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Non‐governmental organizations (NGOs), governmental organizations, or other entities may run their projects as external interventions within a community to reduce disaster risks and adapt to future climatic events. These external interventions may influence the community to take further adaptation measures for enhancing community resilience. The spontaneous adaptation process, referring as responsive adaptation, needs to be identified and acknowledged. This research aims to investigate the impacts of external interventions on the responsive adaptation process by studying a riverside flood‐prone urban slum in Bangladesh. This settlement experienced a site development project, primarily run by an NGO, that allowed several modifications to the built environment, mainly targeting flood risks. Selected tools of participatory rural appraisal (PRA) or participatory urban appraisal (PUA) methods were employed to obtain data about the community's initiatives for further development. The results show that the site development project, especially its impacts on reducing flood risks, has influenced community members to invest in improving the condition of their individual houses. As a means of responsive adaptation, the conscious developments of their houses contribute to enhancing the resilience level. Through exploring the community's initiatives, this research identifies that the engagement of communities with their knowledge and investments can extend the success of the external intervention. [ABSTRACT FROM AUTHOR]

Among other focus areas, the global Sustainable Development Goals (SDGs) 3 and 11 seek to advance progress toward universal coverage of maternal, neonatal, and child health (MNCH) services and access to safe and affordable housing and basic services by 2030. Governments and development agencies have historically neglected the health and well-being associated with living in urban slums across major capital cities in sub-Saharan Africa since health policies and programs have tended to focus on people living in rural communities. This study assessed the trends and compared inequities in MNCH service utilization between slum and non-slum districts in the Greater Accra region of Ghana. It analyzed information from 29 districts using monthly time-series Health Management Information System (HMIS) data on MNCH service utilization between January 2018 and December 2021. Multivariable quantile regression models with robust standard errors were used to quantify the impact of urban slum residence on MNCH service utilization. We assessed the inequality of MNCH coverage indicators between slum and non-slum districts using the Gini index with bootstrapped standard errors and the generalized Lorenz curve. The results indicate that rates of vaccination coverage and antenatal care (ANC) attendance have declined significantly in slum districts compared to those in non-slum districts. However, skilled birth delivery and postnatal care (PNC) were found to be higher in urban slum areas compared to those in non-urban slum areas. To help achieve the SDGs' targets, it is important for the government of Ghana and other relevant stakeholders to prioritize the implementation of effective policies, programs, and interventions that will improve access to and utilization of ANC and immunization services among urban slum dwellers. [ABSTRACT FROM AUTHOR]

Introduction: The nutritional well being of a population is both an outcome and an indicator of national development. Reducing infant and child deaths and improving the level of nutritional status of the child is one of the important priority areas for Government of India. One of the important ways to achieve desired reduction of infant mortality is to ensure 100% exclusive breastfeeding for first 6 months followed by appropriate complementary feeding along continuation of breastfeeding. Objective: To study the prevalence of Breastfeeding practices of children less than 2years Methodology: The present study is a cross sectional study conducted in slums of AMC during June 2018 to August 2019. A total of 840 children between 0 to 2 years were selected using cluster sampling method. The Predesigned pretested proforma comprised of socio demographic details, components of antenatal care and breastfeeding practices of infants up to 24 months was used. The data so collected was entered into computer using appropriate software. The data was then analyzed for various parameters and cross tabulation was done using appropriate software. Results: Breastfeeding within one hour was received by 53.2% of children. 61.9% of the children were given pre lacteal feeding after birth as a part of ritual. Only (70.8%) of the children had received colostrum. One third (33.3%) of children less than 24 months of age, were receiving feedings other than breast-milk. Majority (60%) of children had received breastfeeding for 6 months. [ABSTRACT FROM AUTHOR]

Abstract Background Rapid urbanisation without concomitant infrastructure development has led to the creation of urban slums throughout sub-Saharan Africa. People living in urban slums are particularly vulnerable to food insecurity due to the lack of physical and economic accessibility to food. Hence, it is important to explore how vulnerable groups living in slums interact with the food environment. This study assessed the relationships between food insecurity, including restrictive coping strategies, food purchasing patterns and perceptions about the food environment among dwellers of selected urban slums in Ibadan, Nigeria. Methods This community-based cross-sectional study was conducted with people responsible for food procurement from 590 randomly selected households in two urban slums in Ibadan. Food insecurity and restrictive coping strategies were assessed using the Household Food Insecurity Access Scale and the Coping Strategy Index, respectively. We examined purchasing patterns of participants by assessing the procurement of household foodstuffs in different categories, as well as by vendor type. Participants’ perceptions of the food environment were derived through a five-item composite score measuring food availability, affordability and quality. Chi-square tests and logistic regression models analysed associations between food insecurity, purchasing patterns and perceptions of the food environment. Results The prevalence of food insecurity in the sample was 88%, with 40.2% of the households experiencing severe food insecurity. Nearly a third (32.5%) of the households used restrictive coping strategies such as limiting the size of food portions at mealtimes, while 28.8% reduced the frequency of their daily meals. Participants purchased food multiple times a week, primarily from formal and informal food markets rather than from wholesalers and supermarkets. Only a few households grew food or had livestock (3.2%). Food insecure households had a lower perceived access to the food environment, with an approximate 10% increase in access score per one-unit decrease in food insecurity (AOR = 0.90, 95% CI: 0.84, 0.96). The most procured foods among all households were fish (72.5%), bread (60.3%), rice (56.3%), yam and cassava flours (50.2%). Food-secure households procured fruit, dairy and vegetable proteins more frequently. Conclusion Food insecurity remains a serious public health challenge in the urban slums of Ibadan. Perceptions of greater access to the food environment was associated with increasing food security. Interventions should focus on creating more robust social and financial protections, with efforts to improve livelihoods to ensure food security among urban slum-dwellers.

