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Background: Mass media significantly contributes to the dissemination of scientific information, including health information on prevention, diagnosis, treatment, national programs, and government schemes. Aims and objectives: To identify the number of news articles related to health in 4 regional newspapers and to classify the news items in terms of type of disease/ health issue covered. Methodology: Four leading newspapers were reviewed to identify the health-related news, their importance in terms of location in the newspaper, and the type of health issue covered. These were further classified based on the level of evidence used. Results: We extracted 720 health-related articles; 411 in English and 309 in Kannada dailies. The English newspaper had maximum coverage on environment 95 (23.1%) and health advisories 60 (14.5%). The Kannada papers on the other hand were dominated by health advisories 65 (21%), followed by nutrition and fitness 48 (15.3%), and environment 40 (12.9%). After the articles were categorized according to their evidence, it was discovered that 92% of them were evidence-based, with 84% of those articles based on Grade-II evidence. Conclusion: Health news in newspapers varies, often focusing on environment and health advisories, and relies heavily on expert opinion rather than empirical data. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy is a concerning public health problem in India. Misperception and misunderstanding about pregnancy and its preventive methods lead to pregnancy when adolescents are involved in unsafe sexual intercourse. This scoping review aims to discuss the evidence on the perception, practices, and understanding related to teenage pregnancy among adolescent girls in the Indian context. Method: The Arksey and O'Malley scoping review framework and Joanna Briggs Institute Reviewers' Manual were used for the scoping review. The Population, Concept, and Context strategy (PCC) ensured the review questions, eligibility criteria, and search strategy. The Systematic Review and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) was used. A literature search was done using electronic databases by specific keywords such as "teenage", "adolescences", "pregnancy", "perception", "knowledge", "awareness", etc. Relevant grey literature was identified through further searching. The review included studies that fulfil inclusion criteria having female adolescent groups aged from 10 to 19 years in the Indian context between the years 2000 and 2021. Result: We found 40 eligible studies; more than half of these were from southern (35%) and northern (27.5%) regions, and studies from the rest of India were very sporadically distributed. Most studies (72.5%) were published in the last 10 years. The relevant extracted data from individual studies were synthesized and presented in the two major sections, perception, practices, and the second one, understanding and experiences among teenage girls. The understanding of pregnancy and teenage pregnancy-related preventive methods was detailed analysis in about 72% of papers whereas other aspects, such as perception (22.5%), practices (25%), and experiences (7.5%) were discussed in the remaining papers related to pregnancy among adolescent girls. Conclusion: Evidence in the selected studies shows that understanding and practices are the major areas that were primarily explored, where perception, practices and experiences are the topics that are relatively less investigated. Literature synthesis derives misconception, lack of understanding, and practices without knowing the consequences are the key factors responsible for early pregnancies. Future interventions like increasing awareness, providing comprehensive reproductive knowledge, convenient health care aids, and proper counselling are adequate measures for minimalising the problem. The present analysis showed that studies are limited in their scope concerning various aspects of teenage pregnancy in India, so this scoping review gives essential perspectives on future research and implementation plans and policies in this field. [ABSTRACT FROM AUTHOR]

Purpose: Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions. Design/methodology/approach: We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs. Findings: This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India. Originality/value: Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore factors impacting wearable fitness tracking (WFT) device continued usage intention from perspectives of technology attributes (autonomy benefits), health attributes (self-health management benefits, diet-control benefits and health self-efficacy), and consumer attributes (age, gender, technological innovativeness, symbolic benefits, social benefits and hedonic benefits). Design/methodology/approach: The study integrates constructs from the technology acceptance theories and the health promotion model to develop the research model and hypothesis. The empirical analysis was conducted using data from 217 respondents from India. Logistic regression was used to identify factors that discriminate between groups with low and high continued usage intentions. Findings: Results indicate higher continued usage intention for WFT devices is driven by perceived benefits-health, autonomy, social and hedonic, and individual characteristics-technological innovativeness and perceived health self-efficacy. Further, perceived symbolic benefits, diet control benefits, age, and gender does not discriminate between the groups with low and high continued usage intentions. Research limitations/implications: The results may be limited to the context of the sample and the factors considered. The study suggests future research areas. Practical implications: The paper offers insights for marketers, governments, insurance firms, and related healthcare services on promoting higher usage of WFT devices to yield dual benefits of preventive healthcare and higher profitability. Originality/value: The study extends existing research by examining factors across consumer, health, and technological domains in a single framework and adds to the limited research in the context of usage of WFT devices in developing countries. [ABSTRACT FROM AUTHOR]

Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relative low cost, low levels of technological input, relative low side effects, and growing economic importance are some of the positive features of traditional medicine. In rural India, traditional medicine continues to be the only available form of care. Many communities continue to treat patients using their old methods, unaffected by contemporary medical advancements. Due to their accessibility, affordability, and ease of use, tribal tribes prefer to utilize and consult their own traditional healers. These are likewise thought to be highly effective and without any adverse effects. This paper aims to identify various traditional medicines used for treating illness and infirmities, by taking accounts from the residents of Chungtlang village, Mamit District, Mizoram. The objective here lies in discovering traditional knowledge of medicinal plants and their uses for various infirmities. [ABSTRACT FROM AUTHOR]

India's mainstream political discourse is yet to grant genuine space to environmental issues or sustainable development; their priority being economic development. This is despite noteworthy environmental conservation movements and civil society organizations committed to the cause of the environment. Although the country has an array of competent environmental regulations, the environmental sustainability of the development programmes remains the least addressed. The case is not different for the Kerala state, despite its high literacy and human development matching many developed countries. The "Kerala Development Model" has been highly praised for its high-level social development. The apparently well-informed population of the state also outscores most states regarding environmental identity. In this context, this paper explores the Athirappilly hydroelectric Project pursued by the Kerala State Electricity Board Limited and other interest groups. It appears that the contemporary socio-economic-political scenario is urging the state's highly literate and politicized public to a post-nature or post-truth society increasingly engrossed in a consumerist lifestyle at the cost of the unique environmental setup. The present study also highlights how the Kerala population, once dominated by socialistic/liberal ideologies with egalitarian values, has been riding the neoliberal development wave giving little importance to nature and long-term ecological security. [ABSTRACT FROM AUTHOR]

