmothers regarding breastfeeding and health-seeking behavior for neonatal sickness in a rural community. A cross-sectional survey, using a triangulation of qualitative (focus group discussion) and quantitative (structured questionnaire) methods was carried out. Although most of the grandmothers and mothers believed in early feeding within 2 h of delivery, they often administered prelacteal feeds such as ghutti and honey.

Development of a validated clinical case definition of generalized tonic-clonic seizures for use by community-based health care providers.

Purpose: To develop and test a clinical case definition for identification of generalized tonic-clonic seizures (GTCSs) by community-based health care providers.

Methods: To identify symptoms that can help identify GTCSs, patients with history of a jerky movements or rigidity in any part of the body ever in life were recruited from three sites: the community, secondary care hospital, and tertiary care hospital. These patients were administered a 14-item structured interview schedule focusing on the circumstances surrounding the seizure.

Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana.

Unlabelled: Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW.

Status of serum ferritin and folate levels amongst young women in a rural community of Haryana, India.

A community based cross sectional study was conducted amongst young married non-pregnant women aged 18 years or more from six randomly selected villages in Ballabhgarh block, district Faridabad, Haryana state. Data was collected on socio-demographic profile and obstetric parameters utilizing a pre-tested semi-structured questionnaire. The non-pregnancy status of the women was confirmed by inquiring about the last menstrual period.

Cost of epilepsy in patients attending a secondary-level hospital in India.

The study objective was out to provide an estimate of cost of epilepsy in a secondary level hospital in northern India where a once a week epilepsy clinic is run. Cost data were based on existing information on costs of the hospital and market rates for drugs and investigations. Other necessary information was extracted from patient records for the year 2001.

Magnitude of zinc deficiency among nulliparous nonpregnant women in a rural community of Haryana State, India.

Zinc deficiency during pregnancy affects the outcome of pregnancy. A high prevalence of zinc deficiency (55.5%) has been reported among pregnant women.

Non-specific effect of measles vaccination on overall child mortality in an area of rural India with high vaccination coverage: a population-based case-control study.

Objective: To determine whether vaccination against measles in a population with sustained high vaccination coverage and relatively low child mortality reduces overall child mortality.

Methods: In April and May 2000, a population-based, case-control study was conducted at Ballabgarh (an area in rural northern India). Eligible cases were 330 children born between 1 January 1991 and 31 December 1998 who died aged 12-59 months.