In 2023, the infant mortality rate in India was at about 24.5 deaths per 1,000 live births, a significant decrease from previous years. Infant mortality as an indicatorThe infant mortality rate is the number of deaths of children under one year of age per 1,000 live births. This rate is an important key indicator for a country’s health and standard of living; a low infant mortality rate indicates a high standard of healthcare. Causes of infant mortality include premature birth, sepsis or meningitis, sudden infant death syndrome, and pneumonia. Globally, the infant mortality rate has shrunk from 63 infant deaths per 1,000 live births to 27 since 1990 and is forecast to drop to 8 infant deaths per 1,000 live births by the year 2100. India’s rural problemWith 32 infant deaths per 1,000 live births, India is neither among the countries with the highest nor among those with the lowest infant mortality rate. Its decrease indicates an increase in medical care and hygiene, as well as a decrease in female infanticide. Increasing life expectancy at birth is another indicator that shows that the living conditions of the Indian population are improving. Still, India’s inhabitants predominantly live in rural areas, where standards of living as well as access to medical care and hygiene are traditionally lower and more complicated than in cities. Public health programs are thus put in place by the government to ensure further improvement.

BackgroundIndia is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. Methods and FindingsMixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other) with mortality by sex among infants and children aged 1–4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold), but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1–4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2–6.9%) in 1–4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5–10.0%) and girls (4.1%, 0.8–7.5%) aged 1–4 years. We estimated 119,807 (95% uncertainty interval 53,409 – 214,662) averted deaths in boys aged 1–4 years and 94,037 (14,725 – 206,684) in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. ConclusionsFurther reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country’s 5-year plan for 2012–2017, as public expenditure on health alone has not had major impact on reducing child mortality.

Monthly Data base and Program Indicators. The data file attached provides a complete data set used for this pilot implementation. The data file includes the following sheets – Sheet 1 - For monthly data – One sheet for each monthly data set for the block from May 2016 to May 2017 – these sheets include sub health center wise details of expected and reported deliveries (at home and at institutions), tablets distributed, tablets consumed, tablets and wrappers collected back, adverse events reported, complications reported including PPH cases and any referrals (All these sheets are named month wise for example – May_16, Jun_16 and so on till May_17). Sheet 2 - For cumulative numbers for all parameters in monthly data sheets (Named as– ‘Cumulative data’). Sheet 3- for sub health center wise cumulative data (Named as– ‘Subcenter Wise’). Sheet 4 - A block level Cumulative Summary of main measurement indicators for the program for total duration of pilot implementation. This sheet includes – expected and reported outcomes of pregnancy in the block, numbers of tablets distributed and consumed, number of tablets collected back and PPH cases reported. All of these numbers are further divided according to place of reported deliveries at home, at institution and in transit. (Named as – ‘Program Indictors Cumulative’). Sheet 5 - Various charts showcasing trends of data. (Named as – ‘Charts’). (XLSX 222 kb)

Background: Particulate matter (PM) is one among the crucial air pollutants and has the potential to cause a wide range of health effects. Indian cities ranked top places in the World Health Organization list of most polluted cities by PM. Objectives: Present study aims to assess the trends, short- and long-term health effects of PM in major Indian cities. Methods: PM-induced hospital admissions and mortality are quantified using AirQ+ software. Results: Annual PM concentration in most of the cities is higher than the National Ambient Air Quality Standards of India. Trend analysis showed peak PM concentration during post-monsoon and winter seasons. The respiratory and cardiovascular hospital admissions in the male (female) population are estimated to be 31,307 (28,009) and 5460 (4882) cases, respectively. PM2.5 has accounted for a total of 1,27,014 deaths in 2017. Conclusion: Cities with high PM concentration and exposed population are more susceptible to mortality and hospital admissions.

Association of chest x-ray abnormalities with PCV13, controlling for independent variables.

