Background: Despite the reduction in the maternal mortality ratio, barriers in obstetric care services (OCS) remain a significant risk factor for adverse maternal and perinatal outcomes in India. This review covers the ‘continuum of care’ (ANC, child delivery, and PNC services) and identifies multiple barriers in provisioning as well as utilization of OCS in India. We conducted a systematic review to understand the barriers using a mixed-methods approach. Methods: PubMed, Scopus, Web of Science, Google Scholar, and Science Direct databases were searched from 1 January 2000 to 30 June 2022. The methodological quality of the included studies was assessed using appropriate tools. After a full-text review of 164 studies, total of 56 studies (33 quantitative, 18 qualitative, and 5 mixed-methods studies) were finally included in the review. All the barriers were classified into five major themes: (i) individual and interpersonal barriers, (ii) social and cultural barriers, (iii) structural barriers, (iv) logistical barriers, and (v) organizational barriers. A thematic synthesis approach was used to present the findings of the included studies. Results: Lack of knowledge and awareness and less family support in availing the required OCS were key individual and interpersonal barriers. Negative social and cultural practices, such as belief in traditional herbs/healers, dietary restrictions, and discarding colostrum were frequently reported barriers, especially in rural settings. Poor economic status and high health service costs were the most often cited barriers to low institutional delivery and delayed ANC services. Long distances to health facilities and poor road conditions were the most frequently reported logistical barriers. On the provisioning side, poor quality of treatment, shortage of drugs and equipment, and non-cooperative attitude of health professionals were the most significant barriers. Conclusion: This review identified several important barriers ranging from individual and cultural to structural, logistical, and organizational, which are prevalent in India. To mitigate the barriers, the governments need to develop strategies at the individual and organizational levels. Innovative interventions and program implementation at the community and village levels could also be contributory steps towards improving OCS utilization in India.

Considering the widespread transmission of Coronavirus disease (COVID-19) globally, India is also facing the same crisis. As India already has inadequate waste treatment facilities, and the sudden outbreak of the COVID-19 virus has led to significant growth of Bio-medical waste (BMW), consequently safe disposal of a large quantity of waste has become a more serious concern. This study provides a comprehensive assessment of BMW of India before and during the COVID-19 pandemic. Additionally, this article highlights the gaps in the implementation of BMW rules in India. This study uses various government and non-government organizations, reports and data specifically from the Central Pollution Control Board (CPCB). The finding of the study demonstrated that most of the States/Union Territories (UTs) of India are lacking in terms of COVID-19 waste management. India has generated over 32,996 mt of COVID-19 waste between June and December 2020. During this period, Maharashtra (789.99 mt/month) is highest average generator of COVID-19 waste, followed by Kerala (459.86 mt/month), Gujarat (434.87 mt/month), Tamil Nadu (427.23 mt/month), Uttar Pradesh (371.39 mt/month), Delhi (358.83 mt/month) and West Bengal (303.15 mt/month), and others respectively. We draw attention to the fact that many gaps were identified with compliance of BMW management rules. For example, out of all 35 States/UTs, health care facilitates (HCFs), only eight states received authorization as per BMW management rules. Moreover, the government strictly restricted the practice of deep burials; however, 23 States/UTs are still using the deep burial methods for BMW disposal. The present research suggests that those States/UTs generated on an average of 100 mt/month COVID-19 waste in the last 7 months (June–December 2020) should be considered as a high priority state. These states need special attention to implement BMW rules and should upgrade their BMW treatment capacity.

The study estimates the prevalence and risk factors of accidents and injuries among iron and steel industry workers. A cross-sectional study (N=505) was conducted from November 2019 to March 2020 in Indian Iron and Steel Company (IISCO) Burnpur, West Bengal, India. The result shows that about 28 % of workers experienced accidents and injuries in the last 12 months. The most frequent type of injury reported were cuts from sharp objects (37.32%), followed by fractures and dislocation (30.28%), burns (19.01%), upper head (23.24%), and arm/shoulder (14.08%) were most often reported injured body parts. The factors such as non-technical education (Adjust Odds Ratio (AOR): 2.52), higher exposure (AOR: 2.85), alcohol consumption (AOR:2.47), and poor occupational health and safety knowledge (AOR: 0.65) were significantly associated with work-related injuries. The encouragement of occupational health and safety knowledge may be a novel practice for reducing the prevalence of accidents and injuries.

