Search

Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Background: In the climate change discourse, a body of scholarship focusing on how people perceive climate change and its impact is increasing. However, in the Indian context, such scholarship is limited. Objective: This paper aims to describe the perceptions of people on climate change and its health impacts, which were captured as part of a larger study. Methodology: A cross-sectional study was conducted in randomly selected 983 households in four districts spread across Madhya Pradesh and Jammu and Kashmir. A semi-structured questionnaire was used to collect the data. Results: For 72% of respondents, the perception was not related to climate change per se. Their perceptions were contextual and were based on the anomalies which are observed in the immediate weather conditions. The health impacts of climate change were also not understood at the first place, but with probing 64% of respondents were able to report seasonal diseases. Conclusion: Perceptions of the people regarding climate change are more linked to their own experiences with their local weather conditions rather than the overall concept. This also explains their lack of comprehension about the health impact of climate change, but a sound understanding of seasonal diseases. [ABSTRACT FROM AUTHOR]

Background: The socio-environmental aspects of southern Assam reflect a general pattern of backwardness. Moreover, child healthcare resources in the region are inadequately used, leading to low vaccination coverage. Given this background, this paper attempted to comprehend wealth-based inequality in full vaccination in rural areas of southern Assam. Methodology: Based on a multistage cluster sampling approach, 360 children of 12–23 months were selected from the study area. To identify the predictors of a child, a non-linear model was estimated by using the generalized linear model (GLM) approach followed by Erreygers decomposition technique to quantify the wealth inequality in the obtained predictors in explaining the disparity in full vaccination. Result: The Bacillus Calmette–Guérin (BCG) vaccination recorded the highest vaccination coverage, at nearly 90% and the lowest was observed for the measles vaccine, around 61 percent. Slightly more than half of the eligible children (54 percent) were vaccinated against all the Universal Immunization Programme (UIP)-recommended vaccines. The decomposition analysis revealed that the occupation of the child's father, maternal age, birth order of the child, and health-seeking behavior such as antenatal care (ANC) were the prime factors related to inequality in full vaccination in the region. Conclusion: Vaccination coverage in the region has improved over time, however, full vaccination is concentrated towards the economically advantaged section of the society in rural southern Assam. Targeted, context-specific, and expanded government initiatives could aid in addressing the overall wealth-related full vaccination inequalities in the valley. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India. Objective: To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children. Materials and Methods: A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 µL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard. Results: The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants. Conclusions: Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system. [ABSTRACT FROM AUTHOR]

Introduction: Prosocial behaviour is one of the key features of the development of school-going adolescents. Therefore, the current paper focuses on the prosocial behaviour of school-going adolescents in Kollam District, Kerala. Methodology: A cross-sectional descriptive study where 600 school-going adolescents, their parents and 60 class teachers were selected through cluster sampling method. English and Malayalam version of the Strength and Difficulties Questionnaire (SDQ) was administered among respondents. Chi-square and multiple linear regression models were used for analysing the data. Results: Self-report of prosocial behaviour predictors were significantly associated with gender (P < 0.01), urban-rural settings (P < 0.001) and government-private schools (P < 0.001). Parents' report shows highly significant relationship with gender (P < 0.001) whereas teachers' report is significantly related to urban-rural settings (P < 0.01). Conclusion: The current study found that one-fifth of school-going adolescents had borderline to abnormal (self – 17.4%; parents' – 16.9%; teachers' report – 20.8%) prosocial behaviour. School-going adolescents should involve in volunteer activities and campaigns for better development in society. [ABSTRACT FROM AUTHOR]

Background: Micronutrient deficiencies such as iron, Vitamin A, and iodine are important public health problems in India. Objective: The objective of the study was to assess subclinical Vitamin A deficiency (VAD) and anemia among women and preschool children from Northeast India. Methodology: A community-based cross-sectional study was carried out by adopting systematic sampling in Phek district of Nagaland. Data were collected from women on sociodemographic particulars, and finger prick blood was collected for hemoglobin and free-flowing drop for Vitamin A estimation on Whatman no. 1 filter paper. Results: The overall prevalence of anemia was 27%, 40%, 44%, and 52% among preschool children, nonpregnant nonlactating women, lactating mothers, and pregnant women, respectively, whereas VAD was 37% among preschool children and 24%-32% among adult women. The prevalence of VAD was observed high among those living in kutcha house, illiteracy of head of households, big family size, and low per capita income. Conclusions: Anemia and VAD are important public health problems among tribal population in spite of the rich biodiversity. [ABSTRACT FROM AUTHOR]

Background: Condom is an integral part of all interventions for female sex workers (FSWs). However, certain situations hinder them from practicing consistent condom use. This paper aims at identifying the situations that predict inconsistent condom use by FSWs of Sonagachi red-light area, Kolkata. Subjects and Methods: The cross-sectional community-based observational study was conducted among 296 brothel-based FSWs of Sonagachi. Outcome variable, that is, inconsistent condom use was said to be present if any sex act with any type of partner was not protected by condom. Association with sociodemographic, occupational, and behavioral characteristics of FSWs was examined. Results: Inconsistent condom use was present among 37.5% of the study participants, and this was predicted by the presence of a nonpaying partner (NPP) (adjusted odds ratio [AOR] [95% confidence interval (CI)]: 15.04 [7.52-30.08]), violence (AOR [95% CI]: 2.08 [1.07-4.03]) and sexual intercourse under the influence of alcohol (AOR [95% CI]: 1.86 [1.02-3.39]). The major cause behind nonuse of condom as reported by the participants was trust on partner. Conclusion: NPPs need to be given emphasis in program strategies for FSWs. The FSWs should constantly be motivated for safe sex emphasizing the fact that trust on partner may be detrimental for their health. [ABSTRACT FROM AUTHOR]