A significant number (49 %) of Indian users tend to rely on digital media to either access health-related information or use the internet as a precursor to visit a doctor [20]. According to a report by Raheja [48], "The Internet of Things" (IoT) connection has the potential to change the malfunctioning medical system into a comprehensive, effective, and individualised system. This will allow for a more proactive approach to wellness and overall health, reducing medical expenses through these inclusive practices. Online health communities in India demonstrate significant clout to transform the healthcare industry by empowering patients. They offer a platform to all key stakeholders, that are, the healthcare professionals, patients and even the caregivers alike, to come forth, share their experiences and develop remedies for various issues faced by the healthcare industry. This paper examines the antecedents involved in the empowerment of patients in Online Health Communities (OHCs) and the outcomes of this in the form of participant compliance. The research additionally examines the moderating impact of certain factors such as the patients' e-health literacy and health locus of control (HLOC) and the physicians' paternalism, in examining the relationship between patient empowerment and compliance. The findings of the research propose a construct or a theoretical model for the numerous factors and moderators associated with the patient's participation in online health communities. The social support available to patients leads to more empowered patients, ultimately resulting in higher Patient compliance. Further, this patient empowerment, which comprises of sense of autonomy, competence and self-efficacy makes people more compliant. The theoretical construct between patient empowerment and patient compliance, is further moderated by the patients' e-health literacy and health locus of control (HLOC) and the physicians' paternalism. [ABSTRACT FROM AUTHOR]

One of the most speedy and substantial social shifts in human history has been the evolution of gender relations since the turn of the 20th century. Even though female health, literacy and women participation in workforce have significantly improved, the status of women in Indian society is not very satisfactory leading to gender disparities. It is in this background that this paper attempts to analyse the role of education, labour market and health in reducing gender disparities across the states over the period of time. To analyse the impact of these variables, Gender Disparity Index (GDI) has been constructed utilising the data from Periodic Labour Force Survey (PLFS) and Sample Registration System (SRS) to measure gender disparities in 20 major states and union territories (UTs) of India. For the construction of GDI, we have used three dimensions, namely health, empowerment and labour market participation. The index is prepared to make a decadal comparative study for the years 2011–12 and 2020–21. The statistical results indicate that there is a significant difference in mean of the GDI scores for 2020–21 and 2011–12. The paper concludes with certain policy implications suggesting that there is a need to put more effort into creating infrastructure and cutting-edge policies to improve the health and education systems. The focus should also be to create more employment opportunities for females, helping them to raise their standard of living so as to enhance their contribution towards economic growth. [ABSTRACT FROM AUTHOR]

The study investigates the prevalence of substance use disorder and role of institutions in preventing it in Gangtok, a capital city of the northern Indian state of Sikkim. A survey of 816 respondents was undertaken using a short and easy-to-understand questionnaire. Results reveal that 64% of respondents identified persons with harmful drug use in their immediate families or in their neighborhoods and nearly same percentage of people conceal the actual cause of death in cases where death occurred due to drug overuse. The paper uncovers that cases of substance use disorder have increased and a considerable number of people are reported dying due to it, but families often hide the actual cause of death. The role of institutions is found to be limited in preventing it, as the process of knowledge transmission among families and patients with heavy drug use is abysmally slow. The study argues to empowering society with a potential tool, that is, knowledge transmission, and enabling them to devise meaningful tools to tackle rising cases of substance use disorder. [ABSTRACT FROM AUTHOR]

Introduction: In this paper, we analyzed the study of a mathematical model of non-linear differential equation on the effect of HIV/AIDS disease among unaware HIV/AIDS-infected population. Material and methods: Population was divided into four categories, including HIV-negative individuals, unaware HIV-positive cases, aware HIV-positive, and AIDS patients. The model was investigated numerically and analytically using fourth-order Runge-Kutta approach and homotopy perturbation method (HPM). Results: We have discussed the parameter variation graphically. Conclusions: Determining the dynamics of HIV prevalence and investigating the effect of each parameter on the governing equation can be simple with analytical solution. [ABSTRACT FROM AUTHOR]

Entertainment-education has been touted as a potent delivery channel for health education campaigns. Yet, there is little evidence of its causal effects. This paper aims to fill the gap in the literature by using a field experiment in India to study two questions on the efficacy of health entertainment-education. First, can health entertainment-education, particularly through films that show role models and draw on emotions, lead to lasting, positive change in health knowledge and behavior? Second, can financial incentives for ex-post health literacy boost the effectiveness of health entertainment-education? The results show that health entertainment-education successfully increased health knowledge (e.g. knowledge about cleanliness and hygiene) by 16 percent. These gains persist almost one year later, although there were no observed impacts on health behaviors. Further, financial incentives do not appear to have any effects. These insights contribute to our knowledge of what works for health education in low-income settings, so that future education campaigns can be crafted with more meaningful impact. [ABSTRACT FROM AUTHOR]

Objective: Recently, a novel community health programme-the integrated microfinance and health literacy (IMFHL) programme was implemented through microfinance-based women's only self-help groups (SHGs) in India to promote birth preparedness and complication readiness (BPCR) to improve maternal health. The study evaluated the impact of the IMFHL programme on BPCR practice by women in one of India's poorest states-Uttar Pradesh-adjusting for the community, household and individual variables. The paper also examined for any diffusion of knowledge of BPCR from SHG members receiving the health literacy intervention to non-members in programme villages., Design: Quasi-experimental study using cross-sectional survey data., Settings: Secondary survey data from the IMFHL programme were used., Participants: Survey data were collected from 17 244 women in households with SHG member and non-member households in rural India., Primary Outcomes: Multivariable logistic regression was used to estimate main and adjusted IMFHL programme effects on maternal BPCR practice in their last pregnancy., Results: Membership in SHGs alone is positively associated with BPCR practice, with 17% higher odds (OR=1.17, 95% CI 1.07 to 1.29, p<0.01) of these women practising BPCR compared with women in villages without the programmes. Furthermore, the odds of practising complete BPCR increase to almost 50% (OR=1.48, 95% CI 1.35 to 1.63, p<0.01) when a maternal health literacy component is added to the SHGs. A diffusion effect was found for BPCR practice from SHG members to non-members when the health literacy component was integrated into the SHG model., Conclusions: The results suggest that SHG membership exerts a positive impact on planned health behaviour and a diffusion effect of BPCR practice from members to non-members when SHGs are enriched with a health literacy component. The study provides evidence to guide the implementation of community health programmes seeking to promote BPCR practise in low resource settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. Sample: This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Measurement: Random blood glucose was assessed for each participant using a finger prick test. Results: The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. Conclusion: The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden. [ABSTRACT FROM AUTHOR]