Objective: To assess the factors associated with knowledge, attitude and behavior of contraception use among urban slum population in Chennai. Methods: A cross-sectional study was conducted in the urban slum of Anakaputhur, Chennai. Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling. Pregnant women, postnatal and postmenopausal women were excluded from the study. Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge, attitude, and practices. Data analysis was done using IBM SPSS version 22. Analytical test like Chi square and odds ratio (OR) were used to identify association between knowledge, attitude, and behavior of contraception with the associated variables and enter method of logistic regression analysis was done. Results: Out of the 360 respondents, 228 were females, with a mean age of (34±5) years. Approximately 43% demonstrated adequate knowledge of contraception use, and 91% were aware of at least one contraceptive method. Notably, 72% exhibited a positive attitude towards contraceptive use. Nevertheless, 43% (155 individuals) did not utilize any contraceptive method. Among contraceptive users, intrauterine devices were the most commonly adopted, followed by barrier methods and female sterilization. There was significant association between knowledge of contraception and education (aOR 7.29, 95% CI 2.93-18.10, P

Background: Rapid urbanisation without concomitant infrastructure development has led to the creation of urban slums throughout sub-Saharan Africa. People living in urban slums are particularly vulnerable to food insecurity due to the lack of physical and economic accessibility to food. Hence, it is important to explore how vulnerable groups living in slums interact with the food environment. This study assessed the relationships between food insecurity, including restrictive coping strategies, food purchasing patterns and perceptions about the food environment among dwellers of selected urban slums in Ibadan, Nigeria. Methods: This community-based cross-sectional study was conducted with people responsible for food procurement from 590 randomly selected households in two urban slums in Ibadan. Food insecurity and restrictive coping strategies were assessed using the Household Food Insecurity Access Scale and the Coping Strategy Index, respectively. We examined purchasing patterns of participants by assessing the procurement of household foodstuffs in different categories, as well as by vendor type. Participants' perceptions of the food environment were derived through a five-item composite score measuring food availability, affordability and quality. Chi-square tests and logistic regression models analysed associations between food insecurity, purchasing patterns and perceptions of the food environment. Results: The prevalence of food insecurity in the sample was 88%, with 40.2% of the households experiencing severe food insecurity. Nearly a third (32.5%) of the households used restrictive coping strategies such as limiting the size of food portions at mealtimes, while 28.8% reduced the frequency of their daily meals. Participants purchased food multiple times a week, primarily from formal and informal food markets rather than from wholesalers and supermarkets. Only a few households grew food or had livestock (3.2%). Food insecure households had a lower perceived access to the food environment, with an approximate 10% increase in access score per one-unit decrease in food insecurity (AOR = 0.90, 95% CI: 0.84, 0.96). The most procured foods among all households were fish (72.5%), bread (60.3%), rice (56.3%), yam and cassava flours (50.2%). Food-secure households procured fruit, dairy and vegetable proteins more frequently. Conclusion: Food insecurity remains a serious public health challenge in the urban slums of Ibadan. Perceptions of greater access to the food environment was associated with increasing food security. Interventions should focus on creating more robust social and financial protections, with efforts to improve livelihoods to ensure food security among urban slum-dwellers. [ABSTRACT FROM AUTHOR]

The article explores the social and environmental factors affecting hygiene practices among residents of urban slums in Lucknow, India, revealing alarming gaps in hygiene and access to resources. Topics include gender disparity in hygiene practices, with a low percentage access to basic sanitation facilities, India's ongoing sanitation challenges despite efforts to improve conditions, and the broader implications of inadequate sanitation for public health and waterborne diseases.

Abstract Non‐governmental organizations (NGOs), governmental organizations, or other entities may run their projects as external interventions within a community to reduce disaster risks and adapt to future climatic events. These external interventions may influence the community to take further adaptation measures for enhancing community resilience. The spontaneous adaptation process, referring as responsive adaptation, needs to be identified and acknowledged. This research aims to investigate the impacts of external interventions on the responsive adaptation process by studying a riverside flood‐prone urban slum in Bangladesh. This settlement experienced a site development project, primarily run by an NGO, that allowed several modifications to the built environment, mainly targeting flood risks. Selected tools of participatory rural appraisal (PRA) or participatory urban appraisal (PUA) methods were employed to obtain data about the community's initiatives for further development. The results show that the site development project, especially its impacts on reducing flood risks, has influenced community members to invest in improving the condition of their individual houses. As a means of responsive adaptation, the conscious developments of their houses contribute to enhancing the resilience level. Through exploring the community's initiatives, this research identifies that the engagement of communities with their knowledge and investments can extend the success of the external intervention.

