Multiple faces of the health transition

The present study comes out with the urban-rural differentials in maternal health care services in the districts of Madhya Pradesh. Third round of District Level Household and Facility Survey has been used for the study. A Maternal Health Care Index (MHCI) is constructed to measure degree of health care services utilised by women during childbirth. Result reveals that Indore district tops the list in MP with 0.5671 in MHCI, followed by Ujjain (0.4727) and Hoshangabad (0.4617). Dindori district is in bottom of the list with only 0.1104 MHCI followed by Sidhi (0.1609) and Raisen (0.2116). In rural Madhya Pradesh, not a single district is touching even MHCI of 0.5 points. Among all the 45 districts, Shajapur district is in top of the list with MHCI of 0.427. Dindori district is in bottom most in the list with only 0.0983 MHCI. Though the MHC Indices are higher in urban area as compare to rural yet their overall performance are not so attractive. Even the disparity between highest and lowest district is very high. Hoshangabad district is in 1st rank with MHCI of 0.6801. Among the worst performing districts, Sidhi district is leading with MHCI of only 0.0966 followed by Tikamgarh and Raisen.

Paper examined self perception of body weight, future intention for weight management and actual weight management behaviour among normal, overweight and obese women in Urban India. 325 ever-married aged 20-54 years systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) were re-interviewed after four years in 2003. Information on woman’s perception about their own weight, intention of weight management and actual weight management behaviour were collected through personal interview. Anthropometric measurements were obtained from women to compute their current body mass index. Discrepancy between self perceived body weight and women’s actual body weight was noticed. One-fourth overweight women and one in ten obese women perceived themselves as normal. Though a majority of overweight and obese women wanted to reduce their weight, a significant proportion of overweight (one in four) and 4% obese women also wanted to maintain their weight as it is. Only one in three overweight and one in four obese women were performing exercise to reduce their weight. These finding are important for public health interventions in obesity care in urban India.

Abstract
The specific objectives of the present study are to analyze the differentials in prevalence; initiation and continuation of use of smokeless tobacco. The foundation behind this study is to know the narrow gender gap of use of smokeless tobacco of different dimension. This study utilized the data from the Global Adult Tobacco Survey India (GATS India 2010). This paper is an attempt to find the progression of use of tobacco in all EAG states including Assam of India by using the Kaplan-Meier Survival Analysis and inequality in education and occupation by Gini concentration index. .The prevalence of smokeless tobacco use among males varies from highest in Bihar (62%) to the lowest (17%) in Uttarakhand. Whereas, among females users high in Chhattisgarh (42%) to the lowest in Uttarakhand (2%).The association between each selected characteristic like age, residence, level of schooling, occupation, Exposure of mass media, notice on health warning, perceived impact on health etc clearly revealed that more likely (>1.0) to use of smokeless tobacco among female as compare to male in selected states of India.

Rates of suicide mortality have declined substantially over the past 25 years in most OECD countries. Unfortunately, since 1985 suicide rates have increased by 20% in Japan and by 250% in South Korea. Suicide mortality has increased at an especially rapid pace in South Korea since 2000. To help disentangle the effects of age-related factors, secular change, and birth cohort membership, we estimated a series of intrinsic estimator age-period-cohort models of suicide mortality rates in Japan and South Korea between 1985 and 2010. Results indicate that age-related factors explain much of the increase in Japan, where a large segment of the population has moved into a high-risk age range of 40-65. In South Korea, the increase is driven by multiple factors – including rising period effects, a growing elderly population, and strong cohort effects for those born between the Great Depression and the aftermath of World War II.

One of the main problems concerning the accumulation of population in the urban areas is directly related with the increment of the socio-economic, socio-spatial, and socio-demographic segregation.
The investigation presented here answers those questions by establishing the mortality profile in the four main Colombian cities. This research focuses on georeferencing, presenting the place of residence of the deceased on the city map, determining in this way the differences in the parameters of mortality related to the inhabited space. Building the mortality profile and locating it spatially, keeping in mind the deep socio-spatial segregation that is a constant in Colombian cities, allowed establishing a list of the socio-economic status of the deceased and determine the differences in the mortality parameters as another element contributing the socio-demographic urban segregation.
This study also analyses the question of the difference in life expectancy of population concerning their socio-economic condition. By means of analyzing the differences in the mortality profiles related with the housing site and linking them directly with the socio-economic status it was possible to establish the great differences existing in the life expectancy for someone born in Bogota.