Background: Women's empowerment, a precondition of sustainable development, is a multidimensional and complex concept, often described with three interrelated components: resources, agency, and achievement. There is no universal construct for women's empowerment; rather, it has been assessed based on the context. It had been hardly explored in rural West Bengal. Objectives: This study was formulated to construct a women's empowerment index (WEI), in rural West Bengal, and assess the reliability of the index. Methods: A community-based cross-sectional study focusing on Women's Empowerment, Child Health and Nutrition (WE-CHANT) was conducted in a community development block in West Bengal. Mother (of reproductive age)--child (6--59 months) pairs were recruited from 20 villages by two-stage sampling (n = 268). Mothers were interviewed. Exploratory factor analysis (EFA) with oblique rotation was conducted with 25 measurement variables to construct the WEI. The internal consistency was assessed with Cronbach's alpha, item-rest, average inter-item, inter-domain, and domain-to-index correlation. Results: A 12-item (factor loading ≥0.40) WEI comprising three domains--decision-making power, attitude toward gender-based violence (GBV), and social independence--was constructed with acceptable internal consistency (Cronbach's alpha = 0.747). The multidimensionality of the index was also observed. Conclusion: A concise agency-based WEI was constructed, where decision-making power was explored as the major domain. This index in the context of rural West Bengal could be further utilized to assess women's empowerment and elicit its association with resources and achievements. [ABSTRACT FROM AUTHOR]

Background: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. Objective: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. Methods: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Results: Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Conclusion: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life. [ABSTRACT FROM AUTHOR]

Background: Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans. Material and Methods: Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families. Results: Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population. Conclusions: The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation. [ABSTRACT FROM AUTHOR]

Background: Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India. Materials and Method: In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman's correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI. Results: CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R² = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R² = 0.327) were determinants of CHART mobility. Conclusion: Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity. Material and Methods: Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant. Results: Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively). Conclusion: Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet. [ABSTRACT FROM AUTHOR]

Background: The Indian government launched national teleconsultation services (eSanjeevani OPD) to provide safe doctor-to-patient consultations. This study aimed to determine the awareness and willingness to seek services from eSanjeevani OPDs. Material and Methods: This is a cross-sectional descriptive study conducted in Nandigudi village, Karnataka. The total sample size was 273, and participants were recruited using a systematic sampling technique. Results: The prevalence of awareness about teleconsultations was 2.2% (n = 6, 95% CI: 0.8–4.7%). None of the participants utilized eSanjeevani services in the last year. Approximately 56.0% (n = 153, 95% CI: 49.9–62.0%) were willing to use eSanjeevani OPD. "Not being familiar" (n = 99, 82.5%) with eSanjeevani OPD was the major reason for unwillingness to use teleconsultation, and 73.8% (n = 113) preferred video calls as the mode of communication. Conclusion: The majority of the participants were not aware of and were unwilling to use eSanjeevani OPD. Therefore, healthcare professionals should focus more on creating awareness of teleconsultations. [ABSTRACT FROM AUTHOR]

Backgrounds: The Universal Immunization Program of India is one of the most cost-effective interventions in public health. Missing or delaying vaccination may elicit an uncertain immune response in the body, making the population susceptible to vaccine-preventable diseases. The objectives of this study were to determine the coverage of newborn immunization for birth doses under the National Immunization Schedule and its epidemiological determinants in the rural areas of the Dehradun district, Uttarakhand. Materials and Methods: A community-based cross-sectional study was conducted for a period of one year with a sample size of 570. World Health Organization (WHO) 30 Cluster sampling technique was used with 19 children in each cluster. The data on determinants were collected using a semi-structured, pre-designed schedule through a house-to-house survey. Multivariate analysis was conducted to identify factors associated with immunization coverage, taking the significance level as P < 0.05. Results: The coverage of the Bacillus Calmette-Guérin vaccine, oral polio vaccine zero dose and hepatitis B birth dose were 100%, 91.9%, and 58.8%, respectively in the study area with an overall prevalence of incomplete coverage of newborn immunization as 42.5%. The most cited reason for children being unimmunized with birth doses was the unavailability of vaccines at the birthplace center (29.6%). Conclusions: The prevalence of incomplete coverage of newborn immunization was quite high, which was undermining the holistic approach of the National Immunization Program. Vaccine availability and accessibility at the birthplace with capacity building and training of the healthcare workers may be considered to ensure coverage of birth doses. [ABSTRACT FROM AUTHOR]

Background: Social support has been considered an important social determinant of health because it assists individuals in reaching their physical and emotional needs. The current study was proposed to assess the social support status of the elderly in rural central India. Material and Methods: This observational cross-sectional study was conducted in selected four villages in central India on 460 elderly individuals for 5 months (Aug-Dec 2021) with the use of the MSPSS (Multi-dimensional Scale Perceived Social Support) questionnaire. Univariate analysis and multivariate analysis were carried out using R software. Result: Out of 460, 37 (8.04%) of the elderly were found to have low, 177 (38.47%) were moderate, and 246 (53.48%) were having high social support. The result showed age and education of the elderly were significantly associated with social support. Conclusion: Intergenerational activities, provision and strengthening of social platforms, and the addition social support components with comprehensive geriatric assessment can improve the current status. [ABSTRACT FROM AUTHOR]