BackgroundUnderstanding the level of inadequate water, sanitation, and hygiene (WaSH) services in urban and rural settlements is crucial for prioritizing community interventions and resource allocation. However, there is a lack of evidence regarding discrepancies in WaSH services across rural and urban slum communities in Ethiopia.ObjectiveThis study aims to assess inequalities in households’ WaSH services and their associated factors among urban slums and rural communities in Eastern Ethiopia from February to April 2024.MethodsA comparative community-based cross-sectional study design was conducted, with study participants selected through stratified random sampling using proportional-to-size allocation. Data were entered into Epi Data version 3.1 and then exported to STATA version 17 for analysis. Bi-variable and multivariable logistic regression was conducted, and associations were reported as odds ratios (ORs) with 95% confidence intervals (CI), using a p-value less than 0.05 as the significance threshold.ResultA total of 278 urban and 301 rural households participated in the study, with a response rate of 94%. Key indicators showed that WaSH services were significantly better in urban areas compared to rural households. For example, 98% (95% CI: 96, 99) of urban households had access to an improved water source compared to 76% (95% CI: 71, 80) of rural households. The proportion of households with improved latrines was 44% (95% CI: 38, 50) in urban areas and only 14% (95% CI: 11, 19) in rural areas. Handwashing practices at all five critical times were reported by 52% (95% CI: 46, 58) of urban household heads, compared to 22% (95% CI: 18, 27) of rural households. Additionally, occupation (such as being a farmer, p = 0.000) and water service satisfaction (p = 0.000) were significantly associated with these key WaSH outcomes.ConclusionThe study revealed that the WaSH services in urban slums are considerably better than in rural households. Socioeconomic factors significantly influence the existing disparities in WaSH services. Stakeholders should focus on providing targeted, strategic support to communities to address the challenges in WaSH service provision.

Background: Essential life skills are a vast range of psychological and interpersonal abilities that can help people lead healthy and productive lives, make informed decisions, communicate effectively, and build coping and self-management skills. Adolescence is the building block for these skills, and the current study was planned to estimate these life skills among school-going children in a slum area. Methodology: The study was conducted in a slum area of Mumbai, where 158 adolescents (10–19 years) were selected by systematic random sampling. The assessment of sociodemographic profile and life skills based on five domains: time management, communication, leadership, goal setting, and coping skills, was done for 1.5 years. Results: The study involved participants with a mean age of 15 ± 2.3 years, primarily in early (40.5%) and mid (39.2%) adolescence. Females constituted 51.3%, with 57.6% from UP and 18.4% from Bihar. Most families had male heads, mostly educated till middle school or illiterate. Mothers were often illiterate or had a primary school certificate. Participants typically had 3–5 siblings and stayed with their parents. The mean global life skills score was 212.9. Conclusions: The study will act as a road map for curriculum planning and designing of extracurricular activities for adolescents so that their life skill scores increase and they grow up as better human beings.

Introduction: The majority of Indian women tend to ignore and neglect their menopausal symptoms, which can diminish in intensity over time, leading to a reduced health-related quality of life. We aimed to assess the health-care-seeking behavior of postmenopausal women in light of the increasing burden of menopausal symptoms. Methodology: A cross-sectional study was carried out within urban neighborhoods, involving 384 postmenopausal women aged 45–60, to investigate the health-related issues they faced. The Menopause Rating Scale (MRS) was used to assess the symptoms experienced during the postmenopausal stage. In addition, a predesigned and pretested questionnaire was used to gather information on their health-care-seeking behavior. The participants underwent a comprehensive physical examination, including anthropometric measurements. To analyze the data, descriptive statistics were used. Results: The results showed that 34% of the 384 women were between the ages of 45 and 49 years. Based on the MRS assessment, it was found that around 70% of women experienced mild symptoms, whereas 24% had moderate symptoms, and a mere 2% reported severe symptoms. Regarding treatment, approximately 85% of women had sought medical intervention. However, satisfaction with the treatment was reported by only 71% of the participants. Among the women with modest symptoms, 70% received medical care, compared to 28% of the women with moderate symptoms. Women who were employed, widowed, three-generation family women, and Class IISES women made the most use of health-care facilities, with 90%, 89%, 88%, and 97%, respectively. Conclusion: The prevalence of faint symptoms was significantly higher than that of moderate and severe symptoms. Although most women sought treatment, many were unsatisfied with it. Therefore, behavior modification communication is necessary among postmenopausal women who seek medical care. In addition, the National Health Mission should incorporate components addressing the specific health requirements of postmenopausal women. [ABSTRACT FROM AUTHOR]

Introduction: The quality of drinking water is a public health concern, especially in urban slum areas. Drinking water quality and contamination are seriously threatened by the growing slum population and irregular water supply. Objective: To examine the physicochemical and microbiological quality of drinking water in the field practice area of one of the Tertiary-care hospital in Ahmedabad a part of PG teaching activity. Method: A cross-sectional study was carried out for water quality assessment using stratified random sampling. A total of 139 water samples were collected; samples were collected from different households in different areas of the Asarwa ward of Ahmedabad Corporation. From each ASHA worker’s area, according to population of that area, 6 to 10 samples were selected. The samples were analysed using standard methods and compared with WHO and BIS water quality standards. Results: TDS and alkalinity are above permissible levels in 42.4% and 46.7% samples respectively. pH, turbidity, conductivity, total hardness, and magnesium were found altered in a few samples. The mean free residual chlorine was 0.05 mg/L. Microbiological analysis of water samples revealed the presence of coliform in 5 (3.6%) samples. Conclusion: Except for total alkalinity and TDS, most physicochemical parameters of drinking water were acceptable. By storing water, a low level of free residual chlorine can be justified. A few samples (3.6%) with coliform bacteria indicate water contamination somewhere in the distribution system or at the consumer level.

Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare. [ABSTRACT FROM AUTHOR]

Background: India experiences a growing aging population and prioritizing the comprehension of respiratory health concerns among the elderly becomes crucial. Those in the elderly demographic residing in urban slums confront notable socioeconomic obstacles and encounter restricted healthcare accessibility, heightening their vulnerability to respiratory illnesses. Therefore, examining respiratory health in this specific urban context provides insights into how living conditions impact the health of vulnerable populations. Objectives: The present study aims to evaluate the occurrence of respiratory abnormalities among slum-dwelling elderly women and also to determine the concomitant factors responsible for respiratory abnormalities among them. Material and Methods: The study includes a total of 261 elderly women aged 60 years and above living in slum areas of Kolkata. The standard protocols were followed to collect spirometry and anthropometric data. Descriptive and inferential statistical analyses were performed to satisfy the study objectives. Results: The majority of the participants show forced vital capacity (FVC) and forced expiratory volume in one second (FEV0.1) below the predicted level, indicating the presence of mild-to-moderate respiratory abnormality. Chronic obstructive respiratory disease (COPD) was observed in 15.2% of elderly women, significantly higher than the national average. The study identified significant correlations between age and respiratory abnormalities. Factors such as overcrowded living conditions, the absence of a separate kitchen, and the use of certain cooking fuels increased the likelihood of COPD. Body fat percentage was found to be inversely related to FVC, FEV0.1, and COPD. Conclusion: The poor living conditions and a few other associated factors are indicative of developing respiratory problems among elderly individuals. As the global population ages, this study contributes valuable insights for public health strategies, emphasizing the need for tailored approaches to address the specific challenges faced by elderly women in urban slums in the megacity of Kolkata. [ABSTRACT FROM AUTHOR]

Background: Urban slum dwellers face significant challenges, including overcrowded living conditions, inadequate access to basic necessities, and limited socio-economic opportunities, which adversely affect their mental health. Despite the high prevalence of mental health issues in slum populations, there is a dearth of research addressing this aspect of well-being. Aim: This study aimed to investigate the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. Material and Methods: The study employed a cross-sectional design to examine mental health status and predictors among urban slum dwellers in District Rohtak, Haryana. Using simple random sampling, 301 subjects from the slum area were selected, ensuring demographic representation. A socio-demographic data sheet, the Modified Kuppuswamy scale, and the Mithila Mental Health Status Inventory were administered. Results: The findings revealed a moderate level of mental health challenges among urban slum dwellers, with age, gender, education, occupation, family income, and socioeconomic status identified as the strongest predictors of mental health (F = 7.69, p < .001), accounting for 29.9% of the variance. The remaining variance is attributed to variables not included in the study. Conclusion: This study sheds light on the social determinants and predictors of mental health among urban slum dwellers in Rohtak, Haryana, India. The findings underscore the significant impact of socio-demographic factors such as age, gender, education, occupation, family income, and socioeconomic status on mental health status. [ABSTRACT FROM AUTHOR]

Poor hand hygiene practice has been linked to an increase in the number of infections among children in urban slums. Hands are considered an intersection for bacterial transmission, but it is unclear whether the handwashing technique affects bacteria elimination. This study investigated the effect of handwashing on the concentration of Escherichia coli (E. coli) and factors related to its reduction among children in an urban slum in Bandung, Indonesia. We observed handwashing and conducted repeated hand swabs before and after handwashing among 137 participants. The mean E. coli concentration on the hands decreased after handwashing, with a higher reduction in E. coli count among students who used soap and had soap contact for more than 10 s during handwashing. Cleaning in-between fingers, using soap, soap contact for more than 10 s, and drying hands with a single-use towel were effective factors for reducing E. coli concentration after handwashing (p < 0.05). More than half of the swab samples (59%) tested positive for E. coli after handwashing, indicating that the children's handwashing technique was not effective in completely removing E. coli from the hands. Moreover, sustained and consistent handwashing practice as a daily behavior in children would maximize the effect. HIGHLIGHTS Fecal contamination was detected on the hands of students before and after handwashing.; The children's handwashing practice falls short of the standard, which affects the level of reduction of fecal contamination.; The short duration of soap contact with the hand (

Access to safe water, proper sanitation, and hygienic practices are fundamental to the growth and survival of children. This study assessed the relationship between water, sanitation, and hygiene (WASH) practices and the nutritional status of children aged 6–59 months in the Beere/Oja-Oba community, Ibadan, Oyo State. This cross-sectional study involved 200 mothers/caregivers with under-five children. WASH practices were assessed using an interviewer-administered questionnaire. Anthropometric measurements were taken and analyzed using WHO Anthro. Data were analyzed using SPSS at p < 0.05. The mean age of the children was 24.91±10.52, and the majority were females (77.5%). Prevalence of stunting (44.0%), wasting (37.5%), and underweight (34.0%) were high among the children. Well (71.5%) and tap/borehole (74.0%) were the major sources of domestic and drinking water respectively, and required 5–15 min (36.9%) to source. The occurrence of diarrhea was high (48.5%) among the children. Time to drinking water source and washing a child's hands before feeding were WASH practices significantly associated with stunting (p = 0.000) and underweight (p = 0.003) among the children from lower socio-economic households (p = 0.045). Access to unsafe water was significantly associated with child malnutrition. There is a need to educate and encourage mothers/caregivers to improve their hygiene practices in the community. HIGHLIGHTS This research showed that most households in the location do not have easy access to safe water.; The prevalence of malnutrition was high among the under-five children.; More than half of the under-five children had diarrhea within 2 weeks prior to data collection.; There is a need to increase awareness campaigns for mothers and caregivers on the health implications of poor hygiene and sanitation practices.;

