Environmental and structural factors associated with bacterial diversity in household dust across the Arizona-Sonora border.

We previously reported that asthma prevalence was higher in the United States (US) compared to Mexico (MX) (25.8% vs. 8.4%). This investigation assessed differences in microbial dust composition in relation to demographic and housing characteristics on both sides of the US-MX Border. Forty homes were recruited in the US and MX. Home visits collected floor dust and documented occupants' demographics, asthma prevalence, housing structure, and use characteristics. US households were more likely to have inhabitants who reported asthma when compared with MX households (30% vs. 5%) and had significantly different flooring types. The percentage of households on paved roads, with flushing toilets, with piped water and with air conditioning was higher in the US, while dust load was higher in MX. Significant differences exist between countries in the microbial composition of the floor dust. Dust from Mexican homes was enriched with Alishewanella, Paracoccus, Rheinheimera genera and Intrasporangiaceae family. A predictive metagenomics analysis identified 68 significantly differentially abundant functional pathways between US and MX. This study documented multiple structural, environmental, and demographic differences between homes in the US and MX that may contribute to significantly different microbial composition of dust observed in these two countries.

Domestic access to water in a decentralized truck-to-cistern system: a case study in the Northern Village of Kangiqsualujjuaq, Nunavik (Canada).

Municipal water supply through truck-to-cistern systems is common in northern Canada. Household satisfaction and concerns about water services likely impact user preferences and practices. This case study explores household perspectives and challenges with regard to domestic access to water in a decentralized truck-to-cistern system. A case study was conducted in the Northern Village of Kangiqsualujjuaq, Nunavik (Quebec, Canada). A paper-based questionnaire was completed by 65 households (one quarter of the population). Many households (37%) reported not drinking tap water from the truck-to-cistern system. Chlorine taste was a frequently reported concern, with those households being significantly less likely to drink water directly from the tap (p = 0.002). Similarly, households that reported a water shortage in the previous week (i.e., no water from the tap at least once) (33%) were more likely to express dissatisfaction with delivered water quantity (rs = 0.395, p = 0.004). Interestingly, 77% of households preferred using alternative drinking water sources for drinking purposes, such as public tap at the water treatment plant, natural sources or bottled water. The study underscores the importance of considering household perspectives to mitigate the risks associated with service disruptions and the use of alternative sources for drinking purposes.

The effect of educational intervention according to mindfulness on the psychological well-being of female heads of households.

OBJECTIVE: The low level of psychological well-being is one of the most common problems of the women who are the heads of households, and various educational programs have been conducted to improve the psychological well-being of such a group. The present study was conducted to outline the effectiveness of mindfulness-based educational intervention in the psychological well-being of women as the heads of households. METHODS: This research as a semi-experimental study was done by pretest-posttest design and control group. The study statistical population included all women as the heads of households in Shiraz, who had a file in the Shiraz based welfare office and at the same time their children were studying in schools covered by the 2nd district educational department of Shiraz in 2022-2023. Out of the female heads of the households in the statistical community, 30 women were selected as Purposive sampling and then randomly divided into two 15-individual groups, including experimental group (training on mindfulness-based therapy) and control group. The research tool included Ryff's psychological well-being scale (Ryff, 1989). The experimental group was subjected to training on mindfulness-based therapy (Baer et al., 2006) during eight 90-min sessions. However, the control group did not receive any intervention. RESULT: After running the intervention, a significant difference was seen between the components of autonomy, personal growth, purpose in life, self-acceptance, positive relationship with others, and psychological well-being after running the educational intervention between the experimental and control groups (P < 0.05), while no meaningful difference popped up between the experimental and control groups in terms of environmental mastery as one of the aspects measured in psychological well-being scale after the educational intervention (P = 0.602). CONCLUSION: According to the results, it seems that psychologists can benefit from the method of training on mindfulness-based therapy in order to increase the psychological well-being of women as the heads of households.

Long-term health conditions among household families in Aotearoa New Zealand: cross-sectional analysis of integrated Census and administrative data.