Background: Emotional Intelligence (EI) contributes to overall success in life. Our objectives are to explore EI among adolescents and its gender differences as per some parameters of social environments. Material and Methods: Present cross-sectional study was conducted in secondary schools in one of municipal corporations in western Maharashtra EI of adolescents studying in tenth standard in randomly selected secondary schools, was assessed by Schutte's Self-Reported Emotional Intelligence Test with collection of relevant sociodemographic information maintaining confidentiality. Data were analyzed by SPSS 20 software. Results: Total 1060 adolescents in 14-16 years of age participated in the study. Socio-economic status affected EI of adolescent girls more adversely than adolescent boys (P = 0.003, P = 0.036 respectively). Co-educational type of school favored lower EI than gender specific schools (P < 0.001). After gender wise stratification, EI did not differ significantly among boys (P = 0.154) with respect to type of schooling, but differed significantly (P = 0.001) among girls. Conclusion: Apart from continued efforts directed to for improvement in SES, mental health component of school health services needs to take a step forward for assessment and improvement of towards mental health parameters including EI of adolescents. EI training programs commenced in school activities based on gender, socio-economic status and other issues relevant to the situation shall prove beneficial in long run. [ABSTRACT FROM AUTHOR]

Background: Depression, due to its devastating consequences, emerged as the third leading cause of mortality among adolescent school-going children. This necessitates research on determinants of depression among students for effective management. The present study evaluated the various determinants associated with depression among the science students of a private school in Rajkot city, India. Materials and Methods: A cross-sectional study was carried out among the 1219 students of a private school of science stream in Rajkot city, adopting multistage sampling methods. Students were screened using Patient Health questionnaire-9 (modified for teens) for depression. A pre-tested semi-structured questionnaire was used to assess the determinants associated with depression. Binary logistic regression analysis was done to find out predictors of depression. Results: About 31.99% of students were found suffering from depression. Physical illness, academic performance, substance abuse, feeling study tough, difficulties in transport, food, monetary and accommodation at a hostel or home, pressure from parents for study, physical activities, sleep disturbance, and bad relations with teachers and classmates were significantly associated with depression. While parental education, physical illness, addiction to any substance, and academic performance emerged only as a predictor of depression. Conclusion: The present study showed a significant proportion of students suffering from depressive symptoms and revealed predictors of depression among the students. These required integrated efforts to minimize the risk of depression among the students. [ABSTRACT FROM AUTHOR]

Steady improvement in quality of life has led to increased survival time of elderly, especially of those with noncommunicable diseases. A study about their health-seeking behavior (HSB) and its determinants is essential for provision of comprehensive care and facilitate policy development. A cross-sectional study was conducted among 350 elderly participants over 60 years of age in an urbanized village of Delhi. Data was collected using a semi-structured questionnaire, and detailed general and systemic examination was done. Tests of significance were applied to assess the HSB with various demographic, clinico-social, and economic variables. A total of 87.4% of the study population was suffering from at least one noncommunicable disease (NCD). Majority of the study subjects' NCDs (72.66%) were diagnosed while getting treatment for a symptom of the disease. Also, 52.94% of the participants had inappropriate HSB. HSB was significantly associated with gender, age, duration of illness, and importantly with modifiable variables like the level of literacy, distance of preferred health facility, and presence of multimorbidity. HSB was found to be inappropriate in over half of the participants. Policymaking should focus on modifiable variables like education, distance of health facility, and multimorbidity, especially for commonly ignored diseases like osteoarthritis and diabetes. [ABSTRACT FROM AUTHOR]

Background: Rastriya Kishor Swasthya Karyakram (RKSK) is a holistic approach implemented for betterment of adolescent health. Barriers in the implementation can be identified by conducting the situational analysis of any program. The present study is a part of the multi-centric study conducted at Sabarkantha district for situational analysis of RKSK. To assess the implementation of various components under RKSK at various levels of health facilities, 2) to identify the barriers faced by services providers in RKSK implementation, and 3) to identify the perception of beneficiaries regarding RKSK. Materials and Methods: A Cross-sectional study using a mixed method approach was conducted to review the implementation of the RKSK program at Sabarkantha district. In-depth interview of health personnel involved in implementation of RKSK was conducted using pre-structured and pre-tested interview guide. Ongoing sessions of Adolescent Friendly Health Clinics (AFHCs) were examined, and exit interview of adolescents was conducted. Adolescents residing within limits of the defined facility were also interviewed. Frequency and percentages were used for descriptive analysis, and a thematic qualitative analysis approach was used for qualitative aspects. Results: RKSK was implemented successfully at Primary Health Centers. Infrastructure for AFHC was inadequate particularly at higher care facilities. Weekly Iron Folic Acid Supplementation (WIFS) was successfully implemented in the district. Overall sessions conducted at AFHC were found to be satisfactory. Adolescents interviewed in the community were satisfied with the services delivered to them under RKSK. Conclusion: For better implementation of RKSK, there is a need to focus on certain issues such as inadequate infrastructure of AFHCs, the lack of trained counselors, unavailability of sanitary pads, and inadequate participation of adolescents from the community in availing RKSK services. [ABSTRACT FROM AUTHOR]