Background: Breastfeeding is considered the most important source of nutrients for the baby. But owing to ignorance, lack of education, and cultural norms, exclusive breastfeeding (EBF) is not done by majority of the mothers. Hence, this study is carried out to determine various barriers faced by the mothers that influenced their decision on EBF. Methods: A descriptive qualitative study was conducted among the mothers whose children were less than 1 year of age visiting a well-baby clinic and Immunisation OPD of Urban Health Centre catering to the Urban Slum of Malvani in the Metropolitan city of Mumbai. In-depth interviews (IDIs) were done with 17 participants from August to November 2022. Thematic analysis was conducted on the qualitative data obtained. Results: Four major themes were generated from the transcripts. They are –barriers and concerns faced by mothers to exclusively breastfeed, enablers/motivators, sources of knowledge regarding EBF, and breastfeeding practices. Various barriers faced by mothers were gaps in knowledge, maternal Illness, religious reasons, inadequate milk production, bias toward top feeds, lack of autonomy to take decisions, and cultural norms, while positive family support, good knowledge about breastfeeding, and a supportive home environment motivated mothers to exclusively breastfeed their infants. Sources of knowledge were identified to be doctors and health care workers, mothers/mothers-in-law, sisters, friends, and social media. Conclusions: There are various challenges as well as motivators identified for EBF. Barriers, such as gaps in knowledge, and the negative influence of social media can be improved upon by health education. Therefore, it is crucial to teach expectant mothers as well as families about breastfeeding. Additionally, we advise stepping up public health education initiatives to support breastfeeding.

Abstract Background/introduction One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions. Objectives This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria. Method Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis. Results Six FGD sessions, divided by gender and age, were conducted between September–October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, “epa Ijebu” (a dentrifice), and “orin ata” (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes. Conclusion The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self‐care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people’s education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

Abstract Background Globally, major emphasis has been placed on understanding the physiological consequences of losing a pregnancy. However, its mental health impact on socially disadvantaged women remains unexplored. To further inform the field the present study investigated the prevalence and factors associated with the development of depressive symptoms and anxiety among women with a history of spontaneous abortion living in the urban slums of Dhaka, Bangladesh. Methods Information was obtained from 240 women who experienced a spontaneous abortion from July 2020 to December 2021. It was obtained through the urban health and demographic surveillance system (UHDSS) survey. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to measure mental health symptoms. Bivariate and multivariate linear regression analyses were performed to assess the associated factors with the mental health outcomes. Results Of the 240 women, majority (77.50%) of the women experienced mild to severe depressive symptoms and more than half (58.75%) of the respondants experienced mild to severe anxiety, within one and half years of experiencing spontaneous abortion. A higher level of education and being employed were protective factors for anxiety and depressive symptoms, respectively. However, women with higher sexual and reproductive health rights (SRHR) knowledge had significantly increased anxiety and depressive symptoms. In contrast, receiving post-abortion care (PAC) was associated with decreased anxiety and depressive symptoms. Conclusion The findings indicate that ensuring access to affordable PAC services and integrating mental health services into the standard PAC service package is crucial. This study also emphasizes the importance of providing education for women living in urban slums and encouraging them to participate in economic activities.

Purpose: The present study intends to highlight the issues and challenges pertinent to sanitation practices among urban slum women in India. Design/methodology/approach: The primary qualitative data has been collected from 100 households sampled by stratified random and purposive sampling through in-depth interviews, and a structured interview schedule and themes were developed accordingly. Findings: The main theme-based results of the study included the challenges of open defecation in slums, public toilets as an alternative, sanitation-related stress in slum women, compromised state of health of women and children, menstrual hygiene among women in slums and increasing burden on women in terms of water management. The study recommends the creation of toilets in every slum locality with maintenance and awareness to be raised. Originality/value: Urban sanitation has received less research than rural sanitation. The present study focused on the issues of urban sanitation, which are often neglected. To ensure the study's uniqueness, researchers visited and mentioned each open defecation site to understand the situation. Peer review: The peer-review history for this article is available at: https://publons.com/publon/10.1108/IJSE-12-2022-0782 [ABSTRACT FROM AUTHOR]

