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Background: Menstrual hygiene management is integrally associated with reproductive health of women. Menstrual health and hygiene needs, particularly of tribal women still remain unmet for many reasons. Inappropriate menstrual behaviour leads to adverse health consequences. Objectives: This study aimed to ascertain the menstrual hygiene behaviour of tribal married women aged 15 to 49 years and its correlates. Methods: A descriptive cross‑sectional study was conducted from May 2019 to April 2020 in the Barabani block of Paschim Bardhaman district, West Bengal. A calculated sample of 530 women was selected randomly from 10 tribal villages of the study area; they were interviewed through a pre‑designed schedule for socio‑demographic and menstrual hygiene behaviour characteristics. Menstrual hygiene management score was derived based on five essential components‑ hygienic absorbents, hygienic disposal of absorbents, frequency of changing of absorbents, cleaning of external genitalia and source of water for cleaning; menstrual hygiene behaviour was categorised as favourable and unfavourable. Bivariate and multivariable logistic regression was performed using SPSS v. 20. Results: All 530 women were Hindu and belonged to Santhal ethnicity; 53.4% were illiterate. Sanitary pads were used by 43.8% of women; 63% practised indiscriminate throwing for disposal of absorbents; 86% practised appropriate changing of absorbents. Overall, 63% had favourable menstrual hygiene management behaviour, and the literacy status of women was found to be a significant predictor. Conclusion: Unfavourable menstrual practices are still widely prevalent among tribal women, mainly attributable to lack of knowledge. Awareness generation should be focused on improving those practices, which would also result in the improvement of general health conditions. [ABSTRACT FROM AUTHOR]

Background: Identification of mental health disorders during childhood is crucial for healthy 'adult roles' in the society, so this study aimed to estimate the magnitude of 'any mental health disorder' and to find out its correlates among children attending the pediatric out-patient department (OPD) of a medical college in West Bengal and to estimate parental stress among their parents. Materials and Methods: It was a descriptive cross-sectional study done in the pediatric OPD of Burdwan Medical College, West Bengal, during July--December, 2021. The calculated size of 288 children aged between 4 and 12 years and attending with either of their parents was selected through systematic random sampling. One of their parents (preferably mother) was interviewed using a schedule, containing a pre-validated pediatric symptom checklist and parental stress scale. Ethical clearance was obtained from the Institutional Ethics Committee. Data were analyzed using SPSS-v23. Results: The median age of the children was 7 years (5--8 y.). The majority of them were male (57.6%), lived in urban areas (59.0%), and lived in joint families (57.6%). One-fifth (20.5%) of the children were found to have any mental health disorder (AMHD). Living in an urban area (aOR = 2.5, 95% CI: 1.1--5.7), belonging to a nuclear family (aOR = 3.6, 95% CI: 1.7--8.1), and belonging to a family with social problems (aOR = 7.8, 95% CI: 2.3--27.2) were significant correlates of AMHD. Parental stress [median: 60 (55--63)] was found significantly higher (P < 0.001) among parents of children with AMHD as compared to the parents of others. Conclusion: The magnitude of AMHD was high in this study, indicating toward the necessity of implementing opportunistic screening and appropriate public health action. [ABSTRACT FROM AUTHOR]

Context: Teenage pregnancy and motherhood are globally important public health concerns. In India, 6.8% women between 15 and 19 years were already mothers or pregnant, whereas in Purba-Bardhaman district of West Bengal it was 21.9% (National-Family-Health-Survey-5). Challenges of teenage pregnancy and motherhood needs to be understood from beneficiaries' and providers' perspectives. Aims: This study aimed at exploring the various challenges faced by teenagers during their pregnancies and motherhood and understanding the barriers of service delivery to them in a block of West Bengal. Settings and Design: A qualitative study with phenomenological approach was conducted between January and June 2021 in Bhatar community development block of Purba-Bardhaman district, West Bengal. Methods and Material: In-depth interview (IDI) of 12 purposively selected teenage mothers and two sessions of Focus Group Discussions (FGDs) among 17 Auxiliary Nurse Midwives (ANMs) were conducted. Data was collected by audio recording the IDI and FGD sessions as well as by taking notes. Analysis Used: Inductive thematic analysis was done by using NVIVO software (Release 1.0, QSR International). Results: Throughout teenage pregnancy and motherhood, subjects were found to face various types of medical problems, lack of awareness, and non-supportive family environment. Various social constraints and psychosocial stressors emerged as significant challenges. Communication gaps, behavioural barriers, socio-cultural issues, and administrative issues were major themes emerged as barriers of service delivery. Conclusions: Lack of awareness and medical problems were important challenges faced by the teenage mothers whereas behavioural barriers were the most important service level barriers perceived by the grass root level service providers. [ABSTRACT FROM AUTHOR]

