Fred Arnold | ICF International (original) (raw)

Papers by Fred Arnold

percentage points in urban areas and 17 percentage points in rural areas. At ages 11-14 years and... more percentage points in urban areas and 17 percentage points in rural areas. At ages 11-14 years and 15-17 years, there is a sizeable gender disparity in favour of boys in both urban and rural areas. For example, at age 15-17 years, school attendance is 51 percent for boys but only 23 percent for girls. Literacy and educational attainment Sixty-one percent of women and 24 percent of men age 15-49 have never attended school. More than one-quarter of men (26%) have completed 10 or more years of education, but only 12 percent of women have attained that level of education. In NFHS-3, literate persons are those who have either completed at least standard six or passed a simple literacy test conducted as part of the survey. According to this measure, only 36 percent of women and 74 percent of men age 15-49 are literate in Rajasthan. Attitudes toward family life education in school Virtually all women and men in Rajasthan agree that children should be taught moral values in school. Most adults also think that children should learn about the changes in their own bodies during puberty, but fewer adults think that children should learn about puberty-related changes in the bodies of the opposite sex. Men and women differ somewhat on whether they think that children should be taught about contraception in school. Men are more likely to think that girls and boys should learn about contraception in school than women. Fifty-nine percent of men believe that both girls and boys should be taught about contraception in school, compared with about two-fifths of women who believe that girls and boys should learn about contraception in school. Half of women and three-quarters of men believe that information on HIV/AIDS should be part of the school curriculum. A little more than half of men feel that both boys and girls should be taught about sex and sexual behaviour in school, but only about one-third of women feel that this is an appropriate topic for school children. FERTILITY Age at first marriage The median age at first marriage among women age 20-49 in Rajasthan is 15 years. Men get married four years later, at a median age of 19 years. Almost two-thirds (65%) of women age 20-24 years got married before the legal minimum age of 18 and 57 percent of men age 25-29 years got married before the legal minimum age of 21. Half of women and three-quarters of men believe that information on HIV/AIDS should be part of the school curriculum.

IMPORTANCE Among the United Nations' Sustainable Development Goals is to reduce the neonatal mort... more IMPORTANCE Among the United Nations' Sustainable Development Goals is to reduce the neonatal mortality rate to 12 per 1000 live births by 2030. Identifying high-risk pregnancies can help achieve this target in low-resource countries, such as India, which accounts for one-fourth of global neonatal deaths. OBJECTIVE To analyze the association of maternal history of neonatal death with subsequent neonatal mortality. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included a nationally representative sample of singleton live births from multiparous women. Data were obtained from the 2016 National Family Health Survey in India. Data were analyzed from November 2018 to January 2020. EXPOSURES Maternal history of neonatal death and a comprehensive set of covariates, including socioeconomic environment, maternal anthropometry, and pregnancy care. MAIN OUTCOMES AND MEASURES Subsequent neonatal mortality. Population-attributable risk associated with history of neonatal death was calculated, and sensitivity analyses were performed. RESULTS The overall study population consisted of 127 336 singleton live births from multiparous women aged 15 to 49 (mean [SD] age, 28.8 [5.2] years) years when the survey was undertaken. In our analytic sample, 11 101 (8.7%) mothers had a history of neonatal death, and 506 of 2224 total neonatal deaths (22.8%) were attributed to women with history of neonatal death. The prevalence of history of neonatal death differed by selected covariates and across states or union territories. Maternal history of neonatal death was associated with significantly higher odds of neonatal mortality (adjusted odds ratio, 2.23; 95% CI, 1.96-2.55), and this remained consistent across different subgroups. The population-attributable risk associated with maternal history of neonatal death was 11.8%. Stronger associations were found for maternal history of multiple neonatal deaths (adjusted odds ratio, 3.50; 95% CI, 2.78-4.41) and in respect to the risk of mortality in early neonatal period (ie, 0-2 completed days) (adjusted odds ratio, 2.45; 95% CI, 2.09-2.86). CONCLUSIONS AND RELEVANCE These findings suggest that maternal history of neonatal death is a potentially useful risk factor to identify women and neonates who may need extended and enhanced pregnancy care.