AIM: Little is known about the extent to which families in Aotearoa New Zealand are affected by long-term health conditions (HCs). This study aimed to explore the rates of nine selected HCs among New Zealand family members within the same household. METHOD: Linked population and administrative health data were obtained for families living in the same household according to the 2013 New Zealand Census (N=1,043,172). Health data (2008-2013) were used to ascertain whether people in these families (N=3,137,517) received treatment or services for nine selected HCs: cancer, chronic obstructive pulmonary disease, heart disease, diabetes, dementia, gout, stroke, traumatic brain injury (TBI), or mental health/behaviour conditions (MHBCs). RESULTS: Over 60% of families included at least one person with a HC, and this rate was higher among multi-generation families (73.9%). The most common HCs were MHBCs (39.4% of families), diabetes (16.0%) and TBI (13.9%). At the highest level of socio-economic deprivation, 57.6% of children aged under 18 years lived with a family member who had a HC. CONCLUSION: Three in five New Zealand household families included someone with at least one of nine selected HCs, with differences in the proportion affected according to family composition, socio-economic status and an individual's ethnicity. This suggests that there are a substantial number of people at risk of the poor outcomes associated with the experience of HCs within their family.

Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5.

BACKGROUND: Multiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households. METHODS: Data used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019-21. Data sets of men (15-54 years) and women (15-49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results. RESULTS: A prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33-0.39)), urban areas (AOR 1.11 (1.02-1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81-0.97)), and ST (AOR 1.30 (1.17-1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress. CONCLUSION: A 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.

Allocation of the household food budget among shopping basket items: How is it influenced by promotions?

Retailers have been using promotion as a differentiation strategy that influences consumers' expenditures and their shopping basket budgetary allocation. This study assessed the effect of retail promotions on total shopping basket expenditure and determined whether promotions provoke a reallocation of the shopping budget. The analysis was performed on a chain of supermarkets in Catalonia, Spain using a consumer scanner data set from Kantar Worldpanel for 2017. The methodological approach had two steps: prediction of the effect of promotion on household expenditures using an expenditure regression model and estimation of the promotion own- and cross-effect using the censored Exact Affine Stone Index. Promotion had a positive own-effect and mostly a negative asymmetric cross-effect, implying a small but significant budget reallocation.

COVID-19 seroprevalence cohort survey among health care workers and their household members in Kinshasa, DR Congo, 2020-2022.

INTRODUCTION: Serological surveys offer the most direct measurement to define the immunity status for numerous infectious diseases, such as COVID-19, and can provide valuable insights into understanding transmission patterns. This study describes seroprevalence changes over time in the context of the Democratic Republic of Congo, where COVID-19 case presentation was apparently largely oligo- or asymptomatic, and vaccination coverage remained extremely low. METHODS: A cohort of 635 health care workers (HCW) from 5 health zones of Kinshasa and 670 of their household members was interviewed and sampled in 6 rounds between July 2020 and January 2022. At each round, information on risk exposure and a blood sample were collected. Serology was defined as positive when binding antibodies against SARS-CoV-2 spike and nucleocapsid proteins were simultaneously present. RESULTS: The SARS-CoV-2 antibody seroprevalence was high at baseline, 17.3% (95% CI 14.4-20.6) and 7.8% (95% CI 5.5-10.8) for HCW and household members, respectively, and fluctuated over time, between 9% and 62.1%. Seropositivity was heterogeneously distributed over the health zones (p < 0.001), ranging from 12.5% (95% CI 6.6-20.8) in N'djili to 33.7% (95% CI 24.6-43.8) in Bandalungwa at baseline for HCW. Seropositivity was associated with increasing rounds adjusted Odds Ratio (aOR) 1.75 (95% CI 1.66-1.85), with increasing age aOR 1.11 (95% CI 1.02-1.20), being a female aOR 1.35 (95% CI 1.10-1.66) and being a HCW aOR 2.38 (95% CI 1.80-3.14). There was no evidence that HCW brought the COVID-19 infection back home, with an aOR of 0.64 (95% CI 0.46-0.91) of seropositivity risk among household members in subsequent surveys. There was seroreversion and seroconversion over time, and HCW had a lower risk of seroreverting than household members (aOR 0.60 (95% CI 0.42-0.86)). CONCLUSION: SARS-CoV-2 IgG antibody levels were high and dynamic over time in this African setting with low clinical case rates. The absence of association with health profession or general risk behaviors and with HCW positivity in subsequent rounds in HH members, shows the importance of the time-dependent, and not work-related, force of infection. Cohort seroprevalence estimates in a 'new disease' epidemic seem insufficient to guide policy makers for defining control strategies.

