Abstract
Objectives This study measures the prevalence of risk factors among pregnant women and young children aged 12–24 months in a rural community in West Bengal, India. Methods Community health workers (CHWs) enrolled women and children into this 2015 cross-sectional study. Pregnant women were evaluated for underweight, anemia, and abnormal blood pressure. Children were evaluated for underweight, abnormal head and upper arm circumferences, and low scores from the Ages and Stages Questionnaire (ASQ). Data were collected on smartphones and tablets or by paper. Results More than half of the 279 women (59.9%) had a risk factor during pregnancy: 48.7% were anemic, 35.1% had low blood pressure, and 7.5% were underweight. Among the 366 children, 59.3% had a risk factor, including 24.0% with low ASQ scores and 49.7% who had abnormal anthropometric measures. Conclusions for Practice Vulnerable populations, such as pregnant women and young children, needed a greater connection to doctors in this rural community. This study demonstrated the feasibility of CHWs to listen to health concerns and connect underserved populations with health care services.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10995-018-2509-y/MediaObjects/10995_2018_2509_Fig1_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10995-018-2509-y/MediaObjects/10995_2018_2509_Fig2_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10995-018-2509-y/MediaObjects/10995_2018_2509_Fig3_HTML.gif)
Similar content being viewed by others
References
Alcoba, N. (2009). Hitting the road to alleviate India’s rural doctor shortage. CMAJ, 180, E34-6. https://doi.org/10.1503/cmaj.090439.
Bakshi, R. K., Roy, D., Aggarwal, P., et al. (2016). Application of WHO “Near-Miss” tool indicates good quality of maternal care in rural healthcare Setting in Uttarakhand, Northern India. Journal of Clinical and Diagnostic Research, 10, 10–13. https://doi.org/10.7860/JCDR/2016/15748.7044.
Bodmer-Roy, S., Morin, L., Cousineau, J., & Rey, E. (2012). Pregnancy outcomes in women with and without gestational diabetes mellitus according to the International Association of the Diabetes and Pregnancy Study groups criteria. Obstetrics and Gynecology, 120, 746–752.
Buchbinder, A., Sibai, B. M., Caritis, S., et al. (2002). Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. American Journal of Obstetrics and Gynecology, 186, 66–71.
CDC (2015) Growth Chart Training: Using the WHO Growth Charts. https://www.cdc.gov/nccdphp/dnpao/growthcharts/who/using/assessing_growth.htm. Accessed 14 Feb 2018.
Census 2011 (2011) Paschim Medinipur (West Midnapore) District: Census 2011 data. http://www.census2011.co.in/census/district/18-paschim-medinipur.html. Accessed 3 Jun 2016.
Chattopadhyay, A. (2012). Men in maternal care: Evidence from India. Journal of Biosocial Science, 44, 129–153. https://doi.org/10.1017/S0021932011000502.
Das, J., Holla, A., Das, V., et al. (2012). In urban and rural India, A standardized patient study showed low levels of provider training and huge quality gaps. Health Affairs, 12, 2774–2784. https://doi.org/10.1377/hlthaff.2011.1356.
Directorate of Census Operations (2011) District census handbook: Paschim Medinipur. Ministry of Home Affairs, Kolkata.
Ehrenberg, H. M., Dierker, L., Milluzzi, C., & Mercer, B. M. (2003). Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes. American Journal of Obstetrics and Gynecology, 189, 1726–1730.
Fernald, L. C. H., Kariger, P., Engle, P., & Raikes, A. (2009). Examining early child development in low-income countries: A toolkit for the assessment of children in the first five years of life. Washington, DC: World Bank.
Fraser, A., Nelson, S. M., Macdonald-Wallis, C., et al. (2012). Associations of pregnancy complications with calculated cardiovascular disease risk and cardiovascular risk factors in middle age. Circulation, 125, 1367–1380. https://doi.org/10.1161/CIRCULATIONAHA.111.044784.
Gautham, M., Iyengar, M. S., & Johnson, C. W. (2015). Mobile phone-based clinical guidance for rural health providers in India. Health Informatics Journal, 21, 253–266. https://doi.org/10.1177/1460458214523153.
