Health impacting behaviour & morbidity: Implications for adolescent & youth health programmes in India.

BACKGROUND OBJECTIVES: In Himachal Pradesh (HP), a comprehensive health survey was conducted to assess the prevalent health affecting habits and issues among young individuals aged 10 to 24 yr. The study was aimed to evaluate key factors such as nutrition, substance use (including tobacco and alcohol), mental health concerns such as anxiety and depression, sexual behaviours and personal hygiene, as well as incidents of violence and injury (including road traffic and other injuries). METHODS: A cross-sectional survey was conducted in HP on 2895 individuals aged between 10 and 24 yr. The survey encompassed four districts, namely Shimla, Kinnaur, Kangra, and Sirmaur, and 12 blocks (three in each district). To ensure a representative sample, a stratified multistage cluster sampling approach was used. Districts and blocks were selected purposively so as to represent the diverse sociodemographic and cultural characteristics of this region. Within each block, thirty clusters were chosen using a probability proportional to size method. Clusters were defined as villages in rural areas and wards in urban areas. The World Health Organization 30 × 7 cluster technique was employed to identify households and individuals for the study. RESULTS: Underweight (44.39%), risk of cell phone addiction (19.62%), feeling anxious (15.54%), unintentional injuries (14.72%) and violence (8.19%) were the top five health impacting problems among young people in HP. INTERPRETATION CONCLUSIONS: The leading health impacting problems identified are preventable and/or modifiable factors affecting the overall health and development of young people in HP. These need to be addressed as priority health problems for interventions with a focus on maintaining positive health through integrated approaches including care provision, risk reduction and health promotion related to these health impacting behaviours. Such interventions are likely to yield better results towards the overall health and development of young people in HP.

Engagement of Peer Educators from India's National Adolescent Health Programme for the COVID-19 response activities: Qualitative findings from i-Saathiya study.

BACKGROUND: The COVID-19 pandemic strained India's healthcare system and health workers unprecedentedly. PURPOSE: The extent of the contribution by peer educators (PEs) from India's National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to COVID-19 response activities remains uncertain necessitating an imperative investigation. Within the overarching objective of the 'i-Saathiya' study ('i' signifies implementation science and Saathiya represents PEs in Madhya Pradesh), a key focus was to understand the role of PEs recruited under RKSK during COVID-19 in two Indian states, namely Madhya Pradesh and Maharashtra. The study states differ in sociodemographic characteristics and peer education implementation models. METHODS: In-depth interviews (IDIs) were conducted with stakeholders (n=110, Maharashtra: 57; Madhya Pradesh: 53) engaged in the implementation of RKSK's peer education programme at state, district, block and village levels. Focus group discussions (FGDs) (n=16 adolescents, Maharashtra: 8; Madhya Pradesh: 8) were conducted with adolescents, part of the peer group of PEs (n=120 adolescents, Maharashtra: 66; Madhya Pradesh: 54). IDIs and FGDs were audio-recorded, translated, transcribed verbatim and analysed thematically. Adopting inductive and deductive approaches, a data-driven open coding framework was developed for thematic analysis. RESULTS: The PE recruited under RKSK took a central role that extended beyond their predefined responsibilities within the RKSK. They provided crucial support to healthcare workers in curbing the spread of COVID-19. Their diverse contributions, including COVID-19 pandemic response support, addressing community and adolescent needs, role in COVID-19 vaccination efforts, navigating access to the health system and facilitating health workers in the implementation of various national health programmes and campaigns during COVID-19. CONCLUSION: The findings underscore the potential of PEs in bolstering the health system. Despite their unpreparedness for the context (COVID-19), PEs demonstrated tenacity and adaptability, extending their roles beyond their predefined responsibilities. Recognising PEs through awards and incentives, skill courses and additional grades, can enhance their visibility, sustaining impactful work within RKSK and beyond.

Engagement of health workers and peer educators from the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram during the COVID-19 pandemic: Findings from a situational analysis.

BACKGROUND: To understand the impact of COVID-19 on implementation of the peer education programme of the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK); repurposing of the RKSK health workers and Peer Educators (PEs) in COVID-19 response activities and effect on adolescents´ health and development issues. METHODS: Virtual in-depth interviews were conducted with stakeholders (n = 31) (aged 15 to 54 years) engaged in the implementation of the RKSK and peer education programme at state, district, block, and village levels in Madhya Pradesh and Maharashtra (India). These interviews were thematically coded and analysed to address the research objectives. RESULTS: Despite most peer education programme activities being stopped, delayed, or disrupted during the pandemic and subsequent lockdown, some communication networks previously established, helped facilitate public health communication regarding COVID-19 and RKSK, between health workers, PEs, and adolescents. There was repurposing of RKSK health workers and PEs' role towards COVID-19 response-related activities. PEs, with support from health workers, were involved in disseminating COVID-19 information, maintaining migrant and quarantine records, conducting household surveys for recording COVID-19 active cases and providing essential items (grocery, sanitary napkins, etc.) to communities and adolescents. CONCLUSION: PEs with support from community health workers are able to play a crucial role in meeting the needs of the communities during a pandemic. There is a need to further engage, involve and build the skills of PEs to support the health system. PEs can be encouraged by granting more visibility and incorporating their role more formally by paying them within the public health system in India.