Background and aimIn the last few decades, the prevalence of hypertension has been drastically increased in India. The present study estimates the current prevalence of hypertension and its correlates in the state of Maharashtra. The variation in the prevalence of hypertension associated with individual-level characteristics is explained at the community and district level.MethodsData is used from the recent round of District Level Household & Facility Survey (DLHS-4), 2012–13. The DLHS-4 has used the nationally representative sample, collected through multistage stratified sampling procedure. A similar sampling frame, used in NSSO-2007-08, has been followed. The chi-square test is used to show the significance level of the association between the estimated prevalence of hypertension and its correlates. Multilevel regression analysis is carried out to investigate the effects of individual and community level factors on the prevalence of hypertension.ResultsThe overall prevalence of hypertension is 25% in Maharashtra, and a huge variation in the prevalence of hypertension is found across the districts. Dhule, Gadchiroli (with a low HDI rank), Mumbai and Satara (with higher HDI rank) are the districts with the higher (above 30%) prevalence of high blood pressure. The prevalence also significantly varies according to different correlates. The prevalence of high blood pressure is higher among elderly population (40%), among males (28%), in the urban areas (27%) and in the richest wealth quintile (28%). The prevalence is also higher among cigarette smokers (31%), alcohol consumers (30%) and people with obesity (38%) as compared to their counterparts. The results of the multilevel analysis show that the older and obese persons are at four-time higher risk of hypertension. Again, age, sex, marital status, place of residence, wealth status, unhealthy habits (i.e. smoking and alcohol consumption) and BMI are significantly associated with hypertension. The results of VPC statistics show that 14% of hypertension prevalence could be attributed to differences at the community level.ConclusionThe prevalence of hypertension largely varies in the districts of Maharashtra irrespective of their level of socio-economic development (i.e. HDI rank). The variation in the rate of prevalence of hypertension is higher in the community (PSU) level as compared to the variation in the prevalence rate at the district level. Hypertension is attributable to the modifiable factors like risky lifestyle practices.

A B S T R A C TBackground: Early detection of anemia and subsequent measures to prevent anemia can help children grow healthily. There is considerable attention given to the impact of individual-level factors on Anaemia, but less is known about how community characteristics affect Anaemia among children. The present study was focused at estimating the prevalence and associated risk factors at individual and community level in India among children aged 6-59 months in India. Methods: Descriptive statistics and the chi-square test were applied using fourth round of National Family Health Survey dataset. Later, to explore the association of child anemia and some potential risk factors regarding hierarchy (individual and community level) of data, a multilevel logistic regression model was conducted using STATA-SE 14 software. Results: The results indicate that some aspects of the community influence the anemia risks of children. For instance, a 1% increase in the proportion of mother education in the community decreased the likelihood of anemia by 9% among children. Northeast region was the only region at lesser risk of anemia. Higher community level ethnic and religious homogeneity is associated with decreased odds of anemia among children. Children aged 12-35 months, girl child, children having diarrhoea, mothers of age group 15-24, high parity and low exposure to mass-media were the high risk individual factors of anemia among children. Conclusions: Overall, the present study indicated the requirement to include community-level factors beyond the individual level factors by policymakers to eradicate the burden of anemia in the country and the high prevalence states.

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