Background: Health-care workers at all levels are putting their best efforts to contain the COVID-19 pandemic. In resource-poor country like India, the community health workers are given primary responsibility for prevention and control measures at the village level. Learning from their experiences and addressing constraints will ensure improved service delivery in the face of further waves of pandemic. Aim: The aim of the study is to explore the field level experiences of Accredited Social Health Activists (ASHAs), working in Bhatar block of Purba Bardhaman district, West Bengal, while delivering COVID-19 response services and to elicit the nature of constraints faced by them. Materials and Methods: This was a qualitative study with phenomenological approach conducted among ASHA workers from December 2020 to January 2021. Convenient sampling was done to select 8 participants for data collection by focused group discussion (FGD) using FGD guide. A total of four FGDs with 32 participants were conducted. Data were analyzed using thematic framework approach to identify codes and themes. Results: The experiences are presented under five broad themes and in subthemes. ASHAs were engaged in extensive work amidst various challenges, though they received ample support and cooperation from society and general administration. ASHAs faced issues with inadequate supply of protective equipment and were in need for refresher trainings. Events of social stigma and ostracizations had also surfaced. Limited financial incentives, increased susceptibility to COVID-19, and detachment from family were the main source of stress among ASHAs. Conclusion: The issues identified in this study can be addressed to further utilize ASHAs in delivering services in pandemic context. [ABSTRACT FROM AUTHOR]

Background: There are multiple reasons for which a considerable proportion of the population remains unvaccinated, including vaccine hesitancy. Identifying the reasons behind vaccine hesitancy, especially in marginalized population, is essential. Aims and Objectives: The aims of the study were to estimate the magnitude and determinants of vaccine hesitancy related to under-5 vaccination in slums of Burdwan Municipality, West Bengal. Materials and Methods: A community-based descriptive study with cross-sectional design was conducted between September 2020 and January 2021 among 135 study subjects (under-5 children) selected by multistage random sampling. Data were collected by interviewing the primary caregivers of selected children using a predesigned schedule including vaccine hesitancy survey questionnaire by Strategic Advisory Group of Experts. Data analysis was done using SPSS v.20. Results: Vaccine hesitancy was found in case of 11.9% of the study subjects. Refusal was seen in 2.2%, only in case of birth doses, whereas hesitancy due to delay was seen in 9.7% in case of MR, JE, DPT, and OPV boosters. Stated reasons for hesitancy were - "vaccine was not needed" (47.4%), "fear of needles" (31.5%), and "not able to leave other work at home" (21.1%). Caregivers of 17% of the study subjects faced difficulty from getting their child immunized mainly due to timing of the clinic and lockdown. The presence of vaccine hesitancy was not associated with sociodemographic characteristics of the child or of the caregivers. Conclusion: Vaccine hesitancy was found to be low in the study area, it was mainly to birth doses and mostly due to lack of awareness among caregivers. [ABSTRACT FROM AUTHOR]

Background: Delivering quality comprehensive abortion care (CAC) service, accessible and affordable to all care seekers, at every tier is essential to reduce maternal morbidity and mortality. Objectives: The study aimed to assess the infrastructural availability of the health facilities, describe beneficiary characteristics, and to explore constraints in CAC service provision from the providers' perspectives. Materials and Methods: A mixed-method study was conducted during December 2019 to February 2020 in Paschim Bardhaman District, West Bengal. All 10 public health facilities of the district providing CAC services were visited for infrastructural assessment. Record review of all care seekers from 2015 to 2018 was done to assess their characteristics. In-depth interview of the administrative heads of facilities and district level program officers was done to explore constraints faced in service provision. Quantitative data were analyzed by SPSS version 20, and qualitative data were analyzed thematically using NVivo software. Results: Physical infrastructure was adequate in only 40% of the facilities; however, drugs and contraceptives were universally available. About 49.5% of the care seekers had induced abortion; 63.5% underwent manual vacuum aspiration; 21.5% did not return for follow-up, and only 50% adopted postabortal contraception. Major issues explored were lack of trained manpower, logistics and physical infrastructure, and inadequate supervision and monitoring. Conclusion: The study highlighted gaps in preparedness of the health facilities for the provision of quality CAC services including some major constraints from the provider's perspectives. [ABSTRACT FROM AUTHOR]