The present study aims to assess the knowledge on use of diaper and its impact on child health among mothers of infants. The objectives of the study was to assess the knowledge on use of diaper and its impact on child health among mothers of infants and to find out the association between the knowledge onuse of diaper and its impact of child health among the mothers of infants and selected socio personal variables. Non experimental descriptive study design was used in the study. The data was collected by using a semi structured questionnaire. The collected data was analysed using descriptive and inferential statistics. The result shows that out of 50 samples majority of the children are of age range 0-2 months, 52% were male children and was first born (54%). Majority of the sample are at age group 26-30 years (36%), 58% samples are educated upto graduate level, 42% of samples were housewives and 48% have family income above 30,000, 94% of children were using disposable diapers ,42% of children using diapers for 3-4 hours and 80% children had no exposure to diaper rash. Among the samples, 56% of mother had moderate knowledge, 34% of mothers had poor knowledge and, 10% of mothers had good knowledge. There is significant association between the age of mother and occupation of mother and there is no association between age of child, sex of child, birth order of child, education of mother, income of family, type of diaper used, duration of diaper used, previous exposure to diaper rash. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to document the existing traditional knowledge of the medicinal plants for bone setting health care practices and to analyse the present treatment process and identifying the medicinal plants as key factor of ethno-orthopedic healing system in Gurap area in Hooghly district of West Bengal. Data were collected from the patients as well as practitioners through questionnaires and personal interviews to know about the general information, orthopaedic problems, treatment process, restrictions and the usefulness of the practice through the traditional knowledge and medicinal plant. The predominance of rural folk (86%) indicates the importance of the traditional bone setters as healthcare providers in rural areas. Most of the patients (96%) were satisfied with this treatment. The plant also identified through the present study namely Ipomoea obscura that can be obtained patent and preserve for future generation. The study has drawn upon focuses on the documentation of traditional knowledge, valuable medicinal plant and treatment process adopted in the study area, which may help to the other communities as a medical resource for further use. Library can acts as resource providers of such authentic medicine. [ABSTRACT FROM AUTHOR]

Introduction  Hazardous healthcare waste produced at home contributes to approximately 0.5% of biomedical waste, and although potentially infectious, is often discarded with other domestic wastes. The study aimed to quantify and compare types and patterns of biomedical waste generated in homes and to assess the knowledge, attitude, and practices regarding biomedical waste among selected urban and rural households in the coastal area of Mangalore city in Karnataka. Methods  A cross-sectional study was conducted in households consisting of rural and urban field practice areas of a tertiary care hospital in coastal Karnataka from November 2017 to February 2018. A pretested semi-structured questionnaire on knowledge, attitude, and practice regarding healthcare waste generated at home was assessed. Qualitative variables of the waste segregation practice, types of biomedical waste, the knowledge, perception, and attitude to practices regarding biomedical waste were expressed in percentages proportions and analyzed using SPSS v.20. Results  Baby diapers were the most common hazardous waste. The number of baby diapers produced daily in rural and urban areas was 32 (42.7%) and 64 (85.3%), respectively. The urban households had better knowledge of possible hazardous healthcare waste at home, 28 (37.33%) compared with 7 (9.3%) in rural households. Seventy-one (94.7%) urban and 49 (65.3%) rural households had a favorable attitude toward the disposal of hazardous domestic biomedical waste. Conclusion  The knowledge, attitudes, and practices regarding hazardous healthcare waste produced at the household level were better among urban households compared with rural households. [ABSTRACT FROM AUTHOR]

Purpose: Nutrition education plays a significant role in inculcating lifelong healthy dietary behaviours among adolescents. The purpose of this paper is to understand the opinions of parents and teachers regarding nutrition education in private Indian secondary schools. Design/methodology/approach: A cross-sectional, self-administered, paper-based survey comprising both closed- and open-ended questions was completed by 32 teachers and 280 parents who were recruited from five private English-speaking secondary schools in Kolkata, India. Descriptive and cross-tabulation analyses were conducted to compare the responses of teachers and parents. Thematic data analysis informed by template analysis technique was performed to evaluate the qualitative data. Findings: While the curriculum was considered interesting and easy to understand, the gendered nature of the curriculum, excessive rote learning and lack of synchrony between the curriculum and school food services were highlighted as shortcomings of the existing curriculum. The need for the dissemination of food skills either through a compulsory food and nutrition curriculum or through extra-mural activities was expressed by most respondents. Both these ideas were indicative of strong support and motivation for modification in the current curriculum. Practical implications: These findings emphasise the support for a skills-focussed food and nutrition curriculum to inculcate experiential culinary skills and comprehensive nutrition knowledge in Indian adolescents, thus improving their nutritional and health profiles. Originality/value: This is the first cross-sectional survey to investigate the views of parents and teachers about the status of food and nutrition education in private Indian secondary schools. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8–10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults. [ABSTRACT FROM AUTHOR]

The female foeticide involves the detection of sex of the unborn child in the womb of the mother and the decision to abort it if the sex of child is detected as girl. So, here an attempt has been made to assess the knowledge regarding FF among UG students at selected college of Etawah district Utter Pradesh. In this paper we assess the knowledge regarding female foeticide among under graduate student of selected college of Etawah district. A Cross sectional study research design was utilizes in the present study. Non probability purposive sampling was used to select the sample. Study tool was classi ied in two parts (socio demographical variable and knowledge questionnaire). Result of the study shows that in study 50% students were belong in 17-19 year age group, 45% students had medical profession, 47.5% were male and 53.4 % female student. Study shows that more than 80% students have good knowledge. The mean score and SD were 22.375 and 5.826 respectively. Study concluded that students are having good knowledge regarding female foeticide. [ABSTRACT FROM AUTHOR]

Background: More than forty million people suffer from depression in India. A lack of awareness, stigma related to mental health issues, and limited accessibility to treatment services magnify the profound personal and societal impact of depression. Given the rise of smartphones in India, mobile technology can help alleviate some of these depression-related challenges. Aims and method: The aim of this paper is to investigate the essential features of an India targeted depression smartphone app. We conducted an online survey to profile the needs of individuals with depression in India, which varied based on variables such as socioeconomic background, age, level of awareness toward depression, and the extent of exposure to mental health stigma. We also conducted a systematic evaluation of depression apps currently available to Indian users to investigate the user needs that these apps met and the needs that they failed to meet. Based on our findings, we made a set of recommendations related to the essential features of a future app targeted at managing depression in India. Results: Presently available depression apps fall short in providing some significant features such as local language options, content in audio and video formats, and user location matched resources. These gaps make these apps less than fully relevant to a diverse set of Indian users. Conclusions: It is essential to provide depression-related information in a targeted manner depending upon each user's particular needs and context. Potential customizations, such as offering content in local languages and flexible formats (e.g. audio, video, and text); and providing user-relevant diagnostic tools and location matched treatment resources can help improve the suitability of the app for diverse users. [ABSTRACT FROM AUTHOR]

