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To determine the burden of early growth faltering and understand the care practices for small and sick babies discharged from newborn units in the district.Observational and follow-up study.512 babies discharged from two Special Newborn Care Units (SNCUs) and four Newborn Stabilization Units (NBSUs) in two districts of Himachal Pradesh.Anthropometric assessments, interview of mothers and Accredited Social Health Activists (ASHAs) conducted between August, 2018 and March, 2019. Change in weight-for-age z-score (DWAZ) of-0.67SD between birth and assessment was used to define growth faltering.Proportion of growth faltering (or catch-down growth) in small and sick babies discharged from SNCUs and NBSUs, and infant care practices.Growth faltering was observed in a significant proportion of both term (30%) and preterm (52.6%) babies between 1 to 4 months of age. Among babies with growth faltering (n=180), 73.9% received a home visit by ASHA, and only 36.7% received a follow-up visit at a facility. There were 71.3% mothers counselled at discharge (mostly informed about breast feeding). Most (96.7%) mothers did not perceive inadequate weight gain in their babies post-discharge. During home visits, ASHAs weighed 61.6% of the infants with growth faltering. Amongst infants who had growth faltering, only 49.6% of mothers had been provided information about their infant's growth and 57.1% mothers had received breastfeeding counselling.Small and sick newborn infants (both term and preterm babies) discharged from special care newborn units are at increased risk of early growth faltering. Follow-up care provided to these infants is inadequate. There is a need to strengthen both facility-based and home-based follow up of small and sick newborn infants discharged from newborn care facilities.

Antimicrobial resistance (AMR) is a One Health problem underpinned by complex drivers and behaviours. This is particularly so in low - and middle-income countries (LMICs), where social and systemic factors fuel (mis)use and drive AMR. Behavioural change around antimicrobial use could safeguard both existing and future treatments. However, changing behaviour necessitates engaging with people to understand their experiences. This publication describes a knowledge-exchange cluster of six LMIC-based projects who co-designed and answered a series of research questions around the usage of Community Engagement (CE) within AMR. Findings suggest that CE can facilitate AMR behaviour change, specifically in LMICs, because it is a contextualised approach which supports communities to develop locally meaningful solutions. However, current CE interventions focus on human aspects, and demand-side drivers, of AMR. Our cluster suggests that broader attention should be paid to AMR as a One Health issue. The popularity of mixed methods approaches within existing CE for AMR interventions suggests there is interdisciplinary interest in the uptake of CE. Unfortunately, the specificity and context-dependency of CE can make it difficult to evaluate and scale. Nevertheless, we suggest that in synthesising learnings from CE, we can develop a collective understanding of its scope to tackle AMR across contexts. .

PurposeThe consumer-based study was conducted among the population of Kolkata metropolis to assess the impact of corporate social responsibility (CSR) practices on the purchase intention of selected cooking oil brands.Design/methodology/approachData were collected from a questionnaire based survey on 322 respondents residing in Kolkata metropolis. Reliability of the scales was ascertained by Cronbach’s alpha values. Kendall's W test was used for rank analysis. Pearson’s correlation was examined to correlate the cognitive criteria. Factor analysis was used to sort out influential cognitive criteria which were compared between genders by the Kruskal–Wallis H test. The involvement of CSR components in enhancing the brand equity was analysed by multiple linear regression.FindingsThe brands vouching for the cause of health and nutritional value of the society attained significant loyalty and generate considerable brand association. The regression model predicts a socially accepted cooking oil brand to be one which addresses health, transparency and ethics in unison.Research limitations/implicationsThe study was restricted within the resident population of Kolkata metropolis which ratifies the CSR perception of a confined mass.Practical implicationsThe study delineates the plausible avenue of CSR investments to touch the cognitive centre of the consumers’ mind.Social implicationsThe consumers expect to embrace a healthy yet reasonably priced cooking oil brand which imparts a notion to address multiple social causes.Originality/valueThe study identifies the strategic CSR attributes which might influence the mind of the consumers while they select cooking oil brands for household use.

