Background: Breast cancer and cervical cancer, the most common forms of cancer in women worldwide, are on a fast and steady rise, accounting for more deaths in women than any other cancer in the developing world. Cancer screening tests are an important tool to combat cancer-related morbidity and mortality. World Health Organization aims to accelerate action to achieve Goal 3.4 of the Sustainable Development Goals (SDG 3.4) in order to reduce premature mortality from non-communicable disease, including cancer by one-third by 2030. This study aims to examine the geospatial variation of cervical and breast screening across districts and to identify factors that contribute to the utilization of screening among women in India. Methods: Until recently, there was no evidence pertaining to screening for cervical and breast cancers at the national level. Information on examination of the breast and cervix from over 699,000 women aged 15–49 years was collected for the first time in the fourth round of National Family Health Survey, 2015–16 (NFHS-4). For the present study, the data were aggregated for all 640 districts in India. Moran’s Index was calculated to check for spatial autocorrelation. Univariate Local Indicators of Spatial Association (LISA) maps were plotted to look for spatial dependence associated with the uptake of screening practices. The spatial error model was employed to check for spatial magnitude and direction. Results: The common factors associated with uptake of both cervical and breast screening at the district level were; women belonging to a general caste, residing in rural areas, being currently married, and being well-off economically. Being insured was positively associated with the uptake of cervical screening only. This study provides spatial inference by showing geographical variations in screening of cervix and breast across districts of India. Conclusions: By showing geographical disparities in screening practices across districts of India, this study highlights the importance of ensuring a region-specific and organ-specific approach towards control and prevention of cancer. The identified factors responsible for the uptake of screening could be a guiding force to decide how and where tailored interventions may be best targeted.

Child malnutrition, comprising of undernutrition and obesity, is a global concern with severe implications for survival, leading to acute and chronic diseases that adversely affect the productivity of individuals and society. Asia shoulders the greatest burden, with 7 out of 10 undernourished children residing in the region. Despite the decline in global child stunting, particularly in Asia, its prevalence remains significant. In 2017, an estimated 151 million children under five experienced stunting, and an additional 38 million were overweight, with Africa and Asia accounting for 25% and 46% of the global figures, respectively. Therefore, this paper aims to analyze the geospatial and environmental determinants of undernutrition in rural South and Southeast Asia. To explore the geospatial and environmental determinants of undernutrition (stunting, wasting, and underweight), we use Poisson regression and the data from recent rounds of the Demographic and Health Survey (DHS) from India, Bangladesh, Pakistan, Nepal, Cambodia, and Timor-Leste. This study found a high prevalence of stunting, wasting, and underweight among children aged 0 to 59 months in rural areas of South and Southeast Asia, with considerable variation between countries and clusters/primary sampling units. Results show a positive association between child malnutrition and factors such as maternal illiteracy, unsafe drinking water, and dirty cooking fuel in South and Southeast Asia. Children from impoverished households in India, Pakistan, and Cambodia were disproportionately affected. In addition to socio-economic factors, climatic risks such as temperature increase and rainfall variations also emerged as important determinants of child malnutrition in India, Bangladesh, and Timor-Leste. This paper emphasizes the role of environmental and climatic factors on child nutrition, underscoring their significance regardless of socio-economic conditions. As the impacts of climate change continue to intensify, and agrarian societies bear the brunt, these factors will play a critical role in shaping child nutritional outcomes. Thus, amid growing climate change, nutritional security should be prioritized, considering the spatial domain and targeting climate distress areas along with other socio-economic and demographic aspects.

•Women over age 40, from lower socio-economic status and those widowed/divorced are at elevated risk.•Diabetes, hypertension, obesity and unhealthy diet are the major risk factors.•Treatment-seeking is higher in women over age 40, from upper socio-economic status and those married.•Autonomy, accessibility, affordability and availability influence treatment-seeking behaviour.

