With increasing girls’ enrolment in schools, school preparedness to ensure a menstrual friendly environment is crucial. The study aimed to conduct a systematic review regarding the existing evidence on menstrual hygiene management (MHM) across schools in India. It further aimed to highlight the actions that have been taken by the government to improve the MHM situation in India. We conducted the systematic literature search using PubMed, EMBASE, and Web of Science for searching the peer-reviewed articles and Google Scholar for anecdotal reports published from inception until 30 October 2019. Of 1125 publications retrieved through the search, 183 papers were included in this review, using a priori created data-extraction form. Meta-analysis was used to estimate the pooled prevalence (PP) of MHM practices in schools. Less than half of the girls were aware of menstruation before menarche (PP 0.45, 0.39 to 0.51, I² = 100.0%, n = 122). Teachers were a less common source of information about menstruation to girls (PP 0.07, 0.05 to 0.08, I² = 100.0%, n = 86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I² 100.0%, n = 11). MHM in schools should be strengthened with convergence between various departments for explicit implementation of guidelines.

Early adolescence is the period of the emergence of most mental disorders contributing significantly to the mental health burden globally, including India. The major challenges in India are early identification of mental health problems, treatment gap, lack of professionals, and interventions that address the same. Our review aimed to assess the effectiveness of mental health interventions among adolescents in India. We systematically searched PubMed, PsycINFO, and Cochrane databases and used cross-referencing to review the interventions published from 2010 to 2020. Eleven interventions were included in this review; nine were school-based, one community, and one digital. Most of the school-based programs used a life skills curriculum. Additionally, coping skills and resilience curricula showed improvement in depressive symptoms, cognitive abilities, academic stress, problem-solving, and overall mental well-being. The multi-component whole-school intervention was quite promising and helped in improving the overall school climate and various other mental health outcomes. Hence, school-based programs should be implemented as an entry point for screening mental health problems. However, there is a need for a more comprehensive mental health program in the country for adolescents. Additionally, there is a need to address the gap by conducting more interventions for early and out-of-school adolescents.

Background: Empowered women have improved decision-making capacity and can demand equal access to health services. Community-based interventions based on building women’s groups for awareness generation on maternal and child health (MCH) are the best and cost-effective approaches in improving their access to health services. The present study evaluated a community-based intervention aimed at improving marginalized women’s awareness and utilization of MCH services, and access to livelihood and savings using the peer-led approach from two districts of India.Methods: We used peer educators as mediators of knowledge transfer among women and for creating a supportive environment at the household and community levels. The intervention was implemented in two marginalized districts of Uttar Pradesh, namely Banda and Kaushambi. Two development blocks in each of the two districts were selected randomly, and 24 villages in each of the four blocks were selected based on the high percentage of a marginalized population. The evaluation of the intervention involved a non-experimental, ‘post-test analysis of the project group’ research design, in a mixed-method approach. Data were collected at two points in time, including qualitative interviews at the end line and tracking data of the intervention population (n = 37,324) through an online management information system.Results: Most of the women in Banda (90%) and Kaushambi (85%) attended at least 60% of the education sessions. Around 39% of women in Banda and 35% of women in Kaushambi registered for the livelihood scheme, and 94 and 80% of them had worked under the scheme in these two places, respectively. Women’s awareness about MCH seemed to have increased post-intervention. The money earned after getting work under the livelihood scheme or from daily savings was deposited in the bank account by the women. These savings helped the women investing money at times of need, such as starting their work, in emergencies for the medical treatment of their family members, education of their children, etc.Conclusion: Peer-led model of intervention can be explored to improve the combined health and economic outcomes of marginalized women.