This report provides clear evidence of the poor state of nutrition among young children women and... more This report provides clear evidence of the poor state of nutrition among young children women and men in India and the lack of progress over time based on measurements of height and weight anaemia testing testing for the iodization of household cooking salt utilization of nutrition programmes and information on child feeding practices and vitamin A supplementation. Young children in India suffer from some of the highest levels of stunting underweight and wasting observed in any country in the world and 7 out of every 10 young children are anaemic. The percentage of children under age five years who are underweight is almost 20 times as high in India as would be expected in a healthy well-nourished population and is almost twice as high as the average percentage of underweight children in sub-Saharan African countries. Although poverty is an important factor in the poor nutrition situation nutritional deficiencies are widespread even in households that are economically well off. Inad...

of the Centers for Disease Control and Prevention. MEASURE DHS assists countries worldwide in the... more of the Centers for Disease Control and Prevention. MEASURE DHS assists countries worldwide in the collection and use of data to monitor and evaluate population, health, and nutrition programs. Additional information about the MEASURE DHS project can be obtained by contacting MEASURE DHS, ICF International,

BMC Pregnancy and Childbirth, 2021

Background Population-based household surveys, notably the Demographic and Health Surveys (DHS) a... more Background Population-based household surveys, notably the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), remain the main source of maternal and newborn health data for many low- and middle-income countries. As part of the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study, this paper focuses on testing validity of measurement of maternal and newborn indicators around the time of birth (intrapartum and postnatal) in survey-report. Methods EN-BIRTH was an observational study testing the validity of measurement for selected maternal and newborn indicators in five secondary/tertiary hospitals in Bangladesh, Nepal and Tanzania, conducted from July 2017 to July 2018. We compared women’s report at exit survey with the gold standard of direct observation or verification from clinical records for women with vaginal births. Population-level validity was assessed by validity ratios (survey-reported coverage: observer-assessed co...

Journal of Global Health, 2019

Every Newborn-INDEPTH" (EN-INDEPTH) study protocol for a randomised comparison of household surve... more Every Newborn-INDEPTH" (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites Electronic supplementary material: The online version of this article contains supplementary material.

Malaria Journal, 2019

Background: Nationally-representative household surveys are the standard approach to monitor acce... more Background: Nationally-representative household surveys are the standard approach to monitor access to and treatment with artemisinin-based combination therapy (ACT) among children under 5 years (U5), however these indicators are dependent on caregivers' recall of the treatment received. Methods: A prospective case-control study was performed in Mali to validate caregivers' recall of treatment received by U5s when seeking care for fever from rural and urban public health facilities, community health workers and urban private facilities. Clinician-recorded consultation details were the gold standard. Consenting caregivers were followedup for interview at home within 2 weeks using standard questions from Demographic and Health Surveys and Malaria Indicator Surveys. Results: Among 1602 caregivers, sensitivity of recalling that the child received a finger/heel prick was 91.5%, with specificity 85.7%. Caregivers' recall of a positive malaria test result had sensitivity 96.2% with specificity 59.7%. Irrespective of diagnostic test result, the sensitivity and specificity of caregivers' recalling a malaria diagnosis made by the health worker were 74.3% and 74.9%, respectively. Caregivers' recall of ACT being given had sensitivity of 43.2% and specificity 90.2%, while recall that any anti-malarial was given had sensitivity 59.0% and specificity 82.7%. Correcting caregivers' response of treatment received using a combination of a visual aid with photographs of common drugs for fever, prescription documents and retained packaging changed ACT recall sensitivity and specificity to 91.5% and 71.1%, respectively. Conclusions: These findings indicate that caregivers' responses during household surveys are valid when assessing if a child received a finger/heel prick during a consultation in the previous 2 weeks, and if the malaria test result was positive. Recall of ACT treatment received by U5s was poor when based on interview response only, but was substantially improved when incorporating visual aids, prescriptions and drug packaging review.

Family Planning Perspectives, 1977

European Journal of Clinical Nutrition, 2006

Objective: This study examined the prevalence of obesity and hypertension and associated behavior... more Objective: This study examined the prevalence of obesity and hypertension and associated behavioral risk factors in adult men and women in Uzbekistan. The study also examined the association between obesity and hypertension. Method: The analysis used data from the 2002 Uzbekistan Health Examination Survey, which included a nationally representative sample of 2333 men aged 15-59 years and 5463 women aged 15-49 years. The survey measured height, weight and blood pressure and included questions on physical activity, dietary habits, tobacco smoking, alcohol use and other characteristics. The analysis was conducted using binary and multinomial logistic regression methods, separately for men and women. Results: Eating animal source protein and tobacco smoking in the past were positively associated with obesity, but there were no consistent associations with other dietary indicators, physical activity level or alcohol use. Obese men and women were about three times as likely to suffer from hypertension as those with a normal BMI (odds ratio (OR) ¼ 3.01; 95% confidence interval (CI): 1.67-5.44; Po0.001 for men and OR ¼ 2.82; 95% CI: 2.05-3.86; Po0.001 for women), independent of physical activity level, dietary habits, tobacco smoking and other factors. For men, the risk of hypertension was strongly positively associated with BMI only at BMI levels above 25 kg/m 2 , but for women a positive relationship was observed at all BMI levels. Conclusion: The study found a strong positive association between obesity and hypertension in adult men and women in Uzbekistan. The shape of the relationship between BMI and hypertension is different for women than for men, requiring further research to explore this relationship.