Hypertension has been the most common non-communicable disease in low and middle-income countries for the past two decades, increasing cardiovascular and renal disease risk. Urbanization, aging, dietary and lifestyle changes, high illiteracy rates, poor access to health facilities, poverty, high costs of drugs, and social stress have contributed to an increase in the prevalence of hypertension in developing countries. Nonetheless, little is known about the comprehensive risk factors associated with prehypertension and hypertension among economically active adult populations of South Asia, such as India, Nepal, and Bangladesh. This paper uses the Demographic and Health Survey data of 637,396 individuals from India (2019–21), 8,924 from Nepal (2016), and 8,613 from Bangladesh (2017–18) to examine the prevalence and driver of prehypertension and hypertension. We analyze the prevalence of prehypertension because it leads to hypertension and is directly related to cardiovascular disease, and many people live with it for prolonged periods without realizing it. The paper finds, among other things, that the prevalence of prehypertension and hypertension among adults (18–49 years) is 43.2 and 14.9% in India, 35.1% and 19.8% in Bangladesh, and 25.2% and 13.8% in Nepal, respectively. Better educated, wealthy individuals living in urban areas of developing economies in the South Asian region are more likely to have prehypertension and hypertension. The paper suggests the urgent need to launch preventive programs to reduce prehypertension before it develops to be hypertension as a precautionary measure. Thus, such measures shall help to prevent hypertension, thereby improving the overall wellbeing of individuals and families.

Introduction: Transition to the oldage marks a change in work and social participation. Socio-economic and physical conditions arising from this change pose a risk for cognitive outcomes among the elderly. Gender shows different pathways to deal with the pattern of participation and to maintain cognitive health. In India, work participation in the oldage is an outcome of financial deprivations and lack of support. At the same time, alterations in social interactions can induce stress and precipitate cognitive decline in oldage. A dearth of studies in this domain motivates us to estimate the effect of change in work and social participation on cognitive performance of the elderly in the Indian context.Methods: The study has used the cross-sectional data on 5212 elderly from the World Health Organization’s Study on global AGeing and adult health (Wave 1) (2007–08) in India. A composite score for cognition was generated. Interaction between gender, work status and social participation with respect to cognition was performed using multivariate linear regression. A linear prediction of the cognitive scores across all levels of social participation was post-estimated thereafter.Results: The study found that the elderly who were ‘presently working’ and showed ‘more’ social participation had a higher mean score for cognitive performance than their counterparts. Results of regression did not indicate any gender interaction with work or social participation. Participation in social activities ‘sometimes’ by those who were ‘retired’ or ‘presently working’ showed a positive and significant co-efficient with cognition among respondents. The post-estimated values for cognition specified that ‘retired’ and ‘presently working’ elderly had higher cognition scores. In the age group of 60–69 years, cognition scores were higher for those who were ‘retired’ and did ‘more’ social participation as compared to the other elderly.Conclusion: Cognitive aging is attenuated by higher participation in work and social activities. Adequate financial schemes or the pension system can protect the elderly from developing further stress. Retirement at an appropriate age, along with a reasonable amount of social participation, is a boon for cognitive wellbeing. Hence, building more support can contain the detrimental effect of participation restriction on cognitive outcome among elderly.

Objective: To assess how exposure to multiple, layered interventions predicts HIV-related outcomes among adolescent girls (15–19 years) and young women (20–24 years) in Kenya. Design: Survey data from adolescent girls and young women (n = 736) with 14–16 months of engagement with DREAMS, a comprehensive HIV prevention program that provides a range of health education, life skills, social protection, and social and behaviour change interventions. Methods: Nonparametric recursive partitioning technique – classification and regression tree (CART) – to identify the best predictors (DREAMS interventions) for achieving the desired HIV-related outcomes (consistent condom use and no transactional sex or sexual violence). Results: Among adolescent girls, schooling support reduced the likelihood of engaging in transactional sex, whereas schooling support and exposure to parenting program reduced the likelihood experiencing sexual violence. Likelihood of consistent condom use increased among adolescent girls with exposure to preexposure prophylaxis (PrEP), schooling support, and the violence prevention programming. Among young women, multiple pathways reduced the likelihood of engaging in transactional sex: exposure to the male sexual partner program; exposure to the youth fund program; exposure to the violence prevention program; or exposure/engagement with schooling support, parenting programming, and the youth fund program. For young women, consistent condom use increased with schooling support and male partner engagement. Additionally, engagement in violence prevention program and male partner engagement increased the likelihood of not experiencing sexual violence among young women. Conclusion: Exposure to a combination of DREAMS interventions predicted outcomes that can reduce HIV risk among AGYW, though the pathways differed by outcome and age group.