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Context: In Ashram schools, scheduled tribes (ST) children from age 6 to 17 years belonging to various ethnic groups stay under common living and dietary provisions. However, there are scant reports on ethnotribal height differences. Aims: The aims of the study are to (a) estimate height differences between schoolchildren of three major local STs, (b) compare heights and average skinfold thickness (SFT) of ST with non-ST and urban schoolchildren, and (c) compare median heights and weights of ST and non-ST schoolchildren with the Indian Academy of Pediatrics standards. Settings and Design: Four Ashram schools and one urban school in Northwest Maharashtra. Subjects and Methods: All children from age 6 to 17 years were included for height, weight, and mid-arm circumference (n = 2106). Data were processed with Excel and Epi info software for quantitative comparisons. Statistical Analysis Used: Quantitative methods including ANOVA were used for statistical comparison of heights. Results: There were no differences among heights between ST students (ANOVA P > 0.05). However, there were significant differences between heights of boys and girls between ST and non-ST students across age groups (ANOVA P < 0.0001). ST boys and girls were mostly below 3rd or 10th percentile of IAP height and weight charts while non-ST children were between 25th and 50th percentiles. The average SFT values for prepubertal age groups were significantly lower in ST schoolchildren. Conclusions: ST students showed a significant growth disadvantage against general and other backward classes categories, although no intertribal anthropometry differences were observed.

Background: Tribal ashram schools provide accommodation, food, and other services from 1st to 12th standards to children from marginalized sections of the society. Nutrition and growth are important aspects of this age group. Objectives: This study aims to estimate average macronutrient intakes in private and public ashram schools and to compare the growth of tribal with urban children and national standards. Methods: This is a cross-sectional cluster-based study in Nashik district of Maharashtra in ashram schools with an urban day school for comparison. The study was conducted from November 2017 to February 2018. The study includes 1510 students in four rural ashram schools and 322 urban school day scholars. Daily food amounts used by the school kitchens were analyzed. Height and weight of students were recorded with standard methods. Excel was used to estimate nutrient intakes and Epi Info for analysis of growth parameters. Results: Protein intakes were 76.5 g/student (2.9–3.1 g/kg body weight), with staples contributing 42%–50% and legumes and pulses contributing 22%–25%. Energy intakes were 2519 kcal/student (100–120 kcal/kg body weight) with oils contributing 13%. Boys ate 1.5–2 times than girls going by average intake of Chapattis. Height and weight of students at entry and exit age, respectively, of 7 and 15 years were significantly lower than urban students, ICMR and IAP standards. However, entry-level stunting had reduced by 15 years by 40%–50% in girls and boys. Conclusions: Macronutrient intakes in the ashram schoolchildren were sufficient, but growth gap persisted till adolescence. Protein quality in private schools needs improvement.

Context: Heavy schoolbags are reported worldwide including India. The prescribed safe upper limit was 10% of student bodyweight. Aims: This intervention study explored (a) impact of awareness measures among stakeholders and (b) any systemic constraints for reducing bag loads. Settings and Design: This is a two-stage intervention study following a 2016–2017 baseline study of schoolbag weights in two rural schools. Subjects and Methods: The study involved 175 students (male: 79 and female: 96) from 8th to 9th standards. The intervention consisted of sharing the baseline findings of schoolbag weight, guidelines, and necessary measures for the same. The first intervention involved creating awareness among teachers regarding the harmful effects and the second intervention involved students. Bag weights were recorded on digital luggage scale in prelunch sessions in the following weeks after the intervention. Statistical Analysis: The impact of interventions was tested with (a) Paired t-test for mean bag weights and (b) Chi-square test for the proportion of heavy schoolbags. Results: The mean baseline bag weight of 3.77 kg declined statistically significantly after successive interventions to 3.4 and 3.2 kg. The baseline proportion of 51% of heavy bags (>10% of body weight) declined to 38% and 29%. Despite interventions, 19% students in 8th carried heavier bags than the 3.4 kg cap set by Government guidelines. Subjects taught in 8th standard were above 6/day. Conclusions: Awareness programs for stakeholders only partially succeeded in reducing bag weights. Hence, reducing the daily subject load is necessary.

Background: Institutional birth and Emergency Obstetric Care (EmOC) are important strategies of the National Rural Health Mission (NRHM). While the Community Health Center (CHC) is expected to serve EmOC needs in NRHM, the CHCs are hamstrung due to chronic shortage of specialist doctors. Alternative strategies are therefore needed for ensuring EmOC. Objectives: This study aims to estimate the EmOC needs in a private rural hospital from case records and find some useful predictors for caesarian section (C-section) and to assess C-section needs in the context of on-call specialist support. Materials and Methods: We analyzed a two-decade series of 2587 obstetric cases in a private rural hospital for normal deliveries and EmOC including C-section. Results: About 80% of the obstetric cases were normal deliveries. Of the remaining 20% cases that required EmOC, nearly one-third required C-section. In the series, two maternal deaths occurred due to hemorrhage. About 13% case records showed past abortion, which adds to EmOC workload. Primipararous mothers with higher age had a greater incidence (23%) of C-section. The C-section rate shows a steady rise from 3% to above 10% in the series. Conclusions : This rural hospital required C-section in 6.4% cases. This C-section workload was managed with the help of on-call specialists. The local hospital team could manage 93.6% of the cases and abortions with only two maternal deaths. This strategy of an on-call specialist team can be an option for CHCs till resident specialists are adequately available.