Spatial distribution and geographical heterogeneity factors associated with households' enrollment level in community-based health insurance.

Background: Healthcare service utilization is unequal among different subpopulations in low-income countries. For healthcare access and utilization of healthcare services with partial or full support, households are recommended to be enrolled in a community-based health insurance system (CBHIS). However, many households in low-income countries incur catastrophic health expenditure. This study aimed to assess the spatial distribution and factors associated with households' enrollment level in CBHIS in Ethiopia. Methods: A cross-sectional study design with two-stage sampling techniques was used. The 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) data were used. STATA 15 software and Microsoft Office Excel were used for data management. ArcMap 10.7 and SaTScan 9.5 software were used for geographically weighted regression analysis and mapping the results. A multilevel fixed-effect regression was used to assess the association of variables. A variable with a p < 0.05 was considered significant with a 95% confidence interval. Results: Nearly three out of 10 (28.6%) households were enrolled in a CBHIS. The spatial distribution of households' enrollment in the health insurance system was not random, and households in the Amhara and Tigray regions had good enrollment in community-based health insurance. A total of 126 significant clusters were detected, and households in the primary clusters were more likely to be enrolled in CBHIS. Primary education (AOR: 1.21, 95% CI: 1.05, 1.31), age of the head of the household >35 years (AOR: 2.47, 95% CI: 2.04, 3.02), poor wealth status (AOR: 0.31, 95% CI: 0.21, 1.31), media exposure (AOR: 1.35, 95% CI: 1.02, 2.27), and residing in Afar (AOR: 0.01, 95% CI: 0.003, 0.03), Gambela (AOR: 0.03, 95% CI: 0.01, 0.08), Harari (AOR: 0.06, 95% CI: 0.02, 0.18), and Dire Dawa (AOR: 0.02, 95% CI: 0.01, 0.06) regions were significant factors for households' enrollment in CBHIS. The secondary education status of household heads, poor wealth status, and media exposure had stationary significant positive and negative effects on the enrollment of households in CBHIS across the geographical areas of the country. Conclusion: The majority of households did not enroll in the CBHIS. Effective CBHIS frameworks and packages are required to improve the households' enrollment level. Financial support and subsidizing the premiums are also critical to enhancing households' enrollment in CBHIS.

Food and water insecurity in households of children and adolescents living with HIV and receiving care in a rural Zambian hospital: A mixed-methods study.

Approximately 62,000 Zambian children are living with HIV. HIV care and treatment is generally more limited in rural areas, where a heavy reliance on rain-fed subsistence agriculture also places households at risk of food and water insecurity. We nested a mixed methods study with an explanatory sequential design in a clinical cohort of children and adolescents living with HIV (CHIV) in rural Zambia. We used validated questionnaires to assess household food and water insecurity and examined associations between indicators derived from those scales, household characteristics, and HIV treatment adherence and outcomes using log-binomial regression. We identified caregivers and older CHIV from food insecure households for in-depth interviews. Of 186 participants completing assessments, 72% lived in moderately or severely food insecure households and 2% in water insecure households. Food insecurity was more prevalent in households of lower socioeconomic status (80% vs. 59% for higher scores; p = 0.02) and where caregivers had completed primary (79%) vs. secondary school or higher (62%; p = 0.01). No other characteristics or outcomes were associated with food insecurity. Parents limited both the quality and quantity of foods they consumed to ensure food availability for their CHIV. Coping strategies included taking on piecework or gathering wild foods; livestock ownership was a potential buffer. Accessing sufficient clean water was less of a concern. During periods of drought or service interruption, participants travelled further for drinking water and accessed water for other purposes from alternative sources or reduced water use. Community contributions afforded some protection against service interruptions. Overall, while food insecurity was prevalent, strategies used by parents may have protected children from a measurable impact on HIV care or treatment outcomes. Reinforcing social protection programs by integrating livestock ownership and strengthening water infrastructure may further protect CHIV in the case of more extreme food or water system shocks.

Social contacts patterns relevant to the transmission of infectious diseases in Suzhou, China following the COVID-19 epidemic.

