Gender-based Violence and its Predictors: A Cross-sectional Study Among the Adolescents of Madhya Pradesh, Central India.

Background: Gender-based violence (GBV) is a global public health concern. India's socio-cultural and regional diversity poses challenges for obtaining accurate and comprehensive indicators of gender-based violence. This study aimed to explore the prevalence and predictors of GBV among adolescents. This was a community-based cross-sectional study conducted among adolescents aged 10 to 19 years in six districts of Madhya Pradesh, the central part of India, from December 2017 to 2019. Methods and Material: GBV was assessed using a validated questionnaire adapted from a nationwide survey. Data were analyzed using SPSS (version 16.0). Logistic regression analysis was performed to identify factors associated with GBV. Results: The study revealed that 10.4% of adolescents were victims of GBV. The multi-variable logistic regression showed that girls were at higher risk (odds ratio = 5.7) of facing GBV. Other significant factors associated with GBV included older adolescents (15-19 years old), those belonging to scheduled caste/tribal areas, those whose mothers were literate, those who had a boyfriend/girlfriend, and those who justified wife beating. Conclusion: GBV is a serious public health problem among adolescents, with one in every 10 adolescents experiencing GBV. It is essential to instil awareness of gender-equal norms from early childhood and within households. Implementing violence prevention policies and strategies in educational and work institutions, as well as at the community level, is crucial.

Psychological Impact of COVID-19 and Its Influence on Parental Willingness to Vaccinate Children: A Cross-Sectional Study at a Tertiary Care Hospital in Kolkata.

Background COVID-19 has affected the physical and mental health of people globally, and vaccination is seen as a crucial tool in controlling the pandemic. However, the readiness to vaccinate children remains a concern, particularly in India. Aim The study aimed to investigate the association between the psychological impact of COVID-19 and willingness to vaccinate their children among attendees of the COVID-19 vaccination clinic at Nil Ratan Sircar Medical College, Kolkata. Method The study used an observational, cross-sectional design and collected data from 356 participants between August and September 2022. The COVID-19 Perceived Stress Scale-10 was used to assess participants' psychological impact, and willingness to vaccinate was determined using a survey. Results Approximately 64% (n=227) and 71% (n=253) of the participants exhibited a high level of perceived stress and willingness to vaccinate their children. The vaccine acceptance was significantly associated with perceived stress level and other factors such as family type, presence of chronic illness, and history of acquaintances suffering from COVID-19. Conclusion The study highlights the importance of addressing parental stress and anxiety to enhance vaccination rates among children. To achieve this, population-level awareness of vaccine safety measures and benefits should be raised to alleviate stress and increase vaccine uptake.

Gender inequalities in prevalence, pattern and predictors of multimorbidity among geriatric population in rural West Bengal.

Context: Multimorbidity is considered as a priority for global health research. It is defined as the coexistence of two or more chronic health conditions in an individual. It is increasingly being recognized as a major concern for primary care physicians due to its huge impact on individual, family, and societal level. Aim: The aim of this study was to find the quantum of gender-related inequalities and determinants of multimorbidity among the elderly people in a rural part of West Bengal. Materials and Methods: This is a cross-sectional study carried out among 246 elderly people (60 years and above) in a community setting from Oct 2017 to Sep 2018. Logistic regression analysis was done to find out the predictors of multimorbidity. Data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.). Results: Approximately 82% of the study subjects were suffering from multi-morbidity with a significant difference between males (80.9%) and females (88.5%). In binary logistics, people of both the genders aged >70 years, who had less than primary level education, had more than three children, whose source of income was from their children (sons/daughters), were dependent on others for daily routine were at high risk of being multimorbid; whereas depression was a significant predictor of multimorbidity in females and not in males. In multivariable analysis, age remained the only significant predictor for both the gender and for females; depression remained significant after adjusting with significant variables in binary logistics. Conclusion: Morbidity screening at each visit, individual as well as family counseling and lifestyle modifications help to cope with the rising burden of multimorbidity at the primary care level. More insight into the epidemiology of multi-morbidity is necessary to take steps to prevent it, lower its burden and align health-care services as per needs.

Association Between Household Food Insecurity and Nutritional Status Among Children of age <5 years: A Community-based Study in a Slum of Kolkata, Eastern India.