Introduction: The Transplantation of Human Organs Act (THOA) provided legal status to brain death as a form of death in 1994. However, even after three decades, the deceased organ donation rate in India stands at a mere 0.52 per million population, crucially due to a lack of brain death awareness, and an absence of institutionalized protocols for deceased donations. Objectives: By taking the case of the state of Haryana, this article seeks to understand the existing state of brain death awareness among professionals working in the medical community, and identify the implementation challenges that would be involved in instituting a state‑level policy for donations from deceased persons. Materials and Methods: This paper adopts a qualitative approach, utilizing in-depth interviews with doctors in the districts of Rohtak and Charkhi Dadri in Haryana, and transplant coordinators across the state to gather a nuanced understanding of the issue. Results: The research finds that brain death awareness is lacking among doctors, along with the necessary resources for brain death declarations to become practice. There is also an evident district-wise variation in the responses of doctors when it comes to the potential challenges of instituting a brain death declaration standard operating procedure. It offers recommendations for improved implementation of organ transplant policies and scaling up of deceased donations. Conclusion: To unearth the potential that deceased organ donation holds, some immediate measures that can be taken include mapping all the functional organ retrieval facilities across the state and their closest civil hospitals or postgraduate medical institutions with trauma centres, and focusing on the sensitization of the medical functionaries with respect to brain death and its identification. [ABSTRACT FROM AUTHOR]

India is more challenged than developed nations in reducing the Covid-19 cases and lowering death rates due to the huge population and unprepared health care system. As intention to vaccinate is contextual and its availability does not translate into their de facto adoption., this paper examines the factors that determine intention to vaccinate against COVID-19 in India. A research model was tested using 222 responses was tested using structural equation modeling. Findings suggested that credibility and awareness positively impacted whereas vaccine hesitancy and perceived risk negatively influenced intention to vaccinate. The fear of side effects did not impact the intention to vaccinate. [ABSTRACT FROM AUTHOR]

This paper explores the relationship among Indian mothers' health knowledge regarding proper treatment of diarrhea in children and caste, religion and other mediators, estimating causal impacts through a combination of instrumental variables and matching methods. The results indicate that both caste/religious affiliation and access to health networks (measured across three different dimensions) are important determinants of health knowledge. High caste and non-Muslim women are more likely to have correct health knowledge, but not when accounting for greater female education within these groups. Women with access to health networks are also more likely to have correct knowledge. Additionally, high caste women benefit more in terms of health knowledge from having health networks than women from other groups; except if the health worker is of the same caste/religion, in which case low caste and Muslim women sometimes benefit by twice as much or even more. If caste and religion-related differences in health knowledge are to be reduced it may not be enough to improve access to high quality health networks—such networks also have to be homophilous. Improved treatment from and confidence in the medical profession is found to be part of the mechanism linking health network access with improved health knowledge. [ABSTRACT FROM AUTHOR]

Background: As a signatory of the United Nations Commission on Child Rights, India has enacted laws and policies to protect the child's interests. The Juvenile Justice Act of 2015 addresses the needs and well-being of the most vulnerable children, including those who do not have anyone to care for or have experienced a traumatic upbringing and those who are allegedly in conflict with the law. No research from India addresses these vulnerable children's mental health and well-being. The current paper describes a pilot project to create mental health awareness and improve children's care access in India's Juvenile Justice System (JJS). Methods: Permission was obtained from appropriate governmental agencies in Odisha and Tamil Nadu and Child Care Institutions (CCIs) that consented to participate. A co-creation model was utilized to create youth-friendly spaces and methods to deliver mental health literacy for all stakeholders and access to care. Results: Seven CCIs and 278 children across two states participated in the implementation of the project. 37.8% of the children had resided for less than six months and 34.5% for more than two years in the current CCI. Of the various adverse childhood experiences, neglect was the highest at 76.3% followed by parental issues at 32%. Conclusions: Children in the JJS have many risk factors predisposing them to develop mental health issues. This unique pilot project describes implementing a codesigned and co-created model of delivery of mental health literacy and access to care to this vulnerable group of children. [ABSTRACT FROM AUTHOR]

Civil society engagement around health care and population health improvement is an important driver towards Health for All. Research can improve the effectiveness of health activism by examining the resources, structures and strategies of civil society engagement. However, research to support such engagement faces epistemological and methodological challenges which call for specific research strategies. A four year multi-country study was undertaken by the People's Health Movement, a global network working for health for all. The research took place in six countries (Brazil, Colombia, DR Congo, India, Italy, South Africa) and globally, and was directed to understanding five domains of civil society engagement: movement building; campaigning and advocacy; capacity building; knowledge generation, access and use; and engaging with governance. The research plan and methods of data collection and analysis were tailored to address the objective of improving activist practice, while negotiating research challenges identified during the design phase. Results include insights into the practice of civil society engagement in relation to the five domains of activist practice, as well as experience gained in managing six methodological challenges which we describe as: making meaning, aligning research and action, managing power relations, valuing experiential knowledges, chaos and contingency, challenging preconceptions. Researching activism can produce useful insights into practice as well as support continuous improvement in the effectiveness of such activism. However, there are significant methodological challenges that can be addressed through appropriate strategies. More research, building on the approach described in this paper, can contribute to more effective civil society activism for health. [ABSTRACT FROM AUTHOR]

Background: Despite a growing elderly South Asian population, little is known about the experience of diagnosis and care for those living with dementia. There have been a number of individual qualitative studies exploring the experiences of South Asian people living with dementia and their carers across different contexts. There has also been a growing interest in synthesizing qualitative research to systematically integrate qualitative evidence from multiple studies to tell us more about a topic at a more abstract level than single studies alone. The aim of this qualitative synthesis was to clearly identify the gaps in the literature and produce new insights regarding the knowledge and understanding of the attitudes, perceptions, and beliefs of the South Asian community about dementia. Methods: Following a systematic search of the literature, included qualitative studies were assessed by two independent reviewers for methodological quality. Data were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (QARI). Findings were synthesized using the Joanna Briggs Institute approach to qualitative synthesis by meta-aggregation. Results: Seventeen papers were critically appraised, with 13 meeting the inclusion criteria. Participants were mostly of South Asians of Indian background; followed by Pakistani with a few Sri Lankans. Missing South Asian countries from the current evidence base included those from Bangladesh, Bhutan, Maldives, and Nepal. Three meta-synthesis themes emerged from the analysis: (1) a poor awareness and understanding of dementia, (2) the experience of caregiving, and (3) the attitudes toward dementia care provision. Conclusions: A consistent message from this qualitative synthesis was the limited knowledge and understanding of dementia amongst the South Asians. Whilst symptoms of dementia such as 'memory loss' were believed to be a part of a normal ageing process, some South Asian carers viewed dementia as demons or God's punishments. Most studies reported that many South Asians were explicit in associating stigmas with dementia. [ABSTRACT FROM AUTHOR]