BACKGROUND: The COVID-19 pandemic has profoundly affected human social contact patterns, but there is limited understanding regarding the post-pandemic social contact patterns. Our objective is to quantitatively assess social contact patterns in Suzhou post-COVID-19. METHODS: We employed a diary design and conducted social contact surveys from June to October 2023, utilizing paper questionnaires. A generalized linear model was utilized to analyze the relationship between individual contacts and covariates. We examined the proportions of contact type, location, duration, and frequency. Additionally, age-related mixed matrices were established. RESULTS: The participants reported an average of 11.51 (SD 5.96) contact numbers and a total of 19.78 (SD 20.94) contact numbers per day, respectively. The number of contacts was significantly associated with age, household size, and the type of week. Compared to the 0-9 age group, those in the 10-19 age group reported a higher number of contacts (IRR = 1.12, CI: 1.01-1.24), while participants aged 20 and older reported fewer (IRR range: 0.54-0.67). Larger households (5 or more) reported more contacts (IRR = 1.09, CI: 1.01-1.18) and fewer contacts were reported on weekends (IRR = 0.95, CI: 0.90-0.99). School had the highest proportion of contact durations exceeding 4 h (49.5%) and daily frequencies (90.4%), followed by home and workplace. The contact patterns exhibited clear age-assortative mixing, with Q indices of 0.27 and 0.28. CONCLUSIONS: We assessed the characteristics of social contact patterns in Suzhou, which are essential for parameterizing models of infectious disease transmission. The high frequency and intensity of contacts among school-aged children should be given special attention, making school intervention policies a crucial component in controlling infectious disease transmission.

Social capital, government guidance and contract choice in agricultural land transfer.

This study explores the impact of farm households' social capital characteristics and local government policies on the selection of farmland transfer contracts in China's rural industrial revitalization context. Utilizing field research data from 1,979 households in ethnic areas of Hunan Province, this paper constructs an econometric model to assess how farm households' social capital and local governments' involvement in rural industrial revitalization influence farmland transfer contract selections. The findings indicate that, lacking government program support, farmers' social capital significantly affects contract type and duration, but not the rent. Specifically, farmers possessing extensive social capital prefer verbal and short-term contracts (coefficients of 0.525 and 0.643, significant at the 5% level), whereas their influence on rent (coefficient of 2.418, significant at the 5% level) manifests under government program support. These results challenge the conventional theory of farmland transfer contracts and offer substantial empirical support for the development of local government policies in rural industrial revitalization, underlining the critical role of government guidance and social capital in enhancing farmland transfer.

Determinants of nutritional status of children aged 6-59 months in the case of Itang special woreda, Gambella, Ethiopia.

Nutritional status is one of the most important causes of improper physical and mental development in children. The study attempts to assess the factors affecting the severity status of children aged 6-59 months' malnutrition based on the weight-for-age anthropometric index (z-score) and examine between-kebeles-level differences in determinants of the nutritional status of children. A community-based, cross-sectional study design was conducted from October 12 to November 12, 2022. A sample of 397 children aged 6-59 months primary data by applying multi-stage clustered sampling technique was used by considering their heterogeneity. The data were entered by SPSS and analyzed by using R version 3.4.0 and STATA 14.2 statistical software package using a multilevel ordinal logistic regression model and inferences were conducted at a 5% significance level. The results show that birth interval ≥ 24 months (OR = 1.431253, 95% CI 1.221337 1.6763421, P-value = 0.008), economic status of households medium (OR = 16.21466, 95% CI 1.221403 1.423929, P-value = 0.000), economic status of households rich (OR = 223.2856, 95% CI 1.34295 2.582325, P-value = 0.000), employment status of the mother unemployed (OR = 0.2291348, 95% CI 0.0529511 0.9966281, P-value = 0.049), No toilet facility (bush field) (OR = 0.3163329, 95% CI 0.1825356 0.5481975, P-value = 0.000), number of household members (OR = 0.9100682, 95% CI 0.8313481 0.9967315, P-value = 0.042), breastfeeding < 12 months (OR = 0.53803, 95% CI 0.322315 0.898135, P-value = 0.018), educational level of father Primary (OR = 4.601687, 95% CI 1.758009 2.22053, P-value = 0.000), educational level of father Secondary above (OR = 99.65229, 95% CI 2.533502 4.788896, P-value = 0.000) and geographical area (kebeles) were found to be important factors that affect a child's nutritional status between 6 and 59 months. 15% of the overall variation is attributable to the Kebeles level, according to two-level multilevel ordinal logistic regressions with estimates of the variation attributable to the Kebeles level equal to 0.569 and an intraclass correlation coefficient of 0.15. Due to the nature of the response variable random intercept model with random coefficients fitted the data adequately in predicting the severity status of children aged 6-59 months' malnutrition for the multilevel ordinal logistic regression model analysis. So, the researcher recommended that implementing primary health care and nutrition programs that would fit each kebeles' features in Itang Special Woreda to safeguard children from nutritional deficiency.