Poor hand hygiene practice has been linked to an increase in the number of infections among children in urban slums. Hands are considered an intersection for bacterial transmission, but it is unclear whether the handwashing technique affects bacteria elimination. This study inves- tigated the effect of handwashing on the concentration of Escherichia coli (E. coli) and factors related to its reduction among children in an urban slum in Bandung, Indonesia. We observed handwashing and conducted repeated hand swabs before and after handwashing among 137 participants. The mean E. coli concentration on the hands decreased after handwashing, with a higher reduction in E. coli count among students who used soap and had soap contact for more than 10 s during handwashing. Cleaning in-between fingers, using soap, soap con- tact for more than 10 s, and drying hands with a single-use towel were effective factors for reducing E. coli concentration after handwashing (p, 0.05). More than half of the swab samples (59%) tested positive for E. coli after handwashing, indicating that the children’s handwashing technique was not effective in completely removing E. coli from the hands. Moreover, sustained and consistent handwashing practice as a daily behavior in children would maximize the effect. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is considered the most important source of nutrients for the baby. But owing to ignorance, lack of education, and cultural norms, exclusive breastfeeding (EBF) is not done by majority of the mothers. Hence, this study is carried out to determine various barriers faced by the mothers that influenced their decision on EBF. Methods: A descriptive qualitative study was conducted among the mothers whose children were less than 1 year of age visiting a well-baby clinic and Immunisation OPD of Urban Health Centre catering to the Urban Slum of Malvani in the Metropolitan city of Mumbai. In-depth interviews (IDIs) were done with 17 participants from August to November 2022. Thematic analysis was conducted on the qualitative data obtained. Results: Four major themes were generated from the transcripts. They are –barriers and concerns faced by mothers to exclusively breastfeed, enablers/motivators, sources of knowledge regarding EBF, and breastfeeding practices. Various barriers faced by mothers were gaps in knowledge, maternal Illness, religious reasons, inadequate milk production, bias toward top feeds, lack of autonomy to take decisions, and cultural norms, while positive family support, good knowledge about breastfeeding, and a supportive home environment motivated mothers to exclusively breastfeed their infants. Sources of knowledge were identified to be doctors and health care workers, mothers/mothers-in-law, sisters, friends, and social media. Conclusions: There are various challenges as well as motivators identified for EBF. Barriers, such as gaps in knowledge, and the negative influence of social media can be improved upon by health education. Therefore, it is crucial to teach expectant mothers as well as families about breastfeeding. Additionally, we advise stepping up public health education initiatives to support breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Geriatric population in India is expected to reach about 20% of total population by 2050.4,5 This brings along newer challenges of not only physical morbidities, but psychosocial morbidities too for this group of population. Social withdrawal and isolation, loneliness are two of those mental morbidities of concern. Social isolation is an objective state defined as the absence of contact with other people and integration with other members of society.6 In contrast, loneliness is a subjective feeling caused by 'being without some definite needed relationship or set of relationships'7. Social isolation & loneliness both have impact on physical and mental well being of a person.10-16 So, present study was conducted with the objective of assessing the extent of loneliness and social isolation among elderly in an urban community, and determining the covariates of the same. Methods: This cross-sectional community-based study was undertaken from December 2019 to February 2020 among 246 elderly men and women, 60 years & above residing in a slum in Chetla Kolkata. They were interviewed about their demographic, financial supports and social supports. Social Isolation was assessed with the help of six item Lubben Social network scale-6.17,18 Loneliness was assessed with the help of the UCLA Loneliness Scale version 3.19,20 Statistical Analysis: Descriptive and univariate analysis, multiple logistic regression was done to find out factors associated with loneliness & social isolation. Results: Social isolation and loneliness were present in 120 (48.78%) and 125 (50.81%) subjects respectively. Multivariate logistic regression revealed that age>69 years. marital status other than married, inadequate income, and those living alone were at increased risk of social isolation. Inadequate income and male sex were at greater risk of loneliness. Conclusion: Social isolation & loneliness are present in almost half of the elderly living in an urban slum of Kolkata, which is alarming. [ABSTRACT FROM AUTHOR]

Abstract This study determined the past-year prevalence of physical, sexual and psychological intimate partner violence (IPV) and associated factors among young women in urban slums and non-slums of Ibadan, Nigeria. A cross-sectional study, using a multistage cluster sampling method was used to select 1050 ever-partnered young women aged between 18 and 24 years from the five Local Government Areas (LGAs) in Ibadan municipal. All localities were classified into slums and non-slums using the UN-Habitat 2003 criterion. Independent variables were respondents' and partners’ characteristics. Dependent variables were physical, sexual and psychological IPV. Data were analysed using descriptive statistics and binary logistic regression model (α0.05). Prevalence of physical (31.4%, 13.4%), sexual (37.1%, 18.3%), and psychological IPV (58.6%, 31.5%) were significantly higher in the slum than non-slum communities. Multivariate analysis showed that secondary education (aOR:0.45, 95%CI: 0.21 – 0.92) reduced IPV experience while being unmarried (aOR:2.83, 95%CI: 1.28 – 6.26), partner’s alcohol use (aOR:1.97, 95%CI: 1.22 – 3.18), and partner’s relationship with other women (aOR:1.79, 95%CI: 1.10 -2.91) increased IPV experience in slum communities. In non-slum communities, having children (aOR:2.99, 95%CI: 1.05–8.51), non-consensual sexual debut (aOR: 1.88, 95%CI: 1.07–3.31) and witness of abuse in childhood (aOR:1.82: 95%CI: 1.01 – 3.28) increased experience of IPV. Acceptance of IPV and partner’s witness of abuse in childhood increased experience of IPV in both settings. This study confirms that IPV is common among young women in Ibadan, Nigeria, but higher among women in slum communities. Findings also showed different factors associated with IPV in slum and non-slum communities. Therefore, targeted interventions for each urban stratum are recommended.