This narrative review aims to assess the effects of the climate crisis on various aspects of adolescent wellbeing, and community level coping mechanisms being used to build resilience. This study summarizes research findings from eight South Asian countries based on a scoping review of the peer-reviewed and grey literature (critically evaluated) published between 1st January 2000 and 31st December 2021. We have included multiple dimensions of climate change such as drought, floods, cyclones, tsunamis, storms, raised temperature/heatwaves, heavy rainfall, rising sea level, and glacier melt-related extreme weather events. Findings suggest Extreme Weather Events (EWE) affect adolescents and their wellbeing in various ways, with adolescent girls disproportionately harmed, as EWE are linked to early marriage, trafficking, gender based sexual and physical violence. Regional variation suggested , with Bangladeshi adolescents most vulnerable to EWE, followed by India and Pakistan. Floods, droughts and cyclones are the most commonly reported EWE affecting adolescents in the South Asian region. As the climate crisis is expected to increase the frequency and intensity of EWE, it will be critical to understand the gender sensitive impacts in more in-depth and find more sustainable solutions for the global problem that is adversely impacting the adolescent’s life, wellbeing, and development.

Despite the significant improvement in sanitation coverage , utilization of improved sanitation still does not reach the optimal level across all socioeconomic groups in India. Therefore, achieving improved sanitation facilities and reducing all forms of inequality United Nations Sustainable Development Goal [SDG 6.2] by 2030 is a big challenge to the most populous country in the world. Given this backdrop, this study examines the socioeconomic status-related inequality in the utilization of improved sanitation facilities among Indian Households. The study utilized fifth round of National Family Health Survey (NFHS); a national representative cross-sectional survey of India conducted in 2019–2021. Logistic regression was applied to estimate the effect of various predictors on utilization of improved sanitation facilities. We also used decomposition analyse to identify the factors responsible for utilization of improved sanitation. The results indicate that 69% of Indian households utilized improved sanitation facilities. The study highlights that young and unmarried household heads, lower education, poor household wealth status, living in rural areas, and marginalized social groups had lower access to improved sanitation facilities. The multivariate regression analysis suggested that households belonging to richer [AOR: 14.0; 95%, CI: 13.6–14.3] and richest [AOR: 46.7; 95%, CI: 45.0–48.5] wealth quintiles have 14 and 47-times higher odds of having sanitation facility than households which belong to poorest quintile respectively. The decomposition analysis suggested that 11 to 18% of inequality was explained by the geographical region and social group of household heads. The concentration curve of utilization of improved sanitation was more concentrated in Central and Eastern part of Indian households (Concentration Index: 0.51 and 0.47), which has reduced to 0.17 and 0.22 during NFHS-4 to NFHS-5. We also found that 68 districts out of 707 districts in India had less than 50% utilization of improved sanitation facilities. The study concludes that households with a better socioeconomic status were more able to access improved sanitation. Thus, inclusive strategies are needed to reduce socioeconomic inequality at the micro level and strengthen ongoing policies.

Exclusive use of hygienic methods during menstruation has not received adequate attention in Nepal, with limited research utilizing nationally representative data. Therefore, this study explored the prevalence and factors influencing exclusive hygienic menstrual practices among women of reproductive age in Nepal. This study included 13,065 reproductive-age women from the Nepal Demographic and Health Survey (NDHS-2022). To quantify the proportion of the total variance attributable to differences between communities, the study used multilevel logistic regression and identify significant factors of exclusive use of hygienic methods among women in Nepal. The concentration Index (CI) and Concentration curve (CC) were also calculated to measure the socio-economic inequality of exclusive use of hygienic methods among reproductive age women. Only 48% of Nepalese women aged 15- 49 years used exclusively hygienic methods to prevent bloodstains during menstruation. The results from multilevel model revealed that young women aged 15-24 (AOR = 2.52, p < 0.001), women with 10 years and above education (AOR = 1.98, p < 0.001) from the richest wealth quintile (AOR = 2.26, p < 0.001), never married women (AOR = 1.44, p < 0.001), owned a smartphone (AOR = 1.41, p < 0.001) and women with exposure to mass media at least once a week (AOR = 1.35, p < 0.001) are more likely to use hygienic methods as compared to their counterparts. The concentration curve results indicated that the exclusive use of hygiene methods is concentrated in women from higher economic backgrounds (CI: 0.21). Among the geographical regions of Nepal, the highest inequality was witnessed in Madhesh province (CI: 0.25), followed by Bagmati province (CI: 0.22). The findings suggest the need for multidimensional interventions and educational programs targeting socioeconomically vulnerable women to address unhygienic menstrual practices. Also, there is a need to educate adult women on biological facts and good hygienic practices, as they can impose cultural taboos and restrictions on the next generation.