Does government food demonstration intervention influence household dietary diversity in the Upper West Region of Ghana?

Dietary diversity is crucial in ensuring food and nutrition security. In low-middle-income countries, people frequently prioritize the quantity of food they consume over its quality due to a lack of availability and financial limitations. As a result, achieving dietary diversity is often overlooked in favor of ensuring adequate caloric intake. Through a social cognitive theory perspective, our study examines the relationship between food demonstrations and household dietary diversity in Ghana's Upper West Region utilizing cross-sectional survey data from 517 smallholder farmer households. The results from ordered logistic regression presented in odds ratio (OR) show that participating in food demonstrations (OR: 2.585, p<0.01), engaging in home gardening (OR: 1.932, p<0.001), having access to credit (OR: 1.609, p<0.01), self-rated good nutritional status (OR: 1.747, p<0.01), and Waala ethnicity (OR: 3.686, p<0.001) were all positively associated with high household dietary diversity. Conversely, living in the Wa West district was associated with lower dietary diversity (OR: 0.326, p<0.001). Our research findings suggest that policymakers may want to consider implementing community-based educational programs, such as home and school visits for food demonstrations and sensitizations, promoting mother-to-mother support groups for dietary diversity education, nutrition counseling services, and using role-play and local media. In addition, strengthening local agricultural policies through food banks, indigenous seed development, and mobile food markets and enhancing public-private partnerships like the Ghana Schools Feeding Programme and National Food Buffer Stock company could improve the supply chain and distribution networks for diverse food items. Implementing these interventions in the Upper West Region of Ghana could improve health, well-being, food security, and nutritional outcomes.

Rural Households' Demand Status for Mitigation of Prosopis juliflora (Sw.) DC Invasion and Its Determinant Factors in Ethiopia: Empirical Evidence from Afar National Regional State.

Ethiopia is among the world's poorest nations, and its economy is growing extremely slowly; thus, the government's budget to manage environmental amenities is not always sufficient. Thus, for the provision of environmental management services such as the eradication of Prosopis juliflora, the participation of local households and other stakeholders is crucial. This study is therefore initiated with the objective of assessing rural households' demands for mitigating Prosopis juliflora invasion in the Afar Region of Ethiopia. A multistage sampling technique was employed to obtain the 313 sample rural households that were used in the analysis, and those sample households were selected randomly and independently from the Amibara and Awash Fentale districts of Afar National Regional State, Ethiopia. In doing this, a seemingly unrelated bivariate probit model was used to determine factors affecting rural households' demands for mitigating Prosopis juliflora invasion. Consequently, as per the inferential statistical results, there was a significant mean/percentage difference between willing and nonwilling households for the hypothesized variables, except for some variables such as farm experience; years lived in the area, distance from the market, and dependency ratio. Furthermore, the seemingly unrelated bivariate probit model result indicates that sex, family size, tenure security, livestock holding, frequency of extension contact, and years lived in the area were important factors influencing the willingness to participate in Prosopis juliflora management practices positively, whereas age, off-farm/nonincome, and bid value affected willingness to pay negatively and significantly. Hence, to improve the participation level of households, policymakers should target these variables.

Association of Child Growth Failure Indicators With Household Sanitation Practices in India (1998-2021): Spatiotemporal Observational Study.

BACKGROUND: Undernutrition among children younger than 5 years is a subtle indicator of a country's health and economic status. Despite substantial macroeconomic progress in India, undernutrition remains a significant burden with geographical variations, compounded by poor access to water, sanitation, and hygiene services. OBJECTIVE: This study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India. METHODS: We used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators. RESULTS: Our study showed a decreasing trend in stunting (44.9%-38.4%) and underweight (46.7%-35.7%) but an increasing prevalence of wasting (15.7%-21.0%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions. CONCLUSIONS: Despite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas.

Determinants of child stunting in the dryland area of East Nusa Tenggara Province, Indonesia: insights from a national-level survey.