Background: Plastics, owing to their ease of use and affordability, have taken over every aspect of our modern world. It has become an essential aspect of our everyday lives, permeating every sector from food packaging to toys and electronics, to the degree that it is unimaginable to picture a world without it. Plastic takes around 15 to 1000 years to biodegrade. The consumption of plastic by individuals and the ineffective reuse or recycling of it has detrimental effects on the ecosysystem. Overusing plastic and neglecting disposal solutions for plastic over a long time led not only India but many other nations to adopt laws to limit plastic because of its increasing environmental damage. Objectives: 1. To determine the utilization and disposal of plastic waste among general population in urban slums. 2. To study association between sociodemographic factors and plastic usage and disposal. Methodology: Study Design: A cross sectional analytical study Study Population: General population residing in urban slum Sampling Technique: Simple random sampling Sample Size:216 (p= 50%, l= 7, NR=10%) Study Tools: Self-designed, semi structured, pilot-tested questionnaire will be used for the data collection which will be entered in Microsoft Excel and analysed using SPSS statistical software version 20. Results: Usage of plastic was seen in all the study participants and more than 96% of them were reusing the plastics more than once. Most common method was disposing plastic in municipal dust bins (60.2%) followed by open dumping (20.9%), whereas 16.4% were reusing them for other purposes. Level of education and religion has no association with proper disposal of plastic waste. Present study observed that there was a significantly high percentage (96.1%) of three generation families were following proper plastic waste disposal methods followed by nuclear and Joint families with 56.9% and 48.8% respectively. with P≤0.05. Conclusion: Most common method was disposing plastic in municipal dust bins followed by open dumping. Level of education and religion has no association with proper disposal of plastic waste.

Background: The socially constructed characteristics, qualities and actions of men, women, girls, and boys are referred to as gender. Being a core social determinant, it directly affects attitude and health related behaviour. The variance in exposure to material, psychological, behavioural, and biological aspects is how gender impacts health outcomes. Objectives: To document the knowledge regarding gender equity, violence, sexuality, masculinity and reproductive health. To determine gender wise differences in access to healthcare and perception of one’s own health. Methodology: A cross-sectional study was carried out in the urban health centre field practise area in Surat, Gujarat among 260 youth participants aged 18-24 years. After obtaining ethical approval, participants were selected via convenient sampling technique, written informed consent was obtained. Data was collected through face-to-face interviews maintaining privacy using a pre-tested semi structured questionnaire for a duration of 8 months. Data was entered in excel and analysed using JAMOVI software. Themes were generated for qualitative responses. Results: 147 (56.5%) participants were males. The mean age of the participants was 20.55+2.14. Females had statistically significant higher mean gender equity score (30.90+4.68) than males (26.60+3.27). Significant association was seen for education (p= 0.005) and sibling type (p= 0.005) with gender equity. Negligible positive and significant correlation (r= 0.12) between gender equity scores and total family income. Multiple roles and responsibilities (26.7%) were the major factor identified for perception of health. Conclusion: Results highlight the importance of education and employment in developing high gender equitable attitudes The barriers for accessing healthcare services were varied like autonomy to take decision, monetary problems distance to healthcare services etc. Multiple roles, treatment seeking behaviour and reproductive health were major areas which influenced youth’s perception of their health.

Background: Barriers to utilize maternal healthcare services amongst pregnant women at community level differs substantial variation among slums and urban areas which is essential to recognize and resolve these issues within framework of district-level policy planning. IRAIVI pregnancy prediction model is developed to enhance optimal utilization of maternal healthcare services. The study was conducted to evaluate usability of IRAIVI using System Usability Scale amongst healthcare workforce. Methods: This model was developed with a set of predictors based on data collected during baseline and follow up visits from currently pregnant women as per study protocol. For evaluating efficiency of this model, System Usability Scale (SUS) was adopted and shared with 25 randomly selected experts in the field of public health. The questionnaire was shared via google form and responses recorded on Likert’s scale were then analysed using SPSS. Results: IRAIVI model's usability assessed using SUS found to be user-friendly, best learning curve, adaptable to new system and highly acceptance by healthcare workforce. The SUS score averaging at 84 demonstrates favourable usability of the model. Conclusion: This model has capability to accentuate maternal health services which in-turn can contribute for better ANC services in resource-constrained settings. Additionally, future opportunities can be explored through field studies in different settings.

Introduction: NFHS-5 Telangana reports underweight, stunting, and wasting among under 5 children as 31.8%, 33.1%, and 21.7% respectively. Composite Index of Anthropometric Failure is an aggregate indicator that excludes children with anthropometric failure and includes children who are wasted, stunted, or underweight, and their combinations. The objectives were to determine the prevalence of anthropometric failures and to find its determinants among under-five children in an urban slum area of Hyderabad. Methodology: A cross sectional study was conducted among 310 under 5 children residing in the urban-slum area of Hyderabad. Probability proportionate to size sampling was used. Using questionnaire and standard operating procedures, socio-demographic profile, health details and nutritional assessment was done. Statistical analysis was done using SPSS version 26. Results: The prevalence of anthropometric failure is noted to be 39.6%. The prevalence of stunting, underweight and wasting were found to be 20.7%, 26.8% and 12%, respectively. The illiteracy of father [AOR:2.94(CI: 1.31-6.62); p-value=0.009], low birth weight [AOR:2.024(CI: 1.253-3.26); p-value=0.004], not exclusively breastfed [AOR:4.291(CI:1.55-11.904); p-value=0.005] and deficient calorie intake [AOR: 2.079(CI:1.103-3.906); p-value=0.023] were found to be the significant predictors of Anthropometric failure. Conclusion: Under nutrition is an important public health problem with 40% prevalence in urban slum of Telangana. Enhancing the literacy of fathers, reduction in low birth weight, better IYCF practices and providing calorie adequate diet will aid in enhancing children's nutritional status.