In the context of a growing adolescent population globally, it is imperative to understand which interventions will most effectively advance their sexual and reproductive health (SRH). In India and globally, peer education is often utilised as an intervention for promoting the SRH of young people. Globally, the evidence of its effectiveness is mixed. A systematic review of the literature from the Indian context gave insight into the knowledge, attitudinal, and behavioural (KAB) outcomes affected by peer education, as well as the inputs, coverage, content, and context of such interventions. Out of the over 1500 publications initially identified through the database and bibliographic searches, 13 were included in the review; no quality assessment was done, given the dearth of publications matching the inclusion criteria. Analysis of the included publications highlights the multiple ways that peer education is implemented in the Indian context, as part of multi-component programmes and as a stand-alone intervention. The KAB outcomes from these initiatives are mixed, with some multi-component and some stand-alone initiatives affecting statistically significant outcomes and others not–a finding consistent with global literature reviewed for this paper. Despite the mixed results and the limited effects of behaviour relative to knowledge, this paper proposes that peer education has a place in an overall response to improving the SRH of young people. It calls for better research on peer education in India, and for research in relation to the optimal conditions for peer education to succeed in affecting KAB and other outcomes. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDP), particularly pre-eclampsia and eclampsia, remain one of the leading causes of maternal mortality and are contributory in many foetal/newborn deaths. This editorial discusses a supplement of seven papers which provide the results of the first round of the CLIP (Community Level Interventions for Pre-eclampsia) Feasibility Studies. These studies report a number of enablers and barriers in each setting, which have informed the implementation of a cluster-randomized trial (cRCT) aimed at reducing pre-eclampsia-related, and all-cause, maternal and perinatal mortality and major morbidity using community-based identification and treatment of pre-eclampsia in selected geographies of Nigeria, Mozambique, Pakistan and India. This supplement unpacks the diverse community perspectives on determinants of maternal health, variant health worker knowledge and routine management of HDP, and viability of task sharing for preeclampsia identification and management in select settings. These studies demonstrate the need for strategies to improve health worker knowledge and routine management of HDP and consideration of expanding the role of community health workers to reach the most remote women and families with health education and access to health services. [ABSTRACT FROM AUTHOR]

Background: The famous Tang Dynasty monk Yi Jing travelled to ancient India in 671 AD, visited more than 30 regions and returned to China in 695 AD. He wrote Nanhai Jigui Neifa Zhuan, which he completed in 691 AD. It describes the basic rules, namely 'Inner Dharma' (Neifa,内法) that Buddhist sites and monks should follow in their daily lives. Additionally, the author provided an overview of ancient Indian Buddhist medicine, covering aetiology, diagnosis, medication, acupuncture, health preservation and other aspects, which exhibited distinct characteristics. Methods: This article first delves into the original text of Nanhai Jigui Neifa Zhuan by reading it thoroughly and extracts core chapters related to hygiene, medicine and health care. Later, the extracted information is meticulously classified and organised. Lastly, through a systematic literature review, keywords search, data screening and comparative analysis, an in-depth and comprehensive exploration and analysis of Nanhai Jigui Neifa Zhuan is conducted within the domains of hygiene, medicine and health care. Results: Nanhai Jigui Neifa Zhuan emphasizes the importance of personal hygiene for ancient Indian monks and introduces the basic theories of ancient Indian medicine. It compares ancient Indian and Chinese medicinal materials, highlighting their respective roles in treating different diseases. Furthermore, it briefly discusses the storage and processing of ancient Indian medicinal materials, poisoning and toxicology, and ancient Indian health preservation ideologies. Conclusion: A comprehensive and in-depth study of traditional ancient Indian medicine, including Buddhist medicine and Ayurveda, and its application in the religious environment and communities of the Tang Dynasty (618–907 AD) aids in understanding the treatment methods and health practices of ancient Indian medicine. Additionally, it facilitates a deeper understanding of the similarities, differences and exchange between Chinese and Indian medicine, thereby opening up new horizons for future research. [ABSTRACT FROM AUTHOR]

Background: In India, twenty-five percent of women who menstruate are unable to utilize sanitary methods, and even among those who have access, there are multiple obstacles to achieving proper menstrual hygiene management. The consequences of inadequate menstrual health may extend to affect a girl's socialisation, empowerment, overall well-being, and even survival. Objectives: To estimate the prevalence of unmet menstrual practice needs and its determinants among college going women in Coimbatore district, India. Methodology: A questionnaire based analytical cross-sectional study was conducted among 3144 college going women from October 2022 to January 2023. Menstrual Practice Needs Scale (MPNS-36) was used to collect data regarding the unmet needs and their mean scores were compared across socio-demographic variables, menstrual knowledge, and the choice of hygiene material. Results: The mean (SD) age of the study population was 19.3 (1.8) years. The prevalence of unmet menstrual practice needs was 62.8% with a mean (SD) MPNS score of 1.8 (0.4). The total MPNS score was low for those currently residing in rural or having a rural hometown. The unmet need was better for those residing in-campus of the educational institute and having educated parents. The socioeconomic class and presence of a personal income also influenced the total MPNS scores significantly (p < 0.05). Menstrual talks with friends before puberty and with friends and family after puberty improved the MPNS scores. Regarding menstrual hygiene methods, modern menstrual methods (MMM), disposable and bio-degradable materials had a lower unmet need. Marital status, freedom to manage expenses, pre-pubertal menstrual talks with family, and total number of family members did not influence the scores of MPNS. Multivariate regression analysis showed that maternal education, menstrual talks with family after puberty, and type of menstrual hygiene method including its disposability were independent predictors of total MPNS scores. Conclusion: Addressing unmet menstrual practice needs among college-going women in Coimbatore district necessitates a multifaceted approach encompassing education, access to affordable and sustainable menstrual products, and destigmatization efforts. [ABSTRACT FROM AUTHOR]

Background: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors. Methods: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text. Results: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27–5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34–12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92–12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39–3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08–3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14–16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39–0.97) were less likely to respond. Conclusion: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended. [ABSTRACT FROM AUTHOR]