Context: Adult population visiting COVID vaccination center is a potential teachable moment for screening and preventive advice on non-communicable diseases. Objectives: The objective of this study was to assess the proportion of vaccinees volunteering for screening and to know the proportion of newly detected hypertensives and diabetics among the screened vaccinees at COVID-19 vaccination center. Setting and Design: This descriptive, cross-sectional, operational research study was carried out at the COVID vaccination center at a medical college in central Gujarat from July to September 2021. Methods: After receiving the vaccine, the vaccinee was offered screening through a community-based assessment checklist for risk factors of non-communicable diseases, blood pressure, and blood sugar measurement. Those volunteering for this screening received a slip mentioning their risk score, blood pressure and blood sugar reading, and relevant health information and disease prevention advice. The study variables were acceptability (proportion of vaccinees volunteering for screening) and yield (newly detected hypertensives and diabetics among those screened). Results: Among vaccinees, 27.7% volunteered for risk scoring and blood pressure measurement, whereas 8.3% volunteered for blood sugar measurement. Around 15.5% of vaccinees had high-risk scores as per the community-based assessment checklist. The yield of freshly detected high blood pressure and high blood sugar was 19.3% and 10.5%, respectively. The yield was similar even among vaccinees under 30 years of age. Conclusions: Vaccinees demonstrated interest in undergoing screening for non-communicable diseases. Yield indicates that such screening is worth the effort. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) requiring hemodialysis. The social impact of a chronic disease like this is far reaching and often difficult to quantify. Objectives: To assess the social impact of ESRD among type 2 diabetics requiring hemodialysis and their caregivers. Methods: A cross-sectional study was carried out between February 2017 and 18 among patients with type 2 diabetes requiring hemodialysis and their caregivers, attending the dialysis unit at St. John's Medical College Hospital, Bengaluru, India. Social impact was assessed under the domains of stress (physiologic and psychologic), quality of life (QOL), cost of care, self-perceived burden, and caregiver burden. Study tools used were semi-structured interview schedule for sociodemographic data, details regarding diabetes, hemodialysis and cost of care, EuroQol-5D-3L, hemodialysis stressor scale, Cousineau Self-Perceived Burden Scale, and Caregiver Burden Scale. Results: A total of 160 participants were included. Majority were males (78%) between 46 and 60 years of age. Most participants experienced moderate stress due to hemodialysis (65%) and moderate self-perceived burden (47.5%). Five (10.6%) participants reported full health, while one (0.6%) reported poor health. Anxiety/depression (80.6%) was the top reported problem among all domains of QOL. Caregiver burden was moderate (53.9%). Annual median cost of direct medical expenditure was ..258,600 (interquartile range [IQR]: 197,400--433,500) and ..16,500 (IQR: 9,600-32,100) for nonmedical. Conclusion: We conclude that the social impact of ESRD among type 2 diabetics requiring hemodialysis and their caregivers was moderate. Routine counseling of patients receiving haemodialysis and support groups for patients as well as caregivers will help reduce the impact. [ABSTRACT FROM AUTHOR]

Background: Child malnutrition is linked to household food insecurity. Literature reveals mixed results, but most studies were carried out in adults. Aims: The aim of this study is to assess household food insecurity and nutritional status in children attending Anganwadi centers (AWCs) of Dibrugarh district. Materials and Methods: Cross-sectional study among 510 randomly selected children attending AWCs in Dibrugarh was done. Data on nutritional status and food security were collected, and anthropometric measurements were recorded. Statistical Analysis: Data were analyzed using SPSS version 16. Categorical variables presented as percentages and differences between them tested using Chi-square test. Bivariate analysis was performed to find out independent risk factors. Results: The prevalence of stunting, wasting, and underweight was 39.8%, 26.1%, and 39.2%, respectively. Significant associations found between wasting, stunting, or underweight and household food insecurity. Stunting, wasting, and underweight were significantly associated with the literacy status of parents. Underweight and stunting were also associated with socioeconomic class. Conclusions: Malnutrition in all forms is common in the study population. Rates of stunting, wasting, and underweight were higher than the state average. Along-with access to food, an integrated approach that improves the overall socioeconomic well-being of families and parental education is needed. [ABSTRACT FROM AUTHOR]

Background: In India, iodine deficiency (ID) still remains a serious concern even after five decades of enormous efforts. ID during the preconception period of adolescent girls may negatively affect future neonates, resulting in neonatal hypothyroidism. Hence, the present study was conducted to assess the prevalence of goiter and associated factors among adolescent girls in a poor socioeconomic district of Rajasthan. Methodology: A cross-sectional study was conducted during January–March 2015 in Tonk district of Rajasthan. A total of 1912 adolescent girls were selected from thirty schools using population proportionate to size sampling. Adolescent girls were clinically examined for thyroid using palpation method. Casual urine (n = 344) and salt samples (n = 370) were collected from a subgroup of girls for the estimation of urinary iodine concentration (UIC) and iodine content in salt, respectively. Results: The overall goiter prevalence was 15.3% (95% confidence interval 13.6%–16.9%) and the median UIC was 266 μg/l (interquartile range: 150–300 μg/l) among 1912 adolescent girls (age, 15.7 ± 1.4 years). Around 16.8% of the families of adolescent girls were consuming salt with inadequate iodine (<15 ppm). Goiter prevalence was statistically significantly different with respect to age groups (P = 0.03). There was no statistically significant difference in goiter prevalence with respect to iodine content of salt (P = 0.98) and UIC (P = 0.41). The median UIC increased with an increase in consumption of iodine content of salt from inadequacy to adequacy (P = 0.15). Conclusion: Adolescent girls, residing in an underdeveloped district, are in the transition phase from mild ID (goiter prevalence 15.3%) to iodine sufficiency (median UIC 266 μg/l). [ABSTRACT FROM AUTHOR]