Rabies is a fatal disease of the central nervous system caused by the bites of warm-blooded animals. One of the important methods of controlling rabies is by interventions to limit the number of dog bites, the most common source of transmission of rabies to humans in the community. Community-based data on dog bites are rare from India. The aim of this study is to determine the prevalence of dog bites and knowledge and practices relating to its management and prevention in an urban and a rural slum of North West Delhi, India. A cross-sectional house to house survey of 500 households covering a population of 2887 individuals was conducted. The families were selected by systematic random sampling. A pretested and a prevalidated questionnaire was used. Chi-square test was applied for comparing proportions related to the categorical variables and t-test was used for comparing means. The dog bite incidence rate for the study population for the last year was 25.2/1000 population with higher rates in urban (30.1/1000) than rural (19.6/1000) slum. Two-fifths of the dog bite patients did not wash the wound with soap and water. The practice of washing the wound with soap and water was significantly higher in urban than rural slum. One-fifth of the patients did not receive anti-rabies vaccine. There was lower coverage in rural than urban slum. A majority (79.0%) of the patients did not receive anti-rabies serum. A high prevalence of dog bites coupled with poor knowledge and dog bite management practices is a worrisome trend which policy makers should take into account to make India rabies free.

Introduction: The role of community health workers in healthcare delivery system is considered inevitable to meet the goal of universal healthcare provision. The study was planned to assess the knowledge and practices for maternal health care delivery among Accredited Social Health Activist (ASHA) workers in North-East district of Delhi, India. Materials and Methods: A descriptive cross-sectional study was conducted in North-East district of Delhi among 55 ASHA workers after taking written informed consent. Data were collected using a pretested semi-structured questionnaire consisted of items on sociodemographic profile of ASHA workers, knowledge, and practices about maternal health. The data was analyzed by using SPSS software version 17. Qualitative data were expressed in percentages and quantitative data were expressed in mean ± standard deviation (SD). Results: Mean age (±SD) of ASHAs was 31.84 ± 7.2 years. Most of the ASHAs workers were aware of their role in provision of maternal health services. Most of the ASHAs workers were aware of their work of bringing mothers for antenatal check-up (94.5%), counseling for family planning (96.4%), and accompanying them for hospital for delivery (89.1%). 87% of ASHAs knew that iron tablets have to be taken for minimum 100 days during pregnancy. 51 (92.7%) ASHAs reported that they used to maintain antenatal register. Some problems reported by ASHAs while working in community were shortage of staff at health center (16.4%), no transportation facility available (14.5%), no money for emergency, and opposition from local dais (12.7% each). Conclusion: Present study showed that ASHAs knowledge is good but their practices are poor due to number of problems faced by them which need to be addressed through skill based training in terms of good communication and problem solving. Monitoring should be made an integral part of ASHA working in the field to ensure that knowledge is converted into practices as well.

Nutritional deficiencies among women of reproductive age, especially from socially backward classes, are widely prevalent in India. The present study aimed to assess the nutrient intakes and analyse their associations with sociodemographic attributes among socially backward adolescent girls, newly married women, pregnant women, and lactating mothers from four districts of India. Further, the study looked at the associations between nutrient intakes and anthropometric measurements (body mass index, BMI; waist circumference; and waist-hip ratio, WHR) among adolescents and newly married women. This community-based cross-sectional study used the 24-hour recall method of the dietary survey to assess the food intake of women and girls. Nonparametric tests of associations between sociodemographic characteristics and the median nutrient intakes were conducted. Expected and observed increments in energy and nutrient intakes of pregnant and lactating women from the base (requirement of an adult woman) were calculated. A total of 477 pregnant women, 455 lactating mothers, 532 newly married women, and 223 adolescent girls were interviewed. According to the 24-h dietary recall, only 35% of adolescent girls, 57% newly married women, 40% pregnant women, and 34% lactating mothers were able to meet 70% of the recommended energy requirements. A large percentage of pregnant women had less than 50% of the recommended intakes of iron, calcium, and folic acid. Women living in nuclear families, urban slums, and those from backward classes had lower intakes of almost all the nutrients compared to their counterparts (p<0.001). There were no significant differences in the nutrient intakes of adolescents, newly married, pregnant, and lactating women, and all had poor dietary intakes. We found positive relationships of all three anthropometric measurements (BMI, waist circumference, and WHR) with fats and inverse associations with carbohydrates. Public health interventions should work towards improving the nutrition of these vulnerable populations.