From research in central Chhattisgarh, this paper interprets the bearing that healthcare beliefs and practices may have in shaping maternal and child nutrition both in the light of biomedical recommendations and within the context and constraints of a rural village setting. It contends that health beliefs and practices that are at variance from biomedical recommendations appear to have few consequences for gestational nutrition and for child health in relation to pregnancy. In the postpartum however, health ideas at variance from biomedical recommendations appear to have an important bearing on maternal nutrition and infant feeding, and may put mothers and children at risk of nutritional deficiency. Maternal 'eating down' following a surgical procedure such as a caesarean delivery or tubectomy is especially noteworthy, since food intake quantity is reduced over an extended time frame. While caring practices are influenced by cultural formulations, they also reflect, perhaps, adaptations to health risks. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to track the efficacy of the Test and Treat model of human immunodeficiency virus (HIV) prevention adopted by the government of India, 2015-16, using the last two rounds of National Family Health Survey, providing community-based insights in the testing of HIV prevalence in 2005-06 and 2015-16.Methods: The survey collected information from a nationally representative sample of 69,751 men and 124,385 women in 2005-06 and 103,411 men and 121,118 women age 15-49 in 2015-16 respectively. Both descriptive and multivariate techniques have been used.Results: The 'test and treat' model of HIV in India portrays a women-centric effort to ensure HIV testing as part of their ANC, resulting in a substantial increase in ever being tested for HIV. Women who are educated, living in urban areas, and in economically better households are more prone to have ever undergone HIV testing, it is a welcome change given the existing HIV scenario, with a continuously narrowing gender gap in new HIV infections (NFHS-4). Women and men having positive attitude towards stigma and discrimination to people living with HIV (PLHIV) are in better agreement to ever being tested. Further, women and men having knowledge about antiretroviral therapy (ART) are 1.6 times (p < 0.001) and 1.8 times (p  < 0.001) more likely to have ever been tested for HIV.Conclusions: Despite an improvement in coverage of HIV testing, the existing disparities in HIV testing and treatment require policy instruments with an integrated approach. Government should work in close collaboration with communities/key stakeholders, and efficiently use their resources to provide evidence-based HIV prevention and treatment interventions. [ABSTRACT FROM AUTHOR]

Yakshagana is a traditional theatre form of Karnataka, a southern state in India, having a known history of over 500 years. It is a powerful medium of folk communication that makes extensive use of independent creative elements like gestures, facial expression, body movement, costuming, make-up, music, dance and dialogue. Restricted to religious and mythological themes until the previous century, Yakshagana has shown much flexibility towards adapting modern themes in the recent decades, thus proving its potential towards development communication. Yakshagana has been extensively used in communicating themes related to health, environment, literacy, family planning, women empowerment, social harmony, agricultural development and the like. The present paper is an attempt to understand the potentialities of Yakshagana in communicating environmental consciousness with the case study of a plot titled Marisha Kalyana. The methodology comprises a thematic analysis of the text, interview with the author, and an audience survey to examine the impact of a live show. The results have been analyzed with the help of a Multiple Regression Model in a theoretical framework of attitude change, persuasion and reinforcement. [ABSTRACT FROM AUTHOR]

Background: This paper explores the heterogeneities in antenatal care (ANC) utilization in India's most populated state, Uttar Pradesh. Taking an intersectionality lens, multiple individual- and district-level factors are used to identify segments of any antenatal care usage in Uttar Pradesh Objective: This paper seeks to understand the multilevel contexts of ANC utilization. The planning and programming challenge is that such knowledge of contextual specificity is rarely known upfront at the initial stages of planning or implementing an intervention. Exploratory data analysis might be needed to identify such contextual specificity. Methods: Tree-structured regression methods are used to identify segments and interactions between factors. The results from the tree-structured regression were complemented with multilevel models that controlled for the clustering of individuals within districts. Results: Heterogeneities in utilization of any ANC were observed. The multiple segments of ANC utilization that were developed went from a low utilization of 23.7% for respondents who were not literate and did not have home ownership to a high of 82.4% for respondents who were literate and at the highest level of wealth. Key variables that helped define the segments of ANC utilization include: woman's literacy, ownership of home, wealth index, and district-level sex ratio. Based on the multilevel model of any ANC utilization, cross-level interactions also were obtained between sex ratio and ownership of home as well as between sex ratio and literacy. Increases in sex ratio increased the influence of ownership of home on any ANC, while increases in sex ratio reduced the impact of woman's literacy on receiving any ANC. Conclusion: We argue that a focus on heterogeneous segments of utilization can help build knowledge of the mechanisms that underlie inequities in maternal health utilization. Such knowledge of heterogeneity needs to be incorporated in contextualizing interventions to meet a variety of recipients' needs. [ABSTRACT FROM AUTHOR]

Medical statistics is generally considered a dry, boring, and complex subject and most doctors think that it is not required for them. There has been reluctance amongst doctors including surgeons to learn it. The knowledge of statistics amongst surgeons is poor. To know the attitude and knowledge of the surgeons, we conducted an online survey with Google form. A Google form was created (https://forms.gle/16Be3CJtnVAqtm5t9). It was shared with the heads of the department of general surgery of all medical colleges of Karnataka. We avoided asking personal details to avoid bias. Responders included 16 medical college faculty, 19 PG students in general surgery, and 18 consultant surgeons. 50.1% of responders did not read journals regularly. Only 5.9% understood the statistics part well while reading the journals. 43.1% understood statistics partly and some preferred to skip the statistics part. 88.4% of the responders agreed that statistics should be taught in the undergraduate and postgraduate curriculum. Only 43.4% felt that the medical college teachers have sufficient knowledge of statistics to guide their students. 60.4% approached a statistician and 45.3% searched Google for a solution when they came across a statistical problem. Some suggestions were given by the responders are (a) statistics should be taught in MBBS and MS/MD curriculum. It should be a compulsory subject for the examination. (b) Associations (like ASI) should conduct hands-on workshops on statistics for the benefit of the members. (c) More information on statistics should be provided in our journals etc. [ABSTRACT FROM AUTHOR]

Background: This update outlines amendments to the CHAMPION2/STRIPES2 cluster randomised trial protocol primarily made due to the COVID-19 pandemic and nationwide lockdown in India in 2020. These amendments were in line with national guidelines for health research during the COVID-19 pandemic. Methods: We did not change the original trial design, eligibility, and outcomes. Amendments were introduced to minimise the risk of COVID-19 transmission and ensure safety and wellbeing of trial staff, participants, and other villagers. CHAMPION2 intervention: participatory learning and action (PLA) and fixed day service (FDS) meeting were revised to incorporate social distancing and hygiene precautions. During the COVID-19 pandemic, PLA participation was limited to pregnant women and birthing partners. STRIPES2 intervention: before/after-school classes were halted for a period and then modified temporarily (reducing class sizes, and/or changing meeting places) with hygiene and safe distancing practices introduced. Data collection: The research team gathered as much information as possible from participants by telephone. If the participant had no telephone or could not be contacted by telephone, data were collected in person. COVID-19 precautions: trial teams were trained on COVID-19 precautions and used personal protective equipment whilst in the villages for trial-related activities. After restarting the trial between June and September 2020 in a phased manner, some trial activities were suspended again in all the trial villages from April to June 2021 due to the second wave of COVID-19 cases and lockdown imposed in Satna, Madhya Pradesh. Trial timelines were also revised, with outcomes measured later than originally planned. Trial registration: Clinical Trial Registry of India CTRI/2019/05/019296. Registered 23 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzExOTg=&Enc=&userName=champion2. [ABSTRACT FROM AUTHOR]