Introduction: Globally, India is the largest milk producer with highest population of cattle i.e., 134 million cows and 124 million buffalos, with women accounting for 93 per cent of total employment in dairy production. The Indian subcontinent is one of the four global hot-spots at increased risk for emergence of zoonotic diseases. Health hazards occurring due to lack of awareness about the causes and impact of zoonosis on the public health are significant. In addition, fewer efforts are seen in One-Health programs in India. Objective: To assess the knowledge level regarding the risk of zoonoses and hygiene practices among rural female population with livestock. And also to assess the actual status of practices adopted in the small holder dairy farm. Materials and Methods: A cross-sectional study was conducted among 60 female populations in peri-urban area of Najafgarh, New Delhi. A structured questionnaire and checklist for observing practicing gaps were used for data collection; Knowledge level was calculated with the help of knowledge scores. Snowball sampling was used. The analysis was done with SPSS-(22). Descriptive statistics, one sample t-test, cross tabulation and Chi-square test were used. Results: Out of total score (28), the respondents got a maximum mean score of 11. Majority of respondents (75%) had low knowledge of specific zoonotic diseases and there was an observed gap in practice. Conclusion: 75% of the respondents had low knowledge on specific zoonotic diseases, hence importance should be given on increasing knowledge about the correct handling of the livestock especially in female population through national-programs and strengthening One-Health efforts. [ABSTRACT FROM AUTHOR]

Background: Injuries are considered as an emerging public health problem in India. Globally every year, injuries kill more than 5 million people, and by 2020, injuries will be the third-leading cause of death and disability worldwide. The study aimed to assess the prevalence and characteristics of nonfatal home injuries among the elderly in Tamil Nadu. Methodology: A cross-sectional analytical study was conducted among 1139 elderly (60 years and above), sampled from three districts of Tamil Nadu, India. Probability proportional to size sampling technique was used for sampling; a pretested questionnaire was used to collect the data. Results: Prevalence of nonfatal home injuries among elderly within the past 1 year was 14.6% (12.5–16.7 at 95% confidence interval), (n = 1003), among those injured, 94.5% were unintentionally injured and 5.5% were of intentional nature. When classified according to the types of injuries, majority of them had fall injuries (6.7%) followed by minor domestic injuries (5.4%), animal-related injury (0.2%), burn injuries (1.1%), road traffic injury (0.4%), and suicide attempt (0.8%). Majority of the respondents were in the age group of young-old, 60–69 years of age (84%), and there was more number of males (55%) in the study. Conclusion: The study reveals that nonfatal home injuries among elderly are an emerging public health problem, unintentional injuries contribute to the majority of the injuries, fall was the single largest contributor for all injuries among elderly. [ABSTRACT FROM AUTHOR]

Introduction: Women from a society reflect the culture that they are a part of and tribal women are the most disadvantaged considering the levels of illiteracy and ignorance. As per the National Family Health Survey 4 reports, in Kerala, undernutrition is particularly common among women from scheduled tribes, 20%. This study was done to assess the nutritional status and its associated factors among tribal women in the reproductive age group at Wayanad. Materials and Methods: A hospital-based cross-sectional study was carried out during January 2017 at Amrita Kripa Charitable Hospital in Kainatty, Wayanad. The minimum calculated sample size was 186. Using systematic random sampling, every third tribal woman in the age group of 15–49 years attending the general outpatient department as patient or bystander was interviewed using a pretested semi-structured questionnaire and examined for height, weight, body mass index, and pallor. Data were analyzed using SPSS version 21. Results: Data were collected from a total of 223 study participants; 53.8% of them were undernourished (< 18.5 kg/m2) with 25% severe underweight and 3.1% and 2.7% preobese and obese women. Participants who were <30 years of age (0.001), those who used smokeless tobacco (0.008), and women from the Paniya tribe 0.001 had significantly higher odds of undernutrition. Conclusion: Almost one-fourth of the study participants were severely undernourished and 5.8% belonged to obese and preobese categories, thereby indicating the gravity of the nutritional difficulties among tribal women. A well-planned and coordinated effort is needed to address the scenario of malnutrition among tribal women. [ABSTRACT FROM AUTHOR]

Introduction: Nosocomial transmission of airborne infections, such as H1N1, drug-resistant tuberculosis, and Nipah virus disease, has been reported recently and has been linked to the limited airborne infection control strategies. The objective of the current study was to assess the health facilities for airborne infection control (AIC) practices and adherence to the National AIC (NAIC) guidelines, 2010. Materials and Methods: A cross-sectional study was conducted in 25 public and 25 private hospitals selected from five randomly selected districts in the state of Kerala. A checklist with 62 components was developed based on the NAIC guidelines. Frequencies, percentages, and mean with standard deviation were used to summarize facility risk assessment and compliance to guidelines. Results: Most of the facilities had infection control committees 35 (70%). Annual infection control trainings were held for staff in 21 (42%) facilities. Twenty (40%) facilities were not familiar with NAIC guidelines. Counseling on cough etiquette at registration was practiced in 5 (10%) institutions. Cross ventilation was present in outpatient departments in 27 (54%) institutions. Sputum was disposed properly in 43 (86%) institutions. N95 masks were available in high-risk settings in 7 (14%) health facilities. Conclusion: There exist deficiencies in adherence to all components of NAIC guidelines including administrative, environmental, and use of personal protective equipment in both government and private hospitals in the state. [ABSTRACT FROM AUTHOR]