The susceptibility tests were conducted on adult An. culicifacies as per the WHO standard technique with wild-caught mosquitoes. The blood-fed female mosquitoes were exposed in 3 to 4 replicates on each occasion to the impregnated papers with specified discriminating dosages of the insecticides (DDT: 4%, malathion: 5%, deltamethrin: 0.05%, and alphacypermethrin: 0.05%), for one hour, and mortality was recorded after 24-hour holding.

Overall descriptive statistics and comparison of sociodemographic and clinical variables among the children with or without PEP±OI.

Comparison of sociodemographic and clinical variables among the children exposed or unexposed to PCV13 vaccination.

BackgroundIn 2015, approximately 42,000 women died as a result of hypertensive disorders of pregnancy worldwide; over 99% of these deaths occurred in low- and middle-income countries. The aim of this paper is to describe the incidence and characteristics of eclampsia and related complications from hypertensive disorders of pregnancy across 10 low- and middle-income geographical regions in 8 countries, in relation to magnesium sulfate availability.Methods and findingsThis is a secondary analysis of a stepped-wedge cluster randomised controlled trial undertaken in sub-Saharan Africa, India, and Haiti. This trial implemented a novel vital sign device and training package in routine maternity care with the aim of reducing a composite outcome of maternal mortality and morbidity. Institutional-level consent was obtained, and all women presenting for maternity care were eligible for inclusion. Data on eclampsia, stroke, admission to intensive care with a hypertensive disorder of pregnancy, and maternal death from a hypertensive disorder of pregnancy were prospectively collected from routine data sources and active case finding, together with data on perinatal outcomes in women with these outcomes. In 536,233 deliveries between 1 April 2016 and 30 November 2017, there were 2,692 women with eclampsia (0.5%). In total 6.9% (n = 186; 3.47/10,000 deliveries) of women with eclampsia died, and a further 51 died from other complications of hypertensive disorders of pregnancy (0.95/10,000). After planned adjustments, the implementation of the CRADLE intervention was not associated with any significant change in the rates of eclampsia, stroke, or maternal death or intensive care admission with a hypertensive disorder of pregnancy. Nearly 1 in 5 (17.9%) women with eclampsia, stroke, or a hypertensive disorder of pregnancy causing intensive care admission or maternal death experienced a stillbirth or neonatal death. A third of eclampsia cases (33.2%; n = 894) occurred in women under 20 years of age, 60.0% in women aged 20–34 years (n = 1,616), and 6.8% (n = 182) in women aged 35 years or over. Rates of eclampsia varied approximately 7-fold between sites (range 19.6/10,000 in Zambia Centre 1 to 142.0/10,000 in Sierra Leone). Over half (55.1%) of first eclamptic fits occurred in a health-care facility, with the remainder in the community. Place of first fit varied substantially between sites (from 5.9% in the central referral facility in Sierra Leone to 85% in Uganda Centre 2). On average, magnesium sulfate was available in 74.7% of facilities (range 25% in Haiti to 100% in Sierra Leone and Zimbabwe). There was no detectable association between magnesium sulfate availability and the rate of eclampsia across sites (p = 0.12). This analysis may have been influenced by the selection of predominantly urban and peri-urban settings, and by collection of only monthly data on availability of magnesium sulfate, and is limited by the lack of demographic data in the population of women delivering in the trial areas.ConclusionsThe large variation in eclampsia and maternal and neonatal fatality from hypertensive disorders of pregnancy between countries emphasises that inequality and inequity persist in healthcare for women with hypertensive disorders of pregnancy. Alongside the growing interest in improving community detection and health education for these disorders, efforts to improve quality of care within healthcare facilities are key. Strategies to prevent eclampsia should be informed by local data.Trial registrationISRCTN: 41244132.