Background: As a preventive measure to combat COVID-19 pandemic, India has undergone "lockdown" since March 25, 2020. The pandemic and lockdown can impose a psychological impact in the form of fear, anxiety, stress and insomnia etc. Aims and Objective: The aim of the current study is to assess the magnitude of anxiety, depression, stress and poor sleep quality among the adult population of Kolkata, West Bengal amidst COVID-19 pandemic. Materials and Methods: By this online survey using Google forms, a total of 435 responses were received. The online questionnaire comprises of Socio-demographic characteristics, COVID-19 Anxiety Scale (CAS), Perceived Stress Scale 4 (PSS 4), Patient Health Questionnaire-9 (PHQ 9) and Insomnia Severity Index (ISI). Results: COVID-19 related anxiety were almost similar across age groups, sex, marital and educational status. PSS score was found higher in ≤25 years and >40 years age group, those not currently married, students and homemakers. Patient Health Questionnaire scores were found significantly different across all background characteristics categories except for the level of education whereas Insomnia Severity index Scale scores were found significantly more among subjects not currently married and among subjects who were working from home. Conclusions: The current study provides evidence towards the negative psychological impact of the pandemic and reminds us about the need for widespread psychiatric services during and after pandemic. [ABSTRACT FROM AUTHOR]

Background: Monitoring adequacy of salt iodization at consumption level and exploring the reasons for inadequacy, especially in marginalized communities, is crucial to achieve the target coverage of universal salt iodization. Aims: To assess the iodine content of salt used at household level, related awareness and practice of respondents and their socio demographic correlates. Settings and Designs: This cross-sectional descriptive study was conducted in the slums of Burdwan Municipality in 2019. Methods and Material: A total of 330 households were selected by cluster sampling. Salt iodine content was estimated at household level semi-quantitatively by Iodine testing kit, following recommended guidelines. One respondent from each household was interviewed to assess their awareness and practice regarding iodized salt. Kruskal Wallis test, Mann Whitney U test and Multivariable logistic regression was used. Results: All 330 households were using iodized salt; 77.6% were consuming adequately iodized and 22.4% were consuming inadequately iodized salts. Only 30.9% of the respondents were aware about the importance of iodized salt, few had correct practice despite inadequate knowledge and none, except one, practiced adding salt at the end of cooking. Awareness and practice were associated with caste and age of the respondents, respectively. Keeping salt container near the oven, adjusting for keeping salt in uncovered container, significantly predicted inadequate level of iodization [AOR 6.17 (95% CI: 2.68-14.26)]. Conclusion: Inadequate iodization, lack of awareness regarding iodized salt and faulty storing practices amounting to increased risk of inadequate iodization are still prevalent emphasizing the need, in policy, for health education. [ABSTRACT FROM AUTHOR]

Background: Chronic pain, though a most common cause of disability worldwide, is one of the most underestimated health problems throughout the world. With the ageing population and its increasing prevalence, understanding related care seeking practices is key to plan effective interventions. Objectives: To find out the characteristics of chronic pain and to study related and care-seeking practices and the influence of sociodemographic factors among adult chronic pain sufferers in a rural setting. Methods: Data were collected from 697 adults (>18 years) chronic pain (>12 weeks duration) sufferers chosen randomly from all 81 villages of Amdanga block, West Bengal, through a household-based survey in a cross-sectional design. A pre-designed, pre-tested structured questionnaire containing socio-demographic information, Brief Pain Inventory (BPI) and Patient Health Questionnaire-9 (PHQ-9) was used. During analysis, dimension reduction by Principal Component Analysis was done to derive pain intensity and interference scores. Results: Low back pain and knee pain were first and second most frequent. Major Depressive Syndrome (MDS) was found in 9.04 % [95% CI: 7.95% - 10.13%]. The severity of pain increased with age and decreased with advancing level of education & income. Care-seeking was significantly predicted by MDS (AOR= 0.185), pain intensity (AOR=1.06) & interference (AOR=1.06).Conclusion: Patients tend to seek care more at an advanced severity and more from a private facility. About 1 in 10 persons with chronic pain was seen to suffer from major depression, with which, persons were seen about five times less likely to seek care. [ABSTRACT FROM AUTHOR]