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Biomedical subjects

D V Mavalankar

Publications and source records attributed to D V Mavalankar.

10 recordsLinked to original sources
PubMed1994

Plague in India.

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Disease Outbreaks↗
PubMed1994

Micro-level planning using rapid assessment for primary health care services.

This paper describes the use of a rapid assessment technique in micro-level planning for primary health care services which has been developed in India. This methodology involves collecting household-level data through a quick sample survey to estimate client needs, coverage of services and unmet need, and using this data to formulate micro-level plans aimed at improving service coverage and quality for a primary health centre area. Analysis of the data helps to identify village level variations in unmet need and develop village profiles from which general interventions for overall improvement of service coverage and targeted interventions for selected villages are identified. A PHC area plan is developed based on such interventions. This system was tried out in 113 villages of three PHC centres of a district in Gujarat state of India. It demonstrated the feasibility and utility of this approach. However, it also revealed the barriers in the institutionalization of the system on a wider scale. The proposed micro-level planning methodology using rapid assessment would improve client-responsiveness of the health care system and provide a basis for increased decentralization. By focusing attention on under-served areas, it would promote equity in the use of health services. It would also help improve efficiency by making it possible to focus efforts on a small group of villages which account for most of the unmet need for services in an area. Thus the proposed methodology seems to be a feasible and an attractive alternative to the current top-down, target-based health planning in India.

Community Health Centers↗
PubMed1994

Risk factors for small for gestational age births in Ahmedabad, India.

Intra-uterine growth retardation is an important public health problem in many developing countries. The authors conducted a case-control study of low birth weight (LBW) in three teaching hospitals and a population survey in Ahmedabad city, India during 1987-1988. To identify and quantify risk factors for small for gestational age births, we divided the low birth weight and control infants into small for gestational age (SGA, n = 617) and appropriate for gestational age (AGA, n = 1851) using an Indian birth weight by gestational age standard. Logistic regression was used to estimate adjusted odds ratios for important risk factors. Prevalence of risk factors was estimated from a community sample survey of mothers (n = 1102) who had delivered in the past year. Attributable risks were calculated from odds ratios and prevalence data. The most important risk factors for SGA was poor maternal nutritional status (weight < 51 kg) with an attributable risk of 42 per cent. Other significant risk factors were anaemia, primiparity, poor obstetric history, lack of antenatal care and hypertension during pregnancy, and birth defects, each of which contributed only moderately to the attributable risk. The analysis indicates that improvement of maternal nutrition and antenatal care might prevent a substantial portion of SGA births in this and similar populations.

Adult↗
PubMed1994

Maternal weight, height and risk of poor pregnancy outcome in Ahmedabad, India.

This paper explores the relationships between maternal weight, height and poor pregnancy outcome using a data set from a case-control study of low birth weight (LBW) and perinatal mortality in Ahmedabad, India. Maternal height and weights were compared between mothers of 611 perinatal deaths, 644 preterm-LBW, and 1465 normal birth weight controls as well as 617 small-for-gestational age (SGA) and 1851 appropriate-for-gestational-age (AGA) births. Weight and height were much lower in this population compared to western standards. Low weight and height were associated with increased risk of perinatal death, prematurity and SGA. After adjusting for confounders, maternal weight remained significantly associated with poor pregnancy outcomes, whereas height was only weakly associated. Attributable risk estimates show that low weight is a much more important contributor to poor outcome than low height. Improvement in maternal nutritional status could lead to substantial improvement in birth outcome in this population.

Birth Weight↗
PubMed1992

Risk factors for preterm and term low birthweight in Ahmedabad, India.

To identify and quantify risk factors for preterm and term low birthweight (LBW) we conducted a hospital-based case-control study, linked with a population survey in Ahmedabad, India. The case-control study of 673 term LBW, 644 preterm LBW cases and 1465 controls showed that low maternal weight, poor obstetric history, lack of antenatal care, clinical anaemia and hypertension were significant independent risk factors for both term and preterm LBW. Short interpregnancy interval was associated with an increased risk of preterm LBW birth while primiparous women had increased risk of term LBW. Muslim women were at a reduced risk of term LBW, but other socioeconomic factors did not remain significant after adjusting for these more proximate factors. Estimates of the prevalence of risk factors from the population survey was used to calculate attributable risk. This analysis suggested that a substantial proportion of term and preterm LBW births may be averted by improving maternal nutritional status, anaemia and antenatal care.

Anemia↗
PubMed1991

Levels and risk factors for perinatal mortality in Ahmedabad, India.

To estimate levels and determinants of perinatal mortality, we conducted a hospital-based surveillance and case-control study, linked with a population survey, in Ahmedabad, India. The perinatal mortality rate was 79.0 per 1000, and was highest for preterm low-birth-weight babies. The case-control study of 451 stillbirths, 160 early neonatal deaths and 1465 controls showed that poor maternal nutritional status, absence of antenatal care, and complications during labour were independently associated with substantially increased risks of perinatal death. Multivariate analyses indicate that socioeconomic factors largely operate through these proximate factors and do not have an independent effect. Estimates of attributable risk derived from the prevalence of exposures in the population survey suggest that improvements in maternal nutrition and antenatal and intrapartum care could result in marked reductions of perinatal mortality.

Adult↗