Stunting remains a critical public health issue in Indonesia, particularly in the province of East Nusa Tenggara. This region, characterized by its archipelagic dryland geography, has reported the highest prevalence of stunting among children under five from 2007 to 2021. The study aimed to examine the relationship between various characteristics of children under five and household factors with the occurrence of stunting. This observational study, with a cross-sectional design, used secondary data from the 2021 Indonesian Nutrition Status Survey, covering 7,835 children under five. We analyzed the data to identify patterns and relationships, using univariate analysis to display percentage distributions and bivariate analysis through multiple binary logistic regression tests. The results of the multiple logistic regression test showed that indicators of family characteristics such as age, gender, low birth weight, body length, possession of birth certificates, and receiving complementary feeding were all related to stunting. Additionally, household factors such as toilet type, National Health Insurance coverage, ownership of a Prosperous Family Card, and residential area were significant determinants. Factors contributing to stunting in dryland areas include a range of elements from both family characteristics-such as age, gender, birth certification, low birth weight, and initial body length, to the introduction of supplementary feeding-and household indicators, including the use of specific types of latrines (Plengsengan and Cemplung types without covers), health insurance coverage, possession of Prosperous Family Cards, and the family's residential area.

Toward a more systematic understanding of water insecurity coping strategies: insights from 11 global sites.

INTRODUCTION: Water insecurity-the inability to access and benefit from affordable, reliable and safe water for basic needs-is a considerable global health threat. With the urgent need to target interventions to the most vulnerable, accurate and meaningful measurement is a priority. Households use diverse strategies to cope with water insecurity; however, these have not been systematically characterised nor measured. The Food Insecurity Coping Strategies Index has been insightful for targeting nutrition interventions to the most vulnerable. As a first step towards creating an analogous scale for water, this study characterises the largest empirical data set on water insecurity coping strategies and proposes guidance on measuring it using a novel toolkit. METHODS: Open-ended responses on water insecurity coping (n=2301) were collected across 11 sites in 10 low- and middle-income countries in the Household Water InSecurity Experiences (HWISE) Scale validation study. Responses were characterised and compared with behaviours identified in the literature to construct an instrument to systematically assess coping. RESULTS: We identified 19 distinct strategies that households used when experiencing water insecurity. These findings, paired with prior literature, were used to develop a Water Insecurity Coping Strategies Assessment Toolkit with guidance on its piloting to assess coping prevalence, frequency and severity. CONCLUSIONS: The widespread occurrence of water insecurity coping strategies underscores the importance of understanding their prevalence and severity. The Water Insecurity Coping Strategies Assessment Toolkit offers a comprehensive approach to evaluate these strategies and inform the design and monitoring of interventions targeting those most vulnerable to water insecurity.

Open defecation practice among households with latrines in rural communities of Ararso District, Somali Region, Eastern Ethiopia.

Background: Open defecation contributes to the spread of different feco-oral diseases. Therefore, access to a latrine is strongly recommended, as it considerably reduces the risks. Even though provision of latrine facilities alone does not guarantee the desired health benefits, they should be integrated with behavior change. In Ethiopia, efforts have been made to increase the coverage of latrine facilities. However, evidence on how consistently households use it is limited. Most prior studies focused on latrine utilization among households, and limited evidence is available about open defecation practices among households with latrines and associated factors. Thus, this study is critical for developing effective intervention approaches to prevent open defecation among households with latrines. Objective: The aim of this study was to assess the open defecation practice and associated factors among households with latrines in rural communities of Ararso District, Somali Region, Eastern Ethiopia, 2023. Method: A community-based, cross-sectional study design was employed among households with latrines in the district. A total of 632 households latrines were selected using a systematic sampling technique. Data were collected using a structured questionnaire and an observational checklist. The questionnaire was designed in KoboTool box, Humanitarian Response software, and the data were collected using the Kobo Collect version 2023.2.4 mobile application. The data were downloaded from the server in the Microsoft Excel format for data cleaning before being exported to STATA version 14 for analysis. Bivariate and multivariable analyses were employed to investigate the relationship between outcome and independent variables. Odd ratios with 95% confidence intervals were utilized to assess the association between the outcome and the predictor variables. A P-value of <0.05 was used as the threshold point for statistical significance. Result: In this study, the prevalence of open defecation practice among households with latrines was 32.4% (95% CI: 28.1, 35.9). Sex of the household (AOR = 1.60, 95% CI: 1.06, 2.4), educational status (AOR = 2.40, 95% CI: 1.08, 5.53), family size (AOR = 1.62, 95% CI: 1.22, 2.78), the presence of under-5-year-old children in the house (AOR = 1.84, 95% CI: 1.19, 2.75), the need for latrine maintenance (AOR = 2.37.95% CI: 1.62, 3.48), current status of the latrine (AOR = 2.37, 95% CI: 1.62, 3.48), and latrine cleanness status (being unclean) (AOR = 1.91, 95% CI: 1.29, 2.81) were significantly associated with open defecation practice among households with latrine. Conclusion: The study concluded that open defecation was significantly practiced by households with latrines. This revealed that the presence of a latrine alone was insufficient to considerably reduce open defecation. To alleviate this problem, the government and health workers, in collaboration with the health bureau, should promote frequent sanitation and hygiene education in the communities.