The Participatory Approach for Nutrition in Children: Strengthening Health, Education, Engineering and Environment Linkages (PANChSHEEEL) project is a collaboration between University College London, Save the Children India, Jawaharlal Nehru University and Indian Institute of Technology Delhi to develop a socio-culturally appropriate, tailored, integrated and interdisciplinary intervention in rural India and test its acceptability for delivery through Anganwadi Centre (AWCs) and schools. Recognizing the socio-ecological determinants of under-nutrition, the POSHAN Abhiyan (POSHAN Mission) adopts a multi-sectoral approach to achieve five goals, of which two are directly related to children. The POSHAN Abhiyan resonates with the conceptual framework of the PANChSHEEEL study in its interdisciplinary scope and focus on local linka ges. This paper draws upon empirical evidence from the PANChSHEEEL Project in Banswara (one of the POSHAN mission districts), Rajasthan to help understand linkages between policy and practice, specifically the challenges of operationalizing 'convergence', the core strategy of the Abhiyan.

The ongoing COVID-19 pandemic has reemphasized the criticality of human behaviors and led to an enormous focus on health promotion and risk communication messaging; ‘COVID appropriate behavior’ is indeed a household term now. Dedicated or specialist health promotion professionals and scholars are few and far between and the author, Professor Madhumita Dobe, is both a pioneer and icon to generations of public health students and researchers. She has authored this book, filling up a much-needed void in this discipline. As she has acknowledged, this book is the culmination of a lifetime of teaching, research and practice at the All India Institute of Hygiene and Public Health, Kolkata and her rich experience across the states of India and several countries.

We aimed to identify key barriers to Water Sanitation and Hygiene (WASH) promotion and infant diarrhea prevention services delivered by Accredited Social Health Activists (ASHAs) in rural India.A case-study was conducted across nine tribal villages in Banswara district (Rajasthan), where in-depth observational and qualitative data was collected from frontline health workers and infant caregivers.ASHAs' prioritization of their incentive-based link-worker tasks over their health activist roles, limited community mobilization, and lack of monitoring of such activities hindered the delivery of WASH promotion and infant diarrhea prevention services. Caregivers' lack of trust in ASHA's health knowledge and preference for private providers and traditional healers also hindered the uptake of ASHA's health promotion services.Strengthening ASHAs' health activism roles and building trust on frontline health workers' knowledge among tribal communities will be the key to address the determinants of child malnutrition and stunting and accelerate progress towards the national development agenda.

India's fast-growing cities face three key challenges in improving public health outcomes. The first is the persistence of weak links in the chain -- notably, slums badly underserved with basic civic services -- that can pose public health threats to all. Richer residents corner public resources, such as water and sanitation services, but their children's health indicators suggest they are deeply affected by contagion from the broader urban environment. The second challenge relates to devolution of services to elected bodies. Devolution works poorly for intangible and highly technical services, such as public health, where success is measured by the lack of (adverse) events. The third challenge is high fragmentation of services that directly affect health outcomes. In India, some cities have addressed these challenges more effectively than others have. This paper explores the management of municipal public health services in two major Indian metropolises with sharply contrasting health and sanitation indicators. The paper explains how Chennai mitigates these challenges through active service outreach to vulnerable populations, and a considered approach to devolution that distributes responsibilities appropriately between line agencies, technical personnel, and elected representatives. Services in Delhi are quite constrained. These policy lessons are pertinent to other Indian cities and beyond.

Following the several episodes of zoonotic disease outbreaks and the more recent COVID-19 pandemic, the Indian policy initiatives are committed to institutionalize One Health (OH) approaches and promote intersectoral, transdisciplinary collaboration and cooperation. The OH principle needs to be visualized beyond the scope of zoonoses. While conservation, ecological and veterinary professions are getting increasingly engaged with OH, most of the medical/clinical and social sciences professions are only peripherally aware of its nuances. The OH initiatives, by their essentially multidisciplinary nature, entail working across ministries and navigating tacit institutional hierarchies and allocating leadership roles. The logical operational step will be the constitution of One Health Committees (OHC) at the State and district levels. Here, we outline the key foundational principles of OHC and hope that the framework for implementation shall be deliberated through wider consultations and piloted and adopted in a phased manner.

The Rashtriya Swasthya Bima Yojana (RSBY) is a state-funded health insurance scheme in India, targeted at families living Below Poverty Line (BPL).

Purpose: Infectious diseases are one of the leading causes of death among children under five (U5s) both in India and globally. This is worse in slum environments with poor access to water, sanitation and hygiene (WASH), good nutrition and a safe built environment. Globally, a One Health (i.e. human, animal and environment) approach is increasingly advocated for by the WHO-FAO-OIE tripartite to reduce infections and antimicrobial resistance. As under-5s living in peri-urban slums are exposed to household- and community-owned companion and livestock animals and pests, the CHIP consortium hypothesised that employing a One Health approach to co-produce behavioural change and slum upgrading interventions may reduce this burden where other WASH and nutrition interventions have failed. This study aimed to assess the feasibility of employing a One Health approach to assess under-5 infection and risk factor prevalence in Jaipurs peri-urban slums, prior to undertaking prospective cohort studies involving culture and culture-independent sampling of under-5s and animals across our study sites in Jaipur (Rajasthan, India), Jakarta (Indonesia) and Antofagasta (Chile). Methods: We administered a rapid household survey to 25 purposively selected households across six slums in Jaipur. The questionnaire used evaluated infection prevalence, healthseeking behaviours, the built environment, the presence of companion and livestock animals and pests, and individual- and household-level demographics. We displayed the correlations between infection incidence and a range of factors in our sample, and displayed the portion of children under 5 who experienced one or multiple episodes of ill health, categorised by a range of One Health factors. Results: Parents reported at least one recent episode of ill health for a large portion (40%) of under-5s within the last 30 days. 80% of under-5s had no access to safe drinking water; every household reported the presence of at least one kind of pest within the respondents own home; and 20% of under-5s feeding equipment was cleaned with water only. Only one household reported owning a companion or livestock animal, potentially reflecting confusion about the definition of these animals. The incidence of infection appeared to be related to WASH and socio-economic factors as expected. Conclusion: Safe drinking water, pest control and behavioural change surrounding the cleaning of under-5 feeding equipment should be given consideration in future research in this locale. Future studies should not rely solely on parent reporting of childrens symptoms cross referencing symptom reporting from multiple household members should be combined with culture and culture-independent sampling. Where possible, researchers should measure the presence of companion and livestock animals directly to avoid misinterpretation and to observe practices rather than relying on reporting alone.

The consumer based empirical study was aimed to evaluate the proposition that Corporate Social Responsibility (CSR) initiatives, if implemented appropriately, may bolster the brand equity of tea brands by influencing purchase intention of the consumers. Data were collected using a questionnaire based survey among 322 respondents residing in Kolkata, the populous Indian metropolis. The respondents ranked and rated the cognitive social outlooks that might influence the purchase decision of selected tea brands and the involvement of CSR components in enhancing the brand equity was analysed. Besides favouring flavour and taste, the respondents exhibited loyalty for the brands which campaign for the cause of social awareness. They were conscious about pricing although they could relate it with the quality of the brand. They seemed to associate themselves with their preferred brand and its social objectives and expressed a clear imagery about it. Differential involvement of the CSR components in influencing the brand image of the tea brands was perceived by the respondents. The findings demarcate the possible line of thoughts for CSR initiatives by concerned entrepreneurs for promoting the global beverage brands in the oriental metropolis. The observation challenges the customary ideology about the so called low involvement Fast-Moving Consumer Goods (FMCG) brands and widens the vista of emotional attachment of the consumers for preferred tea brands. The study is first of its kind to fathom the impact of CSR on consumers with relation to making of purchase decision for tea brands.

