Publications by authors named "Thomas Pullum"

Though child anthropometric failure (CAF) is a persistent problem in India, previous studies have often neglected state-level variance and aggregated moderate and severe CAF categories. This study addresses this gap by examining moderate and severe malnutrition across India's states and union territories (UTs) from 1993 to 2021. Data of children under 2 years old from five waves of National Family Health Surveys, a representative cross-sectional survey of Indian households, were analysed.

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Importance: The global success of the child survival agenda depends on how rapidly mortality at early ages after birth declines in India, and changes need to be monitored to evaluate the status.

Objective: To understand the disaggregated patterns of decrease in early-life mortality across states and union territories (UTs) of India.

Design, Setting, And Participants: Repeated cross-sectional data from the 5 rounds of the National Family Health Survey conducted in 1992-1993, 1998-1999, 2005-2006, 2015-2016, and 2019-2021 were used in a representative population-based study.

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Anemia is a significant public health problem in many low- and middle-income countries (LMICs), with young children being especially vulnerable. Iron deficiency is a leading cause of anemia and prior studies have shown associations between low iron status/iron deficiency anemia and poor child development outcomes. In LMICs, 43% of children under the age of five years are at risk of not meeting their developmental potential.

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The importance of breastfeeding for infant and maternal health is well established. The World Health Organization recommends that all infants be exclusively breastfed until they reach 6 months of age. The standard indicator to measure adherence to this criterion is the percentage of children aged 0-5 months who are currently being exclusively breastfed.

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Primarily funded by the United States Agency for International Development (USAID), the Demographic and Health Surveys (DHS) Faculty Fellows Program is designed to strengthen the institutional capacity of universities in low- and middle-income countries to use and analyze DHS data. This article provides an overview of the program's evolution and its current form; presents successes and impacts; and discusses challenges, lessons learned, and potential further directions.Initiated in 2008, the Fellows Program underwent several rounds of improvement.

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Objective: Early breastfeeding has numerous benefits for both the mother and her baby. Previous research typically analyzes breastfeeding initiation in binary terms (within the first hour or day). Although delays are associated with cesarean delivery and skin-to-skin contact may facilitate early breastfeeding, a more nuanced understanding of these relationships is needed.

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Background: Effective coverage research is increasing rapidly in global health and development, as researchers use a range of measures and combine data sources to adjust coverage for the quality of services received. However, most estimates of effective coverage that combine data sources are reported only as point estimates, which may be due to the challenge of calculating the variance for a composite measure. In this paper, we evaluate three methods to quantify the uncertainty in the estimation of effective coverage.

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Background: The persistence of preventable maternal and newborn deaths highlights the importance of quality of care as an essential element in coverage interventions. Moving beyond the conventional measurement of crude coverage, we estimated effective coverage of facility delivery by adjusting for facility preparedness to provide delivery services in Bangladesh, Haiti, Malawi, Nepal, Senegal, and Tanzania.

Methods: The study uses data from Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Bangladesh (2014 DHS and 2014 SPA), Haiti (2012 DHS and 2013 SPA), Malawi (2015-16 DHS and 2013-14 SPA), Nepal (2016 DHS and 2015 SPA), Senegal (2016 DHS and 2015 SPA), and Tanzania (2015-16 DHS and 2014-15 SPA).

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Efforts to simplify the construction of the DHS wealth index are encouraged (while recognizing it is constructed differently in each country), but attempts to assess equity in health programs should bear in mind that it is not sufficient to calculate the wealth index just for the participants in the program. The quintile distributions can vary dramatically within sub-populations. Assessments of equity require knowledge of the distribution of potential participants as well as actual participants.

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While the global objective is exclusive breastfeeding (EBF) for a full 6 months duration, the standard indicator is a "prevalence" indicator, that is, the percentage of all children under age 6 months who are exclusively breastfed at a point in time. That yields a higher percentage than a more direct indicator of duration and can be easily misunderstood, exaggerating the amount of EBF. A measurement of actual percentage of children exclusively breastfeeding for a full 6 months can be easily calculated from standard DHS and MICS data.

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Background: The Kabeho Mwana project (2006-2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems.

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Background: Developing effective context-specific strategies to ensure that a high proportion of children receive timely and appropriate care requires knowing the source from which care is sought. Although Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) collect such data in disaggregated form, they are not made available in the standard DHS and MICS reports.

Methods: Secondary data analysis was done on 42 DHS and MICS surveys conducted since 2005 for care seeking for acute respiratory illness (DHS and MICS), diarrhea (DHS only), and fever (DHS only), disaggregating by urban-rural settings.

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Methodologies to identify and enumerate children outside of family care vary as do the vulnerability categories of the children themselves. Children outside of family care is a broad term encompassing children absent of permanent family care, e.g.

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This study analyzes causes of deaths of 766 patients who died while in methadone treatment in Texas between 1994 and 2002. Compared with deaths in the general population of Texas, deaths of clients in methadone treatment were 4.6 times more likely to be from a drug overdose, 3.

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