Context: Household food insecurity (HFI) is considered one of the main risk factors of undernutrition. However, the evidence is not conclusive in our study settings. This study aimed to examine the association between HFI and nutritional status. Materials and Methods: It was a community-based cross-sectional observational study among children of age <5 years and their mothers (n = 257) conducted in a slum of Kolkata, West Bengal, carried out from March to May 2019. Data were analyzed using the Statistical Package for the Social Sciences software (version 16.0. Chicago, SPSS Inc.). Logistic regression analysis was performed to find out the association. Results: The current study found that 72.4% of participants living in food-insecure households and the proportion of underweight, wasting, and stunting among the under-five children found to be 29.9%, 17.8%, and 27.2%, respectively. Bivariate analysis showed wasting and stunting associated with HFI, whereas in multivariable regression, only stunting remained significant. Conclusion and Implications: Food insecurity (FI) remains a predictor of chronic undernutrition (wasting and stunting) highlighting the need for multisectoral strategies and policies to combat FI and multiple forms of malnutrition which will lay the foundation for sustainable and inclusive growth.

Resilience and its correlates among medical students in the Eastern part of India during the coronavirus disease 2019 (COVID-19) pandemic.

BACKGROUND: There is a great deal of psychological pressure on medical students, which results in depression, addiction, and suicide. Resilience plays a significant role in coping with psychological distress. The study aimed to determine the resilience level of medical students in Kolkata and factors related to it. MATERIALS AND METHODS: A cross-sectional study was conducted among undergraduate students of a medical college in the eastern part of India during October 2020. Resilience was assessed using the validated "Adult Resilience Measure-R." Data were collected on Google Forms and analyzed using SPSS (version 16.0). Logistic regression analysis was performed to find factors associated with low resilience. RESULTS: The study revealed that one-fourth (25.2%) of the participants had low-level resilience. Nearly half (44.9%) of them perceived their mental health status as having worsened during the lockdown. Students who did not enjoy staying at home during the lockdown and who spent <10 h of their time with their family members had higher odds of low resilience. In multivariable analysis, not enjoying staying at home during the lockdown remained the only significant predictor of low resilience. CONCLUSION: Students should spend more time with their parents and family members and learn coping skills. Appropriate resilience training programs have to be integrated into the medical curriculum to help in coping with future challenges.

Is There Any Relationship between Poor Menstrual Hygiene Management and Anemia? - A Quantitative Study Among Adolescent Girls of the Urban Slum of Madhya Pradesh.

BACKGROUND: Anemia and poor menstrual hygiene practices have a considerable impact on all aspects of an adolescent girl's life. There is a dire need for evidence on the burden and its association to provide actionable preventive measures. OBJECTIVE: The objective of this study is to explore the magnitude and association between poor Menstrual Hygiene Management (MHM) practices and anemia. MATERIALS AND METHODS: A cross-sectional study conducted among 393 adolescent girls of the urban slum of Bhopal (June 2017-July 2018). Hemoglobin (Hb) was determined by a portable Hb meter (HemoCue). Logistic regression analysis was done to find out if there is any association between poor MHM practices and anemia. RESULTS: The present study found the prevalence of anemia as 38.7% among which 65.1%, 31.5%, and 3.2% were suffering from mild, moderate, and severe forms of anemia, respectively, and 87.3% were practicing poor MHM. Logistic regression found that the MHM, bleeding during menstruation, religion, educational status, and nutritional status of adolescents were significant factors associated with anemia. CONCLUSION: The study concluded that there is a significant association between poor MHM and anemia. Concerted convergent actions focusing on the provision of awareness regarding MHM and sanitary facilities to maintain proper menstrual hygiene are needed to reduce the burden of anemia.

Self-care practice and its predictors amongst Type-2 Diabetes Mellitus patients in the outpatient department of a tertiary hospital of Kolkata, Eastern India - A cross-sectional study.

PURPOSE: The purpose of this study is to find out the pattern and factors associated with self-care practices among diabetic patients as self-care was considered imperative for the control of disease and enhancement of patient's quality of life. METHODS: This is a cross-sectional clinic-based observational study conducted among the type 2 diabetes mellitus patients who came for follow up to the outpatient department of a tertiary hospital of Kolkata from September to December 2019. Self-care practice assessed using questions adapted from the "Summary Diabetes Self-Care Activities Questionnaire" by face-to-face interview. Logistic regression used to find out the predictors of self-care practice. RESULTS: Self-care practice was unsatisfactory among 67.5% of the patients. Near half (56%) of the patients had mild to moderate distress and about 18% were severely distressed. Self-care practice was significantly associated with the educational level, family history, presence of hypertension, advice given regarding self-care activities, and diabetes distress levels of the participants. CONCLUSIONS: Primary care physicians should be encouraged to give practical aspects of self-care practices and counseling regarding diabetes distress. To perform self-care practices adequate, support from the family level and community level is imperative.