Objectives To evaluate the existing status of human milk banks in India with reference to infrastructure, human resources, funding mechanisms, operating procedures and quality assurance. Methods A pretested questionnaire was administered to 16 out of 22 human milk banks across India, operational for more than one year prior to commencing the study. Results 11 (69%) milk banks were in government or charitable hospitals; only 2 (12.5%) were established with government funding. 8 (50%) had a dedicated technician and only 1(6%) had more than five lactation counsellors. Milk was collected predominantly from mothers of sick babies and in postnatal care wards followed by pediatric outpatient departments, camps, satellite centers, and homes. 10 (63%) reported gaps between donor milk demand and supply. 12 (75%) used shaker water bath pasteurizer and cooled the milk manually without monitoring temperature, and 4 (25%) pooled milk under the laminar airflow. 10 (63%) tracked donor to recipient and almost all did not collect data on early initiation, exclusive breastfeeding or human milk feeding. Conclusions Our study reports the gaps of milk banking practices in India, which need to be addressed for strengthening them. Gaps include suboptimal financial support from the government, shortage of key human resources, processes and data gaps, and demand supply gap of donor human milk.

Known interventions like breastfeeding and kangaroo mother care (KMC) can avert a large share of infant deaths. Mother Baby Friendly Initiative Plus (MBFI+) is an integrated approach to ensure exclusive human milk diet through promotion of breastfeeding, KMC, and provision of donor human milk (DHM) to vulnerable neonates lacking mothers' own milk.Qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their knowledge, perceptions, and practices on breastfeeding, KMC, DHM, and human milk banks (HMBs) in 2 facilities in India, one with and another without an operational HMB. This article presents the findings on breastfeeding and KMC.Nearly all mothers mentioned that antenatal visits lacked information on breastfeeding. Most were unaware of the recommended duration of exclusive breastfeeding. Most parents knew about the benefits of breast milk and colostrum. Limited staff and privacy in facilities resulted in inadequate breastfeeding and milk expression support to mothers, who found feeding of preterm and low-birth-weight babies challenging. Mothers shared challenges in breastfeeding at home, such as low family support and privacy and burden of household chores. Only those mothers who practiced KMC were aware of its benefits. Few service providers and recipients were comfortable with the practice of wet nursing in the absence of breastfeeding.MBFI+ is a promising approach to strengthen breastfeeding and KMC. Quality counseling on breastfeeding and milk expression from antenatal period, increasing awareness and training on KMC for mothers, improving infrastructure, addressing staff shortage, and building capacities of hospital staff on MBFI+ are needed.

Background This study aims to investigate the knowledge, perception and practices related to health, nutrition, care practices, and their effect on nutrition health-seeking behaviour. Methods In order to have maximum representation, we divided Chakradharpur block in Jharkhand state into three zones (north, south and centre regions) and purposively selected 2 Ambulatory Therapeutic Feeding Centre (ATFC) clusters from each zone, along with 2 villages per ATFC (12 villages from 6 ATFCs in total). In-depth interviews and natural group discussions were conducted with mothers/caregivers, frontline health workers (FHWs), Medicins Sans Frontieres (MSF) staff, community representatives, and social leaders from selected villages. Results We found that the community demonstrates a strong dependence on traditional and cultural practices for health care and nutrition for newborns, infants and young children. Furthermore, the community relies on alternative systems of medicine for treatment of childhood illnesses such as malnutrition. The study indicated that there was limited access to and utilization of local health services by the community. Lack of adequate social safety nets, limited livelihood opportunities, inadequate child care support and care, and seasonal male migration leave mothers and caregivers vulnerable and limit proper child care and feeding practices. With respect to continuum of care, services linking care across households to facilities are fragmented. Limited knowledge of child nutrition amongst mothers and caregivers as well as fragmented service provision contribute to the limited utilization of local health services. Government FHWs and MSF field staff do not have a robust understanding of screening methods, referral pathways, and counselling. Additionally, collaboration between MSF and FHWs regarding cases treated at the ATFC is lacking, disrupting the follow up process with discharged cases in the community. Conclusions For caregivers, there is a need to focus on capacity building in the area of child nutrition and health care provision post-discharge. It is also recommended that children identified as having moderate acute malnutrition be supported to prevent them from slipping into severe acute malnutrition, even if they do not qualify for admission at ATFCs. Community education and engagement are critical components of a successful CMAM program.