A comparison between public and private healthcare provider sector has been carried out in Panchkula district of urban Haryana, northern state of India, for services measured against operational and quality indicators to estimate the best of both the worlds and suggest those changes that will make a difference for the welfare of the society.
The study has been carried out in two phases – in the first phase of study- important quality and operational indicators were identified on the basis, which could elaborate on the health status of the existing population in the district and determining efficiency of the services provided to them by public and private sector individually.
Results: It was found that in private hospital bed occupancy rate was only 55 percent whereas nearby public hospital served with a bed occupancy rate of 128 percent. The existing lag in bed occupancy rate (BOR) in private sector and over burden of public hospital could both be overcomed if healthcare was dealt as a unit rather then differentiating on the basis of economies of the population. This could not just help in coping up for improving health scenario but also improving quality of services as a whole in both the sector.

The health vulnerability offers the possibility of detecting the critical areas from a health and epidemiological perspective and the population at risk they involve, constituting a study that is part of the analysis and identification of vulnerable areas and population at risk, in the context of the theory and methodology of the health geography. The results also have particular application in the territory because they can be used as the basis of some orderings in health. (Ramirez, L. 2007)
The objetive of this paper is to analyze the health situation of Latin America and the Latin Caribbean through the development of a Health Vulnerability Index, which allows comparison of the region’s countries, for the period 2008-2010. Also to compare the obtained data on health vulnerability with data about sanitation and access to health services of the region under study, for the same time period. Finally we compare the data obtained through this Health Vulnerability Index with those obtained by applying the health vulnerability criteria used in the Sixth Report on Vulnerability Analysis in Health in Europe and Eurasia 2010, conducted by the United States Agency for International Development (USAID), in order to assess the tools built.

The post communist transition brought along a significant decrease in mortality rates and improvement in health indicators in some Central European countries. That was the case of the Czech Republic and Poland, that witnessed sudden and systematic shift in life expectancy trends. Within two decades, from 1990 to 2009, life expectancies in both countries have increased considerably, by 5.8 years in the Czech Republic (reaching 77.3 for both sexes) and by 5.1 years in Poland (reaching 75.8). The aim of this paper is to present the most important tendencies in mortality by cause of death which allowed for this extension of life expectancies. We present a comparison to France where mortality rates remain at relatively low levels and that constitutes a good frame of reference. On the basis of the single cause-of-death time series restored for the period 1970-2009, it is possible to prove crucial importance of diseases of the circulatory system for the recent mortality developments in Czech Republic and Poland and to point at other specific health issues of the region.

Data from a longitudinal follow up of 14,000 elderly Costa Ricans 1990-2011 show that the death rate ratio (DRR) among males of the Nicoya region is 0.72 (95% CI: 0.62 – 0.82) compared to the rest of Costa Rican males. The DRR for Nicoyan women is not significantly different from one. Accordingly, life expectancy at age 55 for Nicoyan men would be 31.1 years compared to the 26.0 years in Japan, the country with the highest life expectancy. We further explore genetic versus environmental determinants by examining differential effects by migration status: DRR of men born and living in Nicoya (relative to other Costa Ricans) is 0.56 (CI: 0.45 – 0.69), compared to the DRR of 0.87 of immigrants and of 1.10 of out-migrants. The Nicoyan advantage is concentrated in cardio-vascular mortality, with a DRR of 0.50 for non-migrant Nicoya men. Nicoyans do not show significant advantages in most traditional risk factors such as blood pressure or lipids, but do show advantages in three potential markers of stress: overnight urinary cortisol, serum Dehydroepiandrosterone sulfate (DHEAS), and Leukocyte Telomere Length. They also have significantly lower body weight, waist circumference, fasting glucose and disability (physical and cognitive) levels.

This article explores the utilization of postnatal care services among the rural mothers in Bangladesh. The data were used from a baseline household survey evaluating the impact of demand side financing (DSF) voucher scheme on utilization and service delivery for maternal health care services. The survey was conducted in 22 sub-districts among 3300 women who gave birth in the previous year from the date of data collection. Only one-fifth of the respondents reported having a postnatal check-up during their last pregnancy and half of them visited facility, while half received services at home. Less than one-fourth (24%) women received care within 48 hours of giving birth. Lack of awareness (56%) was the main barrier to the utilization of postnatal care. The woman's delivery place, delivery type, antenatal care visits were significantly associated with the utilization of postnatal care services. Use of postnatal care service was also varied by women’s age, education, decision making, wealth quintiles, number of children, etc. The study suggested there is a dire need for promotional programs of maternal services which include postnatal care services like in the DSF scheme. With the right types of interventions, maternal health-related MDG may not be very difficult to achieve.