Context: Environmental sanitation is a major public health issue in India. Sustainable Development Goal 6 envisages the accessibility of safe water and sanitation throughout the world. Swachh Bharat Abhiyan (SBA), a national cleanliness campaign established by the Government of India in 2014, has six main objectives. It has crossed the half-way point of its intended implementation course. Aims: This study aims to assess the impact of SBA on the sanitation of Cochin Corporation and to identify factors associated with awareness and practice of SBA. Settings and Design: A cross-sectional study among residents of Cochin Corporation. Materials and Methods: Semi-structured questionnaire was used to measure awareness, practice, and impact of SBA. Three divisions were selected purposively. A score was assigned for knowledge and impact assessment questions and was classified into three categories. Statistical Analysis Used: Descriptive statistics using frequencies and percentages were done. Chi-square test was used to test differences between proportions. Results: Thirty percent had no awareness regarding SBA and 42% had minimal awareness regarding the program and its objectives. Only 24% responded that SBA had a good impact on the overall sanitation of the community. The impact of SBA was significantly associated with socioeconomic status. The study revealed the major sanitary concern of the community to be the disposal of solid waste. Conclusion: The SBA did not have a significant impact on Cochin population due to existing good sanitation. Solid waste disposal is still a concern of the community. As far as, Kerala is concerned, it appears that the primary focus of SBA should be on Municipal Solid Waste Management. [ABSTRACT FROM AUTHOR]

Background: The major focus of studies related to health among tribes in India has been on malnutrition. The world is in the stage of epidemiological transition, and noncommunicable diseases are overtaking the communicable diseases not only in general but also among the tribal population. Objectives: A cross-sectional study was conducted to find out the prevalence of diabetes and hypertension among the tribal population. Methodology: A house-to-house survey using a semi-structured questionnaire was conducted in three randomly selected tribal villages. Participants aged 18 and above from both genders were included. Blood pressure was recorded and random blood sugar was estimated for all the participants. Chi-square test was used to study association for categorical variables and one-way ANOVA and Student's t-test were used to study association for continuous variables. A P < 0.05 was considered significant. Results: A total of 952 tribal people were interviewed. About 40.2% were males and 59.8% were females. About 82.2% were Illiterate. 18.9% were underweight compared to 8.8% who were overweight or obese. The prevalence of diabetes was 3.8% (36 participants) of which 77.8% was newly detected. Increasing age was associated with diabetes. Overall, prevalence of hypertension was 16.7% (159 participants) of which 62.9% were newly detected. Age, gender, body mass index, and literacy status were associated with the presence of hypertension. Only eight participants had both diabetes and hypertension. Conclusion: Noncommunicable diseases burden in tribal population is as high as in the general population. Effective strategies to prevent this have to be devised. [ABSTRACT FROM AUTHOR]

Background: In India, cardiovascular disease (CVD) is the largest cause of mortality and morbidity in all regions of the country. Now, to reduce the burden of CVD in our country, we first need to assess cardiovascular health status of the adult population. Objective: The aim of this study is to assess cardiovascular health status among adults and to find the influence of sociodemographic factors on it. Methodology: In a cross-sectional study, cardiovascular health status of 100 sampled adult population of urban area of Teliamura Municipality area, Tripura, was assessed using a pre-designed and pre-tested semi-structured schedule from July 2017 to August 2017. Samples were taken from the adult population by simple random sampling. Collected data were compiled and analyzed using the Statistical Package for the Social Sciences (SPSS 16.0.). The Chi-square and Fisher's exact test were applied to find association. Results: The mean age of the study participants was 44.89 (±13.76) years, comprised 52.0% males and 48% females. Hypertension was seen among 58% of the study population and 77% had ideal (<100 mg/dl) level of fasting blood sugar (FBS). The present study showed obesity, hypertension, high level of total cholesterol, high level of FBS was mostly prevalent among 42–61 years age group. Married people were more obese, hypertensive compared to unmarried. Conclusion: Middle age group population were worst affected by high blood pressure, high blood sugar, poor body mass index, and poor level of cholesterol. Healthy lifestyle measures might reduce the burden of CVD which could be evaluated in future research. [ABSTRACT FROM AUTHOR]

Context: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field. Aims: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin. Subjects and Methods: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study. Results: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard). Conclusions: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone. [ABSTRACT FROM AUTHOR]

Background: Community-based health insurance (CBHI) has been one of the options of health financing in India for a large number of population from the informal sector constituting about 90% of the total population. The objective of this study was to find out what are the factors which have influenced the beneficiaries to enroll in the schemes and also compared them to a noninsured group. Methods: A cross-sectional household survey, on 1639 households, was carried out, which had 1108 insured household and 530 noninsured households with a 2:1 ratio. A multivariate analysis was used to find out the determinants of enrolment. Results: The multivariate analysis revealed that household variables such as gender of household head, religion, and family size were determinants of enrolment. Conclusion: The sociodemographic characteristics of the households do influence the acceptability of the CBHI schemes. [ABSTRACT FROM AUTHOR]