Issues related to maternal mental health, such as anxiety, depression, and psychosis both during and after pregnancy, have attracted international attention. The World Health Organization has documented a notable occurrence, particularly in developing nations. The function of print media in raising awareness about these concerns is vital. This study investigates the extent to which Jaipur's daily newspapers in 2022 address the topic of maternal mental health. The objective is to evaluate how often this issue is covered and the influence it has on women's knowledge and understanding. A descriptive survey study methodology was employed to collect data from 250 women. The data collection process involved purposive sampling and the use of questionnaires. An examination of the content of Rajasthan Patrika and Dainik Bhaskar in July 2022 found that there was no reporting or discussion on maternal mental health. According to surveys, 35% of the participants reported experiencing mental difficulties when they were pregnant, although a majority of 84% did not actively seek medical assistance. Many respondents (90%) expressed the opinion that newspapers should publish articles on this subject. The study finds that there is a notable disparity in media coverage of maternal mental health in Jaipur, indicating a requirement for heightened awareness and focused health communication initiatives. [ABSTRACT FROM AUTHOR]

At the foundation of most inequalities in expression of sexuality lie social constructions of gender. In this paper, sex education is considered as a possibility to challenge sexism and promote healthy and self-affirmative sex lives. In the past decade, the discourse of sex education in India has become a ‘battle of morality’ where concerned citizens condemn sex education on the grounds it may encourage sexual activity and immoral conduct (e.g. promiscuity or infidelity). The work of non-governmental organisations (NGOs) is an alternative to the governmental national curriculum plan. This paper discusses NGO potential in terms of sexual empowerment by examining beliefs and understanding, choices of information, strategies and methods, and approaches apparent in sex education programmes and projects. Through qualitative data, findings were analysed by constructing a sexual empowerment model that divides components of sex education into four parts and utilises theories of empowerment. The main findings include that all four components of sex education – foundation, content, strategies and approaches – show great potential to challenge gender inequalities in regard to sexuality. Sexual health programmes and projects are seen to be highly participatory, deliberative and encouraging of critical thinking. Some concerns are highlighted: the strong focus on girls as the main actors of change, and external limitations such as parents and institutions. [ABSTRACT FROM PUBLISHER]

Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

This paper explores how an array of HIV epidemic responders became embroiled in producing quantitative evidence for HIV interventions in India. Based upon extensive ethnographic fieldwork in Karnataka State, I examine the life history of the Gates-funded AIDS initiative in India known as Avahan as a case study to consider the social and political implications of large-scale, standardizing knowledge regimes enacted in the era of global health. Specifically, I analyze a sample of the key material artifacts that are implicated in the production of standardized knowledge in an attempt to illuminate the workings of what I refer to as ‘evidentiary sovereignty’. I argue that documents, forms, and other paperwork used to generate evidence in global health interventions neither merely reflect expert knowledge nor convey information about scientific standards but, rather,are integral to the re-instantiation of sovereignty.The effects of evidentiary sovereignty not only narrow the aperture of global health interventions to overlook the on-the-ground realities that shape health problems, but they also transform the very ground upon which communities responding to HIV epidemics conceive of and enact politics. As highly HIV-affected communities struggle with the bureaucratic demands of intensive form-filling and query agreed upon standards and systems of classification, a form of politicization of knowledge unfurls that pertains to the documents themselves. [ABSTRACT FROM PUBLISHER]

Aims: In India, opioid substitution therapy (OST) has been scaled-up in the recent years for HIV prevention among injecting drug users. This study aimed to assess the change in knowledge and attitude of the OST staff who underwent a five-day training programme on OST.Methods: Using a “pre-test post-test” design, routine data collected from 267 staff who underwent the OST training was analysed. The staff composition was: doctors (n = 42, 15.7%), nurses (n = 49, 18.4%), counsellors (n = 45, 16.9%) and other programme staff (n = 131, 49.1%). A 20-item, pen and paper questionnaire was administered right before the beginning of and immediately after the completion of the training. The questions were categorised into one of the five domains to assess whether changes in scores are confined to certain domains. Overall scores and scores in different domains were compared using paired-sample t-tests. The score difference in different cadres was compared using univariate general linear model with post-hoc comparisons.Findings: The difference between the total mean pre-test scores (9.24) (out of maximum possible score of 20) and post-test score (13.8) was significant. Comparison between various domains showed significant differences across all cadres. Doctors recorded significantly higher scores compared to other cadres.Conclusion: It is feasible to train different cadres of service providers together on OST in five days. The training was able to improve the participants’ knowledge and their attitude towards injecting drug users. [ABSTRACT FROM PUBLISHER]

The contraceptive needs of women for whom the benefits of menstrual bleeding may outweigh its disadvantages have largely been overlooked, especially outside high-income countries. Some providers and researchers have assumed that users of nonhormonal birth control (non-HBC) are misinformed about the positive and negative effects of HBC and/or the need for menstrual bleeding. This study takes the position that many of those rejecting HBC in favor of methods that do not alter bleeding are, in fact, making informed decisions. Using questionnaire data from 4,255 contraceptive users in three countries, we compared current HBC users explicitly open to hormone use ("H-receptive") and non-HBC users explicitly rejecting hormones ("H-averse"). To the extent that menstrual bleeding attitudes affect contraceptive choice, these two groups should have the greatest contrasts in those attitudes. This novel study design mitigates ambiguities arising from posing hypothetical scenarios to those ambivalent about using hormones or who are not currently using contraception. In all three countries, of those agreeing with the prompt, "I don't want to change my natural menstrual cycle," the fractions of H-averse and H-receptive users are disproportionally high and low, respectively (p ≤.0026). Responses to other prompts varied across populations, revealing complex juxtapositions of multiple criteria, including bleeding preferences, that likely influence contraceptive choices. These patterns, reflecting personal and culturally salient values, highlight the necessity of not assuming that menstrual bleeding is undesirable or relying on a single criterion to ascertain clients' contraceptive needs and preferences. Rather, acknowledging a client's personal hierarchy of preferences regarding contraceptive attributes best serves their goals. [ABSTRACT FROM AUTHOR]