Diabetes in tuberculosis patients: An emerging public health concern and the determinants and impact on treatment outcome.

BACKGROUND: Tuberculosis (TB) and diabetes mellitus are still of much public health concern. Screening of TB patients for diabetes will ensure early case detection, better management of diabetes, and better TB treatment outcome. The objective of this study was to determine the prevalence and associated factors of diabetes in TB patients and their impact on treatment outcome of TB. MATERIALS AND METHODS: This was a longitudinal follow-up study of registered TB patients under the Revised National Tuberculosis Control Program in all five TB units of Bhopal district. Participants were contacted and the interview was conducted. The blood sugar of all TB patients was checked, and they were followed up to assess the treatment outcome from October 2014 to September 2017. Data were analyzed using SPSS (version 16.0. Chicago, SPSS Inc.). Logistic regression was done to find the factors for diabetes in TB patients. The Chi-square tests were used to find the difference in treatment outcomes and assess the relative risk for poor outcome in diabetic TB patients. RESULTS: Of total 662 TB patients, 82 (12.39%) were diagnosed as diabetic. Age >50 years, males, higher body mass index, pulmonary TB, patients on Category II treatment, and history of smoking were found to be predictors of diabetes in TB patients. The treatment outcome of TB was more unfavorable (defaulter, failure, and death) in diabetic TB patients (16.17%) than in nondiabetic TB patients (5.8%) (risk ratio = 2.78, 1.469-5.284 confidence interval). CONCLUSION: The high prevalence of diabetes and the unfavorable treatment outcome in diabetic TB patients make screening and management of diabetes at an early-stage crucial for a better outcome in TB patients.

Elder abuse and its predictors: a cross-sectional study in a rural area of West Bengal, eastern part of India.

BACKGROUND: Elder abuse is an important public health problem hidden from public view in spite of its detrimental effect on physical and mental health. In the last three decades, there is responsiveness toward abuse of children and spouses worldwide but even today abuse and neglect of aged people seem to be the matter of least concern. This study aims to reveal the magnitude of elder abuse and its predictors. METHODS: This is a cross-sectional study carried out in a community setting among elderly people (60 years and older) from October 2015 to September 2017 in a rural area of West Bengal, eastern part of India. Elder abuse was elicited by questions adapted from the Actual Abuse Tool. Data were analysed using SPSS (version 16.0). Logistic regression analysis was performed to reveal the factors associated with elder abuse. RESULTS: The study found that 25.6% of the respondents had experienced abuse, psychological abuse being the commonest type. Disability was the most common perceived risk for abuse. Univariate logistic regression showed higher age (70 years and older), female gender, who were Scheduled caste, living in a nuclear family, having more than three children, financially and functionally dependent, who was suffering from depression and multimorbidity had increased odds of being abused. In multivariable logistic regression, people aged above 70 years, living in a nuclear family and dependent for instrumental activities of daily living remained significant predictors of abuse. CONCLUSION: Around one in four of the respondents was abused in a 1 year duration which implies the urgent need for action. Routine screening for elder abuse at ground level and abuse prevention campaigns can be an important measure to alleviate this hidden problem. Also, there is a need to explore culturally specific forms of elder abuse to provide an age-friendly environment.

Assessment of Poor Functional Status and its Predictors among the Elderly in a Rural Area of West Bengal.

CONTEXT: Functional ability considered a proxy for healthy aging, not only related to mental and physical health but it also determines social well-being. Eliciting the determinants of functionality components among the elderly will assist in evolving with appropriate plans at both domiciliary and facility level to eliminate their sufferings and disabilities. AIM: The aim of this study is to find out the magnitude of poor functional status among the elderly and its predictors. MATERIALS AND METHODS: This is a community-based cross-sectional study conducted among 246 geriatric people in a rural area of West Bengal from August 2017 to December 2017; data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.). Logistic regression analysis was performed to find out the factors associated with poor functional status (activities of daily living [ADL] and instrumental ADL [IADL]). RESULTS: The study concluded that 32.4% and 59.3% were dependent for basic ADL and IADL, respectively. Binary logistics showed people aged >70 years, female gender, less than primary level education, widowed/separated, who lived in the joint family, poorest percentile of economic status, who were depressed and who suffered from multimorbidity had increased odds of dependency for ADL and IADL. In multivariate logit regression, age >70 years and depression remained significant for ADL; in addition, marital status, education, and family type remained significant for IADL. CONCLUSION: There should be a provision for community-based comprehensive geriatric health and disability assessment, as it enables older people to avert the illness at the early stage, to delay the onset of disabling diseases. This will ensure their participation in the upliftment of the society, and they thus will be less dependent on their progeny.