Rumors have significantly affected immunization campaigns in the past. The ongoing COVID-19 vaccination program in India needs to frame public communication messages both to promote vaccine demand and update as well as counter COVID-related rumors. COVID-related rumors have had wide-ranging effects in the country, from stigmatization of health workers to a crash of prices in the poultry sector. Appropriate communication strategies are critical for tracking, negotiating, and shaping perceptions around the vaccines and the program. Issues that will shape perceptions around the vaccines include product development, prioritization strategies, program rollout activities, and adverse effects following immunization and adverse effects of special interest.

India’s urbanization, though precipitous, is undirected, random, and opportunistic, shaped more by pressures than by policies. This has resulted in inequitable access to health services and adverse health outcomes for the urban poor. Late 2013 saw the launch of India’s National Urban Health Mission, a broad scheme aimed at prioritizing urban health in the country with an emphasis on the poor. Acknowledging both the diversity and complexity of urban poverty across India’s cities, a Technical Resource Group was convened by the Ministry of Health and Family Welfare to support the process. We describe the context surrounding this effort and the procedure followed, which entailed in-depth interactions with the urban poor themselves and with officials, health system actors, civil society, and other stakeholders. Even as recommendations were accepted, given the meager allocation for health in the country, only piecemeal implementation is underway. Thus, policy processes are often a dialectic involving shifts that a range of stakeholders may variably resist or embrace. The most important lesson, however, is that it is both feasible and desirable to engage directly with the community, implementers, and researchers and to negotiate and connect their knowledge in the crafting of public policy.

In 2013, the National Urban Health Mission (NUHM) was rolled out to effectively address health concerns of the urban poor population. In the last decade, there has been a spate of publicly funded insurance schemes, prominent amongst them being the Rashtriya Swasthya Bima Yojana (RSBY). In 2012, the Government of Chhattisgarh expanded the RSBY into a new avatar, the Mukhyamantri Swasthya Bima Yojana (MSBY), thereby universalising health insurance coverage. This study was conducted in the slums of Raipur, the capital and largest city of Chhattisgarh, with the objective of assessing issues of coverage and utilisation in these areas. The specific focus was on issues of women’s medical conditions and the experiences of women beneficiaries during enrolment in these schemes.

Family-centered care (FCC) for sick newborns is emerging as a paradigmatic shift in the practice of facility-based newborn care. It seeks to transforming a provider-centered model into a client-centered one and thus build a new therapeutic alliance. FCC is the cornerstone of continuum of care, imparting caregiving competencies to parents/caregivers both within institutions as well as after the discharge. This has potential gains for the newborn, family members, and facility-level staff. The initial model piloted in tertiary-care settings is now undergoing translation at five sites across the country; the outcomes are keenly awaited.