Background: Health insurance can be a very useful strategy to mitigate the disabling effects of catastrophic health expenditure in India. Objectives: The aim of the study is to estimate catastrophic health expenditure incurred and the willingness to pay and ability to pay for health insurance among the unsubscribed. Materials and Methods: A total of 201 principal earning members of households belonging to the 25-45 years age group were interviewed in a community-based household survey in a conveniently selected ward in Mumbai with the help of a pretested, semi-structured interview schedule. Results: The proportion of households with catastrophic health expenditure was 22.4% (total expenditure estimate) and 17.4% (nonfood expenditure estimate). There was a statistically significant association between socioeconomic class and occurrence of catastrophic health expenditure. The average amount the respondents were willing to pay as premium for health insurance per month was ...272 and the average amount they were able to pay was ...259. Conclusion: Catastrophic health expenditure continues to be a disastrous problem in around 20% of Indian households. Targeted health insurance schemes with different premiums and coverages for different income and employment groups should be considered. [ABSTRACT FROM AUTHOR]

Objectives: Prevalence of under-nutrition is very high in India. Under-nutrition is a result of interplay between different immediate, underlying, and basic causes. The study was conducted with the objective to identify significant predictors of stunting, wasting, and underweight. Methods: Cross-sectional studies with 2299 children from five high-burden pockets of four Indian states were conducted. Primary data on their anthropometric measurements along with their households' demographic and socioeconomic characteristics were collected. Binary logistic regression analyses were performed to examine the predictors of stunting, wasting, and underweight. Results: Results show very high prevalence of stunting, wasting, and underweight in all five regions covered in the study. Multivariate analyses show that food security, use of toilets, and low body mass index status of mothers were the major predictors of stunting and underweight among children. Acute respiratory infection disease was the major predictor of underweight and diarrhea was the major predictor of stunting. Younger children (<24 months) had lower odds of underweight and stunting compared to older children (24-59 months). The analyses showed higher odds of wasting among male children. Regional variations were also seen in the study with higher odds of underweight and wasting in Khuntpani block and higher odds of stunting in Naraini block. Conclusion: The above findings indicate that for comprehensively addressing child under-nutrition, it is very important to address maternal nutrition, improve food security, and reduce poverty status, provide better water and sanitation facility to the community, control infections, and address regional disparity. [ABSTRACT FROM AUTHOR]

Elder abuse is a serious problem that has adverse consequence on health. Still, research on elder abuse is sparse in India. Aims: This study aimed to find the nature, prevalence, and factors such as depression and physical problems associated with elder abuse in an urban North Indian community. Materials and Methods: A cross-sectional study was conducted with 222 elders with 97 males, aged 60 years or older residing in an urban community of Delhi. Elders were assessed for abuse by modified Vulnerability to Abuse Screening Scale questionnaire, Geriatric Depression Scale, and self-reported questions on health problems. Results: Mean age of the study population was 66.3 ± 4.2 years. The overall prevalence of any type of elder abuse was 24.3%. Psychological abuse was the most common type (22.9%) followed by financial abuse (5.8%), physical abuse (1.4%), and anti-constitutional abuse (nil). Among the abused, nearly 20% experienced more than one type of abuse. Thirty-seven women (30%) and 17 men (18%) reported elder abuse. Low income (

Context: The state of Gujarat had introduced Extruded Fortified Blended Food, Balbhog, as take-home ration for children 6–35 months of age. The study aimed to understand awareness, availability, and consumption pattern of Balbhog and gain insights on factors influencing its regular use. Aims: This study aims to understand coverage and feeding practices of micronutrient fortified blended food (Balbhog) and determine factors for its regular use. Subjects and Methods: A cross-sectional survey of 1623 households with children of 6–35 months of age registered in Anganwadi centers was conducted in the four districts of Gujarat. Household and dietary survey were conducted to understand child care and feeding practices at household level. Results: The results showed high awareness about Balbhog (88.6%) among caregivers, with majority reporting using it (81.7%) before. Regular Balbhog consumption (42.2%), however, declined considerably across all population characteristics. Monthly distribution of adequate Balbhog packets, taste of Balbhog preparations, meal frequency of children, and caregivers' participation in the monthly Integrated Child Development Services (ICDS) event emerged as strong predictors of regular Balbhog consumption. No disparity in consumption was observed across socioeconomic characteristics of the population. Conclusion: Household feeding practices and ICDS program factors mediated regular use of Balbhog among children. Improving availability of entitled Balbhog packets, raising awareness about Balbhog preparations, and improving child feeding practices could help in increasing Balbhog consumption in the community. [ABSTRACT FROM AUTHOR]