Globally, adolescent pregnancy is one of the key issues in women's reproductive health. Adolescent mothers face a higher risk of obstetrical concerns, and motherhood in adolescence is strongly influenced by lower education level and lower socioeconomic status. The present study was carried out across all Indian states and Union Territories using the National Family Health Survey, rounds 1 to 5 (1992–1993 to 2019–2021) in which various socioeconomic and cultural factors associated with adolescent pregnancies was examined in detail. The article uses univariate, bivariate with chi-square test, and multivariate logistic regression models to understand the extent of which socioeconomic factors and sexual behavior of the couple are related to early motherhood experiences. It was found that age at marriage, respondent education, employment, age gap between partners, and religion are some of the important variables that affect the likelihood of adolescent pregnancy among females in Indian states. Comprehensive institutional efforts like free contraceptives and counseling services should be provided to address the increasing risk of pregnancy among adolescents. [ABSTRACT FROM AUTHOR]

Background: In July 2022, self‐collection became universally available as part of Australia's National Cervical Screening Program. This change aims to address screening inequities experienced among underscreened populations, including women of Indian descent. This study explored experiences of cervical screening, alongside the acceptability of self‐collection, among women of Indian descent living in Victoria, Australia. We also aimed to articulate the informational needs to promote self‐collection among this population. Methods: Five focus group discussions with 39 women living in Victoria were conducted in English (n = 3) and Punjabi (n = 2). Transcripts were thematically analysed, as informed by the Theoretical Framework of Acceptability. Results: Women were motivated by the choice to self‐collect, perceiving the ability to maintain modesty and greater autonomy as key enablers. Healthcare practitioners were seen as central in supporting patient‐centred models of care. Perceived barriers to self‐collection included concerns around its accuracy and women's confidence in collecting their own sample. Widespread dissemination of culturally tailored promotion strategies communicating concepts such as 'privacy' and 'accuracy' were suggested by women to promote self‐collection. Conclusion: Self‐collection was highly acceptable among women of Indian descent, particularly when assured of its accuracy, and sociocultural norms and previous screening experiences are considered. This study highlights the huge potential that self‐collection can play in increasing equity in Australia's cervical screening programme. Patient or Public Contribution: Members of the public were involved in focus group discussions. Findings were summarised and disseminated via a poster. A bicultural worker was involved in all stages of the research. [ABSTRACT FROM AUTHOR]

Background: Public Private Partnerships (PPP) are increasingly utilized as a public health strategy for strengthening health systems and have become a core component for the delivery of TB control services in India, as promoted through national policy. However, partnerships are complex systems that rely on relationships between a myriad of different actors with divergent agendas and backgrounds. Relationship is a crucial element of governance, and relationship building an important aspect of partnerships. To understand PPPs a multi-disciplinary perspective that draws on insights from social theory is needed. This paper demonstrates how social theory can aid the understanding of the complex relationships of actors involved in implementation of Public-Private Mix (PPM)-TB policy in India. Methods: Ethnographic research was conducted within a district in a Southern state of India over a 14 month period, combining participant observations, informal interactions and in-depth interviews with a wide range of respondents across public, private and non-government organisation (NGO) sectors. Results: Drawing on the theoretical insights from Bourdieu's "theory of practice" this study explores the relationships between the different actors. The study found that programme managers, frontline TB workers, NGOs, and private practitioners all had a crucial role to play in TB partnerships. They were widely regarded as valued contributors with distinct social skills and capabilities within their organizations and professions. However, their potential contributions towards programme implementation tended to be unrecognized both at the top and bottom of the policy implementation chain. These actors constantly struggled for recognition and used different mechanisms to position themselves alongside other actors within the programme that further complicated the relationships between different actors. Conclusion: This paper demonstrates that applying social theory can enable a better understanding of the complex relationship across public, private and NGO sectors. A closer understanding of these processes is a prerequisite for bridging the gap between field-level practices and central policy intentions, facilitating a move towards more effective partnership strategies for strengthening local health systems. The study contributes to our understanding of implementation of PPP for TB control and builds knowledge to help policy makers and programme managers strengthen and effectively implement strategies to enable stronger governance of these partnerships. [ABSTRACT FROM AUTHOR]

Purpose: People with intellectual disabilities are deeply affected by health inequity, which is also reflected in their access to and use of assistive technology (AT). Including the perspectives of adults with intellectual disabilities and their caregivers, together with the views of local health professionals, suppliers of AT and policy-makers, this paper aims to provide an overview of factors influencing access to AT and its use by people with intellectual disabilities in Bangalore, a southern region of India. Method: Face-to-face interviews were conducted with 15 adults with intellectual disabilities (ranging from mild to profound) and their caregivers, and with 16 providers of AT. This helped to gain insight into the current use, needs, knowledge, awareness, access, customisation, funding, follow-up, social inclusion, stigma and policies around AT and intellectual disability. Results: Access to AT was facilitated by community fieldworkers and services to reach out and identify people with intellectual disabilities. Important barriers were stigma, and lack of knowledge and awareness among parents. Factors related to continued use were the substantial dependence on the care system to use AT, and the importance of AT training and instructions for the user and the care system. Conclusion and Implications: The barriers and facilitators related to AT for people with intellectual disabilities differ from other populations in need. The findings of this study can be used to inform and adjust country policies and frameworks whose aim is to improve access to AT and enhance the participation of people with intellectual disabilities within their communities. [ABSTRACT FROM AUTHOR]

Menstruation frequently poses psychological, social, and health challenges for young women living in low- and middle-income countries. In countries such as India, where menstruation is stigmatised, it can be particularly difficult. This paper examines challenges related to menstruation for young women living in slums in Lucknow, Uttar Pradesh, India. The research was informed by the socio-ecological model. Life course interviews were conducted with 70 young women ages 15–24 living in the slums of Lucknow. Thematic analysis was used to identify salient themes regarding individual, social, and systemic challenges related to menstruation. On the individual level, young women lack knowledge about menstruation. In the social sphere, young women experience stigma around menstruation, lack opportunities to discuss menstruation, and experience limitations around mobility and other activities during menstruation. At the institutional level, for example in school, there are few resources to support menstruating young women as toilets are dirty and doors are broken. Therefore, menstruating adolescents and young women in Lucknow, Uttar Pradesh, India, face an array of challenges at multiple levels. These findings suggest that multi-level interventions are warranted to create a supportive context for menstruation. [ABSTRACT FROM AUTHOR]