Numerous studies have found that most Indian couples have a strong preference for sons over daugh... more Numerous studies have found that most Indian couples have a strong preference for sons over daughters. In an effort to have sons, many couples continue to have children after achieving their desired family size. This practice may have retarded India's fertility decline. Using data from the 1992-93 National Family Health Survey, this report assesses the prevalence of son preference in India as a whole and in the 19 most populous states. The state-level analysis is important because fertility levels, social and economic conditions, and the strength of son preference vary widely from one part of the country to another. The analysis compares the ideal number of sons and the ideal number of daughters mentioned by Indian women as well as contraceptive use by women with two sons and women with two daughters. It goes on to compare the situation for boys and girls in terms of immunization rates, period of breastfeeding, prevalence of three common childhood diseases and likelihood of treatment, prevalence of chronic undernutrition among children under age 4, and infant and child mortality rates. On nearly all these measures and in most states, male children have a decided advantage over female children. Son preference is particularly strong in northern and central India and somewhat weaker in the southern and western regions. Next, the analysis uses life-table methods and hazard models to examine the effect of son preference on fertility. It also examines how the effect of son preference interacts with a woman's social and economic characteristics, in particular her rural or urban residence, literacy, and religion. The effect of son preference on fertility is found to vary substantially by region and state. In states where fertility is very high or very low, the effect is small, as expected, but in states with intermediate levels of fertility (between 2.0 and 3.0 children), it varies widely. It is highest in Himachal Pradesh, Punjab, Gujarat, and Maharashtra and lowest in West Bengal and most of the southern states. If gender preferences could be eliminated entirely, the fertility level in India would decline by about 8 percent. A decline of this magnitude would have a substantial impact on the population growth rate. Eliminating son preference would also have important social benefits.

produced three data layers in 2001 that estimated the first month, last month, and duration of th... more produced three data layers in 2001 that estimated the first month, last month, and duration of the malaria transmission season in Africa (MARA 2004). 1.4 Ownership of Insecticide-Treated Nets Although the links between malaria endemicity and household mosquito net ownership have not been fully explored, the relationship between other factors and mosquito net ownership are much better understood. Ownership of an ITN in a country is highly influenced by the ITN distribution campaign in that that country. Many countries initially focused on women for ITN distribution (free or voucher) during antenatal care visits and/or on young children during routine vaccination campaigns. In some countries, campaigns have focused on rural areas considered more likely to be malaria-prone, while some have provided free or low-cost ITNs to poor households. In recent years it has become more common for countries' ITN distribution campaigns to be part of the universal coverage campaign, including all households. Officially, RBM launched the universal campaign in April 2008 (Smith 2008). The timing, roll-out, and implementation of these distribution campaigns is country specific and might vary widely within a country. However, many countries have also maintained their customary distribution activities targeting pregnant women and young children, while also implementing universal distribution campaigns. Studies over the past 15 years have found that ownership of ITNs or any mosquito nets can be influenced by several household-level factors, which may be linked to the type of distribution campaign in a country and year the study took place. These include residence (urban-rural), wealth, and presence of a household member who part of the target population of the country's distribution campaign.

This book presents findings of the second National Family Health Survey (NFHS-2) undertaken in 19... more This book presents findings of the second National Family Health Survey (NFHS-2) undertaken in 1998-99 in Sikkim India. The objective of NFHS-2 is to provide estimates of fertility the practice of family planning infant and child mortality maternal and child health and utilization of health service provided to mothers and children. In Sikkim information was collected from 1299 households and from 453 children born to eligible women in the 3 years preceding the survey as well as interviewed 1107 women from these households. The survey revealed a fertility level of 2.75 children each woman throughout their childbearing years. It was noted that 54% of married women are currently using some form of contraception with female sterilization as the most popular method by far. As for infant and child mortality NFHS-2 indicated that 1 in 23 children die in the first year of life and 1 in 14 die before reaching age five. In addition almost 50% of the currently married women in Sikkim are noted to have some type of reproductive health problem; 77% of then have not sought an advice or treatment. Recommendations in addressing health issues are presented in this book.

Additional file 8. ROC for corrected ACT recall by each adjustment question/method.

Additional file 5. Summaries of sensitivity, specificity and accuracy of caregiver recall of trea... more Additional file 5. Summaries of sensitivity, specificity and accuracy of caregiver recall of treatment with ACT (assessed by questionnaire response only) by various facility, caregiver and child characteristics.

Additional file 4. Random effects multivariate logistic regression models of sensitivity, specifi... more Additional file 4. Random effects multivariate logistic regression models of sensitivity, specificity and accuracy of caregiver recall of treatment with ACT, corrected by visual aids, prescriptions and packaging.

Additional file 3. Sensitivity, specificity and accuracy of caregiversâ recall of diagnosis proce... more Additional file 3. Sensitivity, specificity and accuracy of caregiversâ recall of diagnosis procedures and treatment received during consultation, by facility type.