IntroductionEarly initiation with optimal duration of Kangaroo Mother Care (KMC), for all stable small babies (  4 weeks of life, who were residing in the Gangawati sub-district, were recruited on a rolling basis (Dec 2017-Sept 2018) to obtain the estimated sample size of 210. Mother-baby dyads were visited in their homes to collect information [knowledge, attitude, and support received] for KMC initiation and maintenance till required. Secondary data on KMC duration was obtained from the district-wide project database.ResultsA total of 209 mothers with 227 small babies were interviewed (18 had twins). The mothers had a mean age of 23 (±4) years; and 7(±5) years of education, with 5 (±2) family members >  18 years in their households. More than half (51%) of the babies were female with a mean age of 35.6 (±7.5)days/ 4-6weeks and mean birth weight of 1693.6 (±221.4)grams irrespective of gestational age; 21.6% of whom were ≤ 1500g at birth. Most of the babies 205 (90.3%) were initiated on KMC at the health facility. The score obtained for KMC initiation [45%} and KMC maintenance support at the health facility [51.3%] was minimal. Multiple regression linear analysis showed that overall KMC support at the health facility was significantly higher for first-time mothers [β coefficient -1.54 (95% CI -2.87, -0.22)] and better knowledge scores on KMC [β coefficient 0.21 (05% CI 0.01, 0.42)]. KMC maintenance support was significantly higher for first-time mothers [β coeff -3.62 (95% CI -6.29, -0.96)] and for mothers whose babies had lower birth weights [β coeff -4.27 (95% CI -7.50, -1.05)].ConclusionMothers require support to initiate and continue KMC along the health facility-community continuum (S1 Table). The role of support at home would require further exploration to determine its association with KMC practice.

Over *** thousand deaths due to suicides were recorded in India in 2022. Furthermore, majority of suicides were reported in the state of Tamil Nadu, followed by Rajasthan. The number of suicides that year had increased from the previous year. Some of the causes for suicides in the country were due to professional problems, abuse, violence, family problems, financial loss, sense of isolation and mental disorders. Depressive disorders and suicide As of 2015, over ****** million people worldwide suffered from some kind of depressive disorder. Furthermore, over ** percent of the total population in India suffer from different forms of mental disorders as of 2017. There exists a positive correlation between the number of suicide mortality rates and people with select mental disorders as opposed to those without. Risk factors for mental disorders Every ******* person in India suffers from some form of mental disorder. Today, depressive disorders are regarded as the leading contributor not only to disease burden and morbidity worldwide, but even suicide if not addressed. In 2022, the leading cause for suicide deaths in India was due to family problems. The second leading cause was due to illness. Some of the risk factors, relative to developing mental disorders including depressive and anxiety disorders, include bullying victimization, poverty, unemployment, childhood sexual abuse and intimate partner violence.

Details of KMC support received by mothers and fKMC providers along the health facility-community continuum.

Univariate and multivariable analysis on KMC maintenance support at home with maternal and baby characteristics.

Univariate and multivariable analysis on KMC support at health facility with maternal and baby characteristics.

Data gathered from countries across the globe revealed that 54 journalists were killed worldwide in 2024. Journalism may not be considered the most dangerous profession in the world, but the risks for those entering into certain segments of the industry are clear. After a peak in 2012, when 147 journalists were killed, the numbers thankfully declined, with 2021 recording the lowest number of journalist deaths since 2003. The perils of being a journalist: global insights Journalist death statistics by region show that six journalist killings occurred in Iraq in 2020 along with four in Pakistan and four in India, some of which were sadly particularly brutal. The most dangerous country in the world for journalists is Mexico, where eight journalists were killed in 2020. Journalists in Mexico are frequently placed under surveillance, threatened, and fatally punished for attempting to expose or publicize political corruption, and despite the country being war-free, an average of eight to ten journalists are murdered in the country each year. Journalists arrested and imprisoned Journalists are at risk of being captured and detained as punishment for criticizing a political regime or a religious ideology, persecuted for insulting those in positions of power, hunted down for images they published, and shot dead simply because they were in the wrong place at the wrong time. The yearly number of imprisoned journalists regularly surpasses 250 worldwide, and arrests and kidnappings are also common. Between 2014 and 2019, almost 1,500 journalists were arrested and close to 400 were kidnapped, highlighting the harsh reality for many media workers around the world.