Modeling determinants of time-to-premarital cohabitation among Ethiopian women using parametric shared frailty models.

BACKGROUND: Premarital cohabitation is rampant and currently practiced worldwide, particularly in sub-Saharan Africa. It is a known cause of marital instability and divorce. It is also associated with intimate partner violence and harms the psychology of children in later life. However, in Ethiopia, there has been limited attention given to premarital cohabitation. OBJECTIVE: The main goal of this study was to identify the determinants of time-to-premarital cohabitation among Ethiopian women. METHODS: The 2016 EDHS data was used to achieve the study's goal. The survival information of 15683 women was analyzed based on their age at premarital cohabitation. The regional states of the women were used as a clustering effect in the models. Exponential, Weibull, and Log-logistic baseline models were used to identify factors associated with age at premarital cohabitation utilizing socioeconomic and demographic characteristics. RESULTS: The median age of premarital cohabitation was found to be 18 years. Surprisingly, 72.7% of participants were cohabitated in the study area. According to the Log-logistic-Gamma shared frailty model, place of residence, occupation, educational status, and being pregnant were found to be factors determining the time to premarital cohabitation. CONCLUSION: Premarital cohabitation among Ethiopian women was higher compared to women in the sub-Saharan Africa and East Africa. Place of residence, occupation, educational status, and being pregnant were found to be factors determining the time for premarital cohabitation. Therefore, we recommend the concerned bodies set out strategies to educate women about the influencing factors and dangers of premarital cohabitation.

Perceptions and compliance with COVID-19 preventive measures in Southern and Central regions of Mozambique: A quantitative in-person household survey in the districts of Manhiça and Quelimane.

The COVID-19 pandemic has prompted countries to swiftly implement rigorous preventive measures on a population-wide scale worldwide. However, in low-income countries like Mozambique this was difficult, coupled with a generalised lack of knowledge on how the population understood and complied with these measures. This study assessed community perceptions and implementation of anti-COVID-19 measures recommended by Mozambican authorities in Manhiça and Quelimane districts, including confinement, social distancing, frequent handwashing, mask wearing, and quarantine as the key practices to evaluate. We conducted a cross-sectional quantitative survey in October 2020 and February 2021, interviewing heads of households, face-to-face. The data collected included self-evaluation of compliance and existence of handwashing facilities and face-masks in the households, aided by observations. We present descriptive statistics on perceptions and compliance at individual and household levels. Out of the 770 participants, nearly all (98.7%) were aware of Coronavirus disease, including the term COVID-19 (89.2%). Knowledge varied between districts, with Manhiça participants showing higher levels of sufficient ability to define the disease. The symptoms most mentioned were dry cough (17.8%), fever (15.7%), flu-like symptoms (14.2%), breathing difficulties (13.6%), and headache (13.1%). Participants recognized various transmission modes, including touching infected objects and inhaling infected air. Preventive measures like handwashing with soap or sanitizing hands with alcohol, wearing masks, and social distancing were acknowledged, but the understanding varied. Compliance with these measures was generally low, with fewer than half of respondents reporting adherence to them. Only 30.4% of households had handwashing facilities (of which only 41.0% had water), and masks were often limited to one per person aged 6 years or more. Community members in Manhica and Quelimane were aware of COVID-19 but had limited understanding of what the preventive measures meant, and had lower levels of compliance. Understanding and addressing the factors affecting the proper implementation of these measures is crucial for improving community adherence in preventing infectious diseases with epidemic potential.