Gogoi, M., Unisa, S., & Prusty, R. K. (2014). Utilization of maternal health care services and reproductive health complications in Assam, India. Journal of Public Health, 22, 351–359. https://doi.org/10.1007/s10389-014-0614-y.
Hartung, C. (2010) Open data kit: Tools to build information services for developing regions. In Proceedings of the 4th ACM/IEEE International Conference on Information and Communication Technologies and Development. New York, NY: ACM Press.
Juneja, M., Mohanty, M., Jain, R., & Ramji, S. (2012). Delay in Indian Children. Indian Pediatrics, 49, 457–461.
Kaji, D., & Niehof, A. (2013). Women’s autonomy and husbands’ involvement in maternal health care in Nepal. Social Science and Medicine, 93, 1–10. https://doi.org/10.1016/j.socscimed.2013.06.003.
Källander, K., Tibenderana, J. K., Akpogheneta, O. J., et al. (2013). Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in lowand middle-income countries: A review. Journal of Medical Internet Research, 15, e17. https://doi.org/10.2196/jmir.2130.
Labrique, A. B., Vasudevan, L., Kochi, E., et al. (2013). mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Global Health: Science and Practice, 1, 160–171. https://doi.org/10.9745/GHSP-D-13-00031.
Maulik, P. K., & Darmstadt, G. L. (2007) Childhood disability in low- and middle-income countries: Overview of screening, prevention, services, legislation, and epidemiology. Pediatrics. https://doi.org/10.1542/peds.2007-0043B.
Ministry of Health and Family Welfare (2015) District fact sheet: Paschim Medinipur (2012-13). Mumbai: International Institute for Population Sciences.
Ministry of Panchayati Raj (2009) A note on the Backward Regions Grant Fund Programme. http://www.nird.org.in/brgf/doc/brgf_BackgroundNote.pdf. Accessed 1 Jun 2016.
Modi, D., Gopalan, R., Shah, S., et al. (2015). Development and formative evaluation of an innovative mHealth intervention for improving coverage of community-based maternal, newborn and child health services in rural areas of India. Global Health Action, 8, 26769.
Pal, J., Dasika, A., Hasan, A., et al. (2017). Changing data practices for community health workers: Introducing digital data collection in West Bengal, India. In Proceedings from the International Conference on Information & Communication Technologies and Development. https://doi.org/10.1145/3136560.3136582.
Perry, H. B., Zulliger, R., & Rogers, M. M. (2014). Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness. Annual Review of Public Health, 35, 399–421. https://doi.org/10.1146/annurev-publhealth-032013-182354.
Rydz, D., Shevell, M. I., Majnemer, A., & Oskoui, M. (2005). Developmental screening. Journal of Child Neurology, 20, 4–21.
Sifakis, S., & Pharmakides, G. (2000). Anemia in pregnancy. Annals of the New York Academy of Sciences, 900, 125–136.
Story, W. T. (2014). Social capital and the utilization of maternal and child health services in India: A multilevel analysis. Health Place, 28, 73–84.
Tamrat, T., & Kachnowski, S. (2012). Special delivery: An analysis of mHealth in maternal and newborn health programs and their outcomes around the world. Maternal and Child Health Journal, 16, 1092–1101. https://doi.org/10.1007/s10995-011-0836-3.
World Health Organization (2005) The World Health Report 2005: Make every mother and child count. Geneva: World Health Organization.
World Health Organization (2016) Child growth standards. http://www.who.int/childgrowth/standards/en/. Accessed 13 Jun 2016.
World Health Organization, World Bank (2011) World report on disability. Geneva: WHO Press.
Zhang, J., & Klebanoff, M. A. (2001). Low blood pressure during pregnancy and poor perinatal outcomes: An obstetric paradox. American Journal of Epidemiology, 153, 642–646.
Funding
The funding was provided by the Trehan Foundation through the University of Michigan MCubed Diamond program. ALW’s salary was funded through the PhRMA Foundation.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Wagner, A.L., Xia, L., Pandey, P. et al. Risk Factors During Pregnancy and Early Childhood in Rural West Bengal, India: A Feasibility Study Implemented via Trained Community Health Workers Using Mobile Data Collection Devices. Matern Child Health J 22, 1286–1296 (2018). https://doi.org/10.1007/s10995-018-2509-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2509-y