Background: Infertility is a neglected service component in the public health-care system in India. Objectives: This study aims to assess the availability and practices on prevention and management services for infertility in the district health system. Methodology: A cross-sectional survey of selected health facilities and the staff from 12 district hospitals (DHs), 24 community health centers (CHCs), 48 primary health centers (PHCs), and 48 subcenters was conducted using qualitative and quantitative methods. Interviewed staff included 26 gynecologists; 91 medical officers; 91 auxiliary nurse midwife; 67 laboratory technicians; and 84 accredited social health activist workers. Results: The findings indicate that adequate staff was in place at more than 70% of health facilities, but none of the staff had received any in-service training on infertility management. Most of the DHs had basic infrastructural and diagnostic facilities. However, the majority of the CHCs and PHCs had inadequate physical and diagnostic facilities related to infertility management. Semen examination service was not available at 94% of PHCs and 79% of CHCs. Advanced laboratory services were available in <42% at DHs and 8% at CHCs. Diagnostic laparoscopy and hysteroscopy were available in 25% and 8% of DHs, respectively. Ovulation induction with clomiphene was practiced at 83% and with gonadotropins at 33% of DHs. Conclusion: The district health infrastructure in India has a potential to provide basic services for infertility. With some policy decisions, resource inputs and capacity strengthening, it is possible to provide advanced services for infertility in the district health system. [ABSTRACT FROM AUTHOR]

Background: Urban Social Health Activists (USHAs) are the grass root health care workers of urban areas. There are 290 USHAs distributed in various Urban Health Centers (UHCs) of Rajkot city. Objectives: To compare the (i) effectiveness of the training received by the USHAs on their knowledge and counseling skills (ii) knowledge and counseling skills of USHAs on the awareness and utilization of Maternal and Child Health (MCH) care services by their beneficiaries. Methods: This cross-sectional study involved 32 USHAs and 416 beneficiaries served by the same USHAs. 32 USHAs serving in the same field practice area for more than two years were randomly selected. The beneficiaries were those mothers who had a child between 1-2 years age, and who had availed their antenatal and postnatal services in the same area. A scoring system was used to assess the knowledge and counseling skills of the USHAs and the knowledge and utilization of services by their beneficiaries. Results: The utilization of health services was significantly more in the beneficiaries who were serviced by USHAs having comparatively better knowledge (72.7% vs. 35.3%) and counseling skills (62.2% vs. 30.6%). The median score for knowledge (41 vs. 30) and counseling skills (20 vs. 16) of the USHAs was found to be more (P < 0.05) in those who had undertaken induction training. Conclusions: Induction training helped the USHAs to improve their knowledge and counseling skills. Utilization of MCH services was more in those areas served by USHAs having better knowledge and counseling skills. [ABSTRACT FROM AUTHOR]

Introduction: Up until now, poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem. The lack of attention to this issue is striking as we cannot achieve several Millennium Development Goals (MDGs), that is, 2, 3 4,5, and5B. This study aimed to assess the level of awareness about menarche and hygienic practices during menstruation in context of schooling . Materials and Methods: Community-based cross-sectional study using a mix method approach (qualitative and quantitative). It was conducted among 650 adolescent girls in the field practice area of Rural Health and Training Centre, Chiraigaon block of district Varanasi between January and June2011. Pretested, semistructured interview schedule was used. Data were analyzed statistically by using Statistical Package for Social Sciences (SPSS) software. Results: Out of the total 650 respondents, 590 (90.78%) had attained menarche at the time of interview and only one-third of the respondents (29.4%) were aware of menstruation before menarche and sisters (55%) played the key role in providing information to them. Only 31% respondents were using sanitary pads during menstruation. Self-reported reproductive tract infection (RTI) was observed more in respondents not maintaining hygienic practices (6.6%) as compared to those maintaining hygiene (2.6%). Conclusion and Recommendations: From the Focus Group Discussions (FGDs) as well as quantitative survey it was observed that the awareness about menarche before its onset was still poor in rural areas. Significant association ( P < 0.05) was observed between respondent education and their awareness about menarche before its onset. Therefore, it is recommended that teachers can play an influential role in informing them about changes during adolescence, especially about menarche and other issues related to menstruation. As per the present study, sisters and mothers were the major source of information. Therefore, there is a need for the provision of comprehensive family life education for the parents also. [ABSTRACT FROM AUTHOR]

Background: Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program's potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people. Objectives: To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV. Materials and Methods: A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire. Results: In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV). Conclusion: Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India. [ABSTRACT FROM AUTHOR]

Background: Although school eye screening is a major activity of the National Program for Control of Blindness, inadequate evidence exists about accuracy of school teachers in screening. Objectives: Compare quality of referral for subnormal vision by school teachers and primary eye care workers (PECW) in school children and to establish appropriate cutoff for identification of subnormal vision in school going children. Materials and Methods: This was a cross-sectional study involving school children studying in classes 1 to 9 in different schools of Delhi evaluated for sub-normal vision. Vision was recorded by the teacher and a primary eye care worker especially trained for the study using the optotypes of Early treatment Diabetic Retinopathy Survey (ETDRS) vision chart with standard lighting. Results: The total number of children enlisted in the 20 selected schools was 10,114. Of these, 9838 (97.3%) children were examined in the study. The mean age of children enrolled in the study was 11.6 ± 2.19 years with 6752 (66.9%) males. The sensitivity and specificity of teachers in comparison to PECW using 6/9.5 vision level as cutoff for referral was 79.2% and 93.3%, respectively compared to 77.0% and 97.1%, respectively on using the 6/12 optotype. The results showed significantly higher sensitivity and lower specificity for private schools against government schools and for older against younger children. Conclusions: Our results show that the use of teachers and shift to use of the 6/12 sized “E” for the school eye screening (SES) program is appropriate and would substantially reduce the work of eye care providers while improving its overall efficiency. [ABSTRACT FROM AUTHOR]