Background/introduction: One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions. Objectives: This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria. Method: Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis. Results: Six FGD sessions, divided by gender and age, were conducted between September–October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, "epa Ijebu" (a dentrifice), and "orin ata" (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes. Conclusion: The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self‐care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people's education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities. [ABSTRACT FROM AUTHOR]

This study aimed to explore the magnitude and determinants of health care seeking behaviors for common infectious disease and malnutrition among Bangladeshi under-five children living in slum areas. A cross-sectional study of 300 children-caregiver dyads was conducted in an urban slum of Bangladesh. Data were collected via a structured questionnaire with accompanying anthropometric assessments of children administered by research staff. Multiple logistic regression was employed to identify associated factors of health care seeking behaviors. Only 44.7% and 13.0% of respondents sought care for childhood infectious diseases and malnutrition, respectively. Being a male child, 2–5 years old, having ≤5 family members, monthly family income >125$, and living in close proximity to a health facility were found to be potential determinants of health care seeking behavior for childhood infectious diseases. Mother/caregivers with poor nutritional information knowledge and who had a child 2–5 years old reported engaging in less care seeking behaviors regarding their child's malnutrition compared to their counterparts. Caregivers of children under the age of 5 years old reported low participation in health care seeking behaviors in relation to childhood infectious disease and malnutrition. Families living in slums require additional support targeting health and nutritional educational programs. [ABSTRACT FROM AUTHOR]

Background: Globally, major emphasis has been placed on understanding the physiological consequences of losing a pregnancy. However, its mental health impact on socially disadvantaged women remains unexplored. To further inform the field the present study investigated the prevalence and factors associated with the development of depressive symptoms and anxiety among women with a history of spontaneous abortion living in the urban slums of Dhaka, Bangladesh. Methods: Information was obtained from 240 women who experienced a spontaneous abortion from July 2020 to December 2021. It was obtained through the urban health and demographic surveillance system (UHDSS) survey. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to measure mental health symptoms. Bivariate and multivariate linear regression analyses were performed to assess the associated factors with the mental health outcomes. Results: Of the 240 women, majority (77.50%) of the women experienced mild to severe depressive symptoms and more than half (58.75%) of the respondants experienced mild to severe anxiety, within one and half years of experiencing spontaneous abortion. A higher level of education and being employed were protective factors for anxiety and depressive symptoms, respectively. However, women with higher sexual and reproductive health rights (SRHR) knowledge had significantly increased anxiety and depressive symptoms. In contrast, receiving post-abortion care (PAC) was associated with decreased anxiety and depressive symptoms. Conclusion: The findings indicate that ensuring access to affordable PAC services and integrating mental health services into the standard PAC service package is crucial. This study also emphasizes the importance of providing education for women living in urban slums and encouraging them to participate in economic activities. [ABSTRACT FROM AUTHOR]

Background: Despite the early institution of a family planning program, following its inception, Pakistan is still struggling to stabilize its fast-growing population. Objectives: The objectives of the study were, to determine the contraceptive practices & related factors among married women in an urban slum and also to assess the reasons for non-utilization of contraceptives among these women. Methods: The Cross-sectional study was conducted in an urban slum, Shah di Khui, in district Lahore following approval. A total of 300 eligible married females were selected through a systematic random sampling technique. After obtaining informed consent, information was solicited using a structured pretested questionnaire in privacy. Confidentiality of participants was maintained. SPSS version 24 was used for data analysis. The chi-square test was used to determine a statistically significant relationship between independent and dependent variables. Results: It was found that 33.7% of married women were using contraceptives as compared to 66.3% of nonusers. Among users, 76.2% were using Modern methods and 23.8% were using traditional methods. The duration of marriage (p =0.000), education standing of the respondent (p = 0.012) and her spouse (p = 0.003), and total number of alive children (p = 0.018) were significantly related to contraceptive usage. The main reasons for non-utilization were a desire for more children (30.2%), fear of side effects (25.1%), objection by spouse/in-laws (21.1%), and Lack of knowledge (15.6%). Conclusion: It was concluded that only 33.7% of slum dweller married women were using contraceptives. Contraceptive usage was found to be related significantly with the duration of marriage, Education status of husband and wife, and total number of living children. There is a need to make targeted efforts to address barriers and enhance uptake in this often-neglected segment of society. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic has affected all sections of society; this study was conducted with the aim to assess the behavioral and economic impact of the COVID-19 lockdown among people living in an urban slum in Pune city, Maharashtra. Materials and Methods: A descriptive cross-sectional study was conducted among people living in an urban slum of the southeastern Pune region using a semistructured questionnaire by house-to-house interviews of residents. Participants were asked about knowledge and practice of COVID-appropriate behavior and change in income and expenditure patterns to assess economic impact. Results: A total of 130 households with one adult member from each household were included in the study with a mean age of 46 years with a standard deviation of 15. On inquiring about the COVID appropriate behavior, 94.6% agree that face mask is essential and 93% of the respondents agree that hand washing is essential for the prevention of COVID-19 infