Low birth weight (LBW) is one of the major public health challenges in India. LBW etiology is multifactorial and linked to multiple determinants, including maternal undernutrition and sociodemographic characteristics. The objective of the present endeavor was to assess how maternal dietary diversity and other sociodemographic factors among marginalized populations are associated with the incidence of LBW. The study was a part of the community-based intervention that aimed to improve maternal and child health in the Morena district of Madhya Pradesh, a state in central India. In this case-control study, cases were defined as mothers with an LBW child (<2500 grams) and controls as mothers without an LBW child. A quantitative survey was done with women of reproductive age, having at least one child aged 0–24 months. We calculated the dietary diversity based on the number of food groups consumed during pregnancy by women on a daily basis. Stepwise logistic regression models were built to test for associations between sociodemographic and dietary diversity variables and LBW incidence. There were 157 mothers with and 214 without an LBW child. Women’s diets mainly consisted of grains, such as wheat, rice, maize, and roots and tubers. Eggs and meat were consumed by less than 1% of the women. There were 20% lesser chances of an LBW child with increasing maternal dietary diversity scores (odds ratio: 0.79; 95% CI: 0.65, 0.96). The poor maternal diet quality during pregnancy may result in adverse birth outcomes with long-term consequences in a child.

Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of incomebased inequality in the full immunization of children aged 12-23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (− 13.5%) and age of the child (− 2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums.

Background: In the recent decade, dietary pattern assessment has evolved as a promising tool to describe the whole diet and represent inter-correlations between different dietary components. We aimed to derive the dietary patterns of adolescents (10–19 years) using cluster analysis on food groups and evaluate these patterns according to their socio-demographic profile.Methods: This community-based cross-sectional study was conducted in two districts, each from Bihar and Assam in India. Adolescents (10–19 years) were enrolled from both rural and urban areas. The dietary intake was assessed through a pre-validated single food frequency questionnaire. Cluster analysis was performed by a 2-step procedure to explore dietary patterns, pre-fixed at 2 clusters. Clusters were analyzed with respect to socio-demographic characteristics using binomial logistic regression.Results: A total of 826 girls and 811 boys were enrolled in the study. We found two major dietary patterns, namely a low- and high-mixed diet. The low-mixed diet (76.5% prevalence) had daily consumption of green vegetables, including leafy vegetables, with less frequent consumption of other foods. The high-mixed diet (23.5% prevalence) had more frequent consumption of chicken, meat, egg, and milk/curd apart from green vegetables. Adolescent boys had 3.6 times higher odds of consuming a low-mixed diet compared to girls. Similarly, adolescents with lower education grades and from marginalized social classes had two times higher odds of taking a low-mixed diet than their respective counterparts.Conclusions: The high consumption of a low-mixed diet and relatively less milk consumption limit the comprehensive growth of adolescents. Improvement in dietary intake of adolescents from marginalized sections of society can prove to be an important deterrent in mitigating India's nutritional challenges.

Background: Adolescents lack adequate knowledge, self-efficacy, and access to sexual and reproductive health services; thereby, predisposing them to sexual violence, sexually transmitted infections, early marriage, and high fertility rates. Socio-economic inequalities fuel such problems, but we have limited evidence from some of the least developed states of Eastern India. Therefore, we aimed to assess the inequalities in the reproductive health knowledge and practices of unmarried adolescents (10-19 years) from marginalized populations in one district each from the state of Bihar and Assam in India.Methods: It was a community-based cross-sectional study with a quantitative research methodology. In our study, we captured data on five domains related to reproductive health, including knowledge about HIV/AIDS, and contraceptives, awareness and perceptions related to right age at marriage, general self-efficacy, menstrual hygiene practices among girls, and access to health services for reproductive health problems; besides socio-demographic details. We performed a 2-step cluster analysis to gain insights into the patterns of reproductive health knowledge and self-efficacy among unmarried adolescent boys and girls, separately. Multinomial logistic regression analysis was employed to identify the predictors associated with the cluster membership determined through cluster analysis.Results: A total of 811 boys and 826 girls participated in the study. Three-clusters were identified for boys and girls in the analysis, varying from high to low knowledge and self-efficacy for boys, and high to low knowledge with constant low self-efficacy in all the three clusters for girls. Higher educational status and increasing age were positively associated with the high knowledge clusters among boys and girls. Additionally, marginalized social class and working status were associated with higher knowledge cluster in girls.Conclusions: We emphasize on the need of comprehensive (covering a broad range of reproductive health issues, such as child marriage, contraceptives, HIV/AIDS, menstrual hygiene, etc.), contextualized (relevant for adolescents in the least developed states like Bihar), and customized (tailored for different cultures and religions through appropriate means) sexual and reproductive health education for adolescents.