Scaling-up human milk banks (HMBs) is a promising solution for saving vulnerable newborns. Exploring perceptions and practices on donor human milk (DHM) and HMBs is essential to strengthen and scale-up an integrated HMB system resting on a model called the "Mother Baby Friendly Initiative Plus" (MBFI+), which includes promoting breastfeeding, encouraging kangaroo mother care, and providing safe DHM to vulnerable babies without access to mother's own milk.A qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their perceptions and practices on DHM and HMBs.Service providers opined that DHM is safe and lifesaving for vulnerable babies. Challenges shared were limited supply of DHM because of low awareness on milk donation, shortage of trained staff, and risk of milk contamination. They stated that although most mothers were comfortable in donating milk, few were reluctant to donate milk as they feared shortage of milk for their own babies, or milk expression may cause weakness. Recipient mothers accepted use of DHM as per facility norms but had concerns about donor mothers' health and hygiene and measures for ensuring milk safety. Most grandmothers were resistant toward donating or receiving DHM for their grandchildren. Many fathers were comfortable with donating once they knew it is lifesaving and did not compromise supply for their babies. Service providers shared opportunities for scale-up, like improving awareness and infrastructure, lactation counseling by skilled personnel, supportive hospital environment, and establishing HMBs in every city and district.Human milk banking should be strengthened as part of the MBFI+ model. For this, behavior change communication targeted at mothers and influencers about breastfeeding and HMB from the antenatal period, capacity-building among service providers, and government ownership is necessary.

Child health and nutrition is nested within a larger gamut of child care and development, functioning through the health care system. Malnutrition is multidimensional and rooted in poor early childhood care and development that is shaped by environmental, social and economic factors. Current nutrition care interventions are marked by a piecemeal approach, focusing on treating malnutrition but overlooking the need for rehabilitation and care support. Continuum of care (CoC) as an approach aims for a seamless and need-based care, bearing an impact on improved care output, beneficiary participation, care experience and access to care. CoC in nutrition care shall contribute to integration of nutrition and health care services, addressing distal and proximal causes of undernutrition through a gamut of preventive, promotive, treatment and rehabilitative care.

National Family Health Survey 4 (NFHS-4) data shows a ten percentage point decline in timely complementary feeding rates in the backdrop of increases in breastfeeding indicators. There is large-scale decline in this indicator across all regions and states. An understanding of social determinants is critical for generating transformative ideas to address these challenges.

Introduction The existence of a parallel cash-based economy is a major economic and political issues in India. The Government of India in a bid to curb corruption had notified ≠500 and ≠1000 as illegal tender on 8th November, 2016, and asked citizens to deposit the demonetised notes constituting 86% of total money in circulation. Commentators have indicated several hardships of common people including delayed or non-payment of wages, job loss. The tea- industry which employed 1.1 million individuals is thought to be majorly affected. However, there is no study which has assessed the psycho social consequences of demonetisation of tea garden workers (TGW’s). Methods Focus Group discussions (FGD) have been carried out with TGW’s of 3 districts- Jalpaiguri, Alipurduar, and Coochbehar. In depth interviews (IDI) have been conducted with district and labour administration (4), tea garden managers (3), TGW’s (6), Tea garden doctors (3), psychosocial counsellor (2), bank manger (1), worker’s union (1). Semi-structured topic guide would cover- experiences of demonetisation, job satisfaction, self esteem, insecurity, absenteeism, physical discomfort, addiction. An iterative approach would be taken modifying the topic guide during the course of the study. Data would be analysed based on the general guidelines of grounded theory. Multi step data analysis includes data reduction, coding and identification of dominant themes. Ethics approval has been acquired. Results So far interaction has identified some negative psychosocial consequences due to fear of less productivity in coming seasons, drop in prices and wages and loss of job, uncertain future and migration. However, the complete results of the study will be available by 30th August 2017. Discussion The results of the study will provide evidence on the psycho-social consequences of TGW’s in relation to the job-insecurity and economic loss, if any, due to demonetisation, may contribute in future policy formulation.