Safety of food served in Mid-Day Meal program: An in-depth study in upper primary schools of Kolkata.

INTRODUCTION: The Mid-Day Meal (MDM) program is the world's biggest supplementary school lunch program and is being implemented all over India for primary and upper primary school students. To continue a healthy program, personal hygiene of food handlers and beneficiaries should be well maintained. OBJECTIVE: This study aims at examining the status of food safety measures including personal hygiene of food handlers and beneficiaries of MDM. METHODOLOGY: An institution-based observational study with cross-sectional design was conducted in upper primary schools (government, government-aided school) in Kolkata over a period of 2 years from November 2016 to October 2018. A sample of 52 schools from a total of 515 schools were then selected by simple random sampling. Analyses were conducted using SPSS software (SPSS Inc., released 2007 SPSS for Windows, version 16.0). RESULTS: Among 52 schools, 53.8% were government-aided schools and 46.2% were government schools. There were significant differences in cleaning practice by cook-cum-helper (CCH) (χ2 = 4.4, df = 1, P = 0.036), personal hygiene of CCH (χ2 = 19.01, df = 1, P = 0.000) and beneficiaries (χ2 = 9.3, df = 1, P = 0.002), practice during serving (χ2 = 4.4, df = 1, P = 0.036), and use and storage of oils and condiments in MDM (χ2 = 27.7, df = 1, P = 0.000) between government and government-aided schools. CONCLUSION: School authority should be concerned about maintaining proper hygiene. Adequate facilities and training program must be arranged for CCH to provide a healthy meal.

Capacity Building of Private Sector Workforce for Public Health Services in India: Scope and Challenges.

Indian health sector is a complex admixture of public and private providers, but several lacunae of public health service delivery system in terms of human resource, access, and quality have resulted in unprecedented growth of private sector. Although seamless delivery of services at rural and urban areas, timely approach, and improved information technology system are the strength of the private sector, this package comes at the cost of high out-of-pocket expenditure. Mobilization of private sector health workforce by their capacity building in terms of orientation toward public health services is one of the available solutions to move toward wider coverage of public health services. However, numerous challenges need to be addressed before realization of this vision.

Urinary Incontinence, Its Risk Factors, and Quality of Life: A Study among Women Aged 50 Years and above in a Rural Health Facility of West Bengal.

CONTEXT: Urinary incontinence (UI) is a chronic debilitating disease which is often under reported, but laid significant impact on one's quality of life (QoL) thus is of public health importance. AIMS: The aim of this study is to find out proportion of rural women have UI, its associated risk factors and treatment-seeking behavior, QoL of affected women. METHODS: This was a cross-sectional clinic-based study conducted from October 2016 to January 2017 among 177 women aged 50 years or above attending a rural health facility with a structured schedule. Data were analyzed using appropriate statistical methods by SPSS (version 16). RESULTS: Forty-nine (27.7%) out of 177 women were found having UI. The most prevalent type of UI was stress UI (51.0%), followed by mixed UI (32.7%) and urge UI (16.3%). In bivariate analysis, study participants who were illiterate, having a history of prolonged labor, having a history of gynecological operation, normal vaginal deliveries (NVDs) (>3), diabetic, having chronic cough, having constipation, and having lower urinary tract symptoms (LUTS) had shown significantly greater odds of having UI. In multivariable illiteracy (adjusted odds ratio [AOR] - 2.41 [1.02-5.69]), NVDs (AOR - 3.37 [1.54-7.37]), a history of gynecological operation (AOR - 3.84 [1.16-12.66]), chronic cough (AOR - 2.69 [1.21-5.99]), LUTS (AOR - 2.63 [1.15-6.00]) remained significant adjusted with other significant variable in bivariate analysis. Those with mixed UI had 5.33 times higher odds having unfavorable QoL. Only 30.6% sought medical help. Treatment-seeking behavior shown negative correlation with QoL while fecal incontinence and LUTS shown possitive correlation. CONCLUSIONS: The study revealed that rural women are indeed at high risk of developing UI. Majority of them did not sought treatment for UI which is matter of concern. Generating awareness regarding UI may help to improve health-seeking behavior and QoL.