BACKGROUND Inadequate administrative health data, sub-optimal public health infrastructure, rapid and unplanned urbanization,environmental degradation and poor penetration of information technology make the tracking of health and well being of the populations within developing countries more challenging. This necessitates setting-up comprehensive surveillance platforms integrated with the information technologies that can cater to the full spectrum of the public health problems. OBJECTIVE This manuscript aims to provide methodological insights on establishing GIS integrated comprehensive surveillance platform in resource constrained rural settings. METHODS The INCLEN (International Clinical Epidemiology Network) Trust International established a comprehensive SOMAARTH Demographic, Development and Environmental Surveillance Site (DDESS) in a northern Indian rural setting. The surveillance platform evolved through adopting four major steps: 1) site preparation 2) data construction 3) data quality assurance 4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geo-spatial data construction. Surveillance data architecture was built upon the geo-referenced land parcel data sets. The composition data pertaining to the land use (residential, non-residential, and vacant), water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, demographic characteristics were constructed in relational manner within the surveillance platform. RESULTS A comprehensive surveillance platform encompassing 0.2 million population residing in 51 villages over a land mass of 251.7 sq. Km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions etc.) is established. The processes adopted for subdivision of villages into sectors helped in developing geo-referenced location identification system in a setting where no postal addresses or postal codes system were in place. Also the socially and economically homogeneous community clusters (78% of 676 sectors) which usually hide within the village aggregates were disclosed. Characterization and storage of variety of data sets critical for health and epidemiology and generation of new information e.g. water, sanitation and hygiene through geo-analytics were demonstrated. Settlement pattern was compact to the extent that 80% of habitation was concentrated in 9% of the total village area. Community involvement proved helpful in the ground-truthing of the data sets for ascertaining the level of positional, temporal and attribute accuracies and identification of small habitations, missing in the official records. CONCLUSIONS SOMAARTH experience allowed characterization and monitoring of wide range of attributes from demography, development, and environmental domains and developed geospatial inter-phase to explore and explain their dynamic relationships, associations and pathways across multiple levels i.e. individual, household, neighborhood, and village. The methodology takes care of the common challenges faced while building information system in the developing countries. However generalizability and scalability needs to be tested in other resource constrained settings as well.

Background: Inadequate administrative health data, sub-optimal public health infrastructure, rapid and unplanned urbanisation, environmental degradation and poor penetration of information technology make the tracking of health and wellbeing of the populations and their social determinants in the developing countries challenging. Technology integrated comprehensive surveillance platforms have thepotential to overcome these gaps. Objective: The manuscript provides methodological insights into establishing a geographic information system (GIS) integrated, comprehensive surveillance platform in rural North India, a resource constrained setting. Methods: The INCLEN (International Clinical Epidemiology Network) Trust International established a comprehensive SOMAARTH Demographic, Development and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved through adopting four major steps: 1) site preparation 2) data construction 3) data quality assurance 4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geo spatial land parcel data sets.Dedicated software (SOMAARTH-1 ) was developed for handling high volume of longitudinal data sets.The built infrastructure data pertaining to the land use, water bodies, roads, railways, community trails,landmarks, water, sanitation and food environment, weather and air quality, and demographiccharacteristics were constructed in a relational manner. Results: The comprehensive surveillance platform encompassed 0.2 million population residing in 51 villages over a land mass of 251.7 sq. Km having 32,662 households and 19,260 non-residential features(cattle shed, shops, health, education, banking, religious institutions etc.). All the land parcels were assigned geo-referenced location identification numbers to enable space and time monitoring.Subdivision of villages into sectors helped in identifying socially homogenous community clusters (61.8%of 676 sectors). Water and hygiene paramenters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators)was significantly (P .001) associated with the caste of individual household and the path was mediated through socio-economic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvent in mapping exercise and identification of small habitations not recorded in in the administrative data were key learnings. Conclusion: The SOMAARTH DDESS experience allowed to document and explore dynamic relationships,associations and pathways across multiple levels of the system i.e., individual, household, neighborhood and village through a geospatial interface. This could be used for characterization and monitoring of awide range of proximal and distal determinants of health of the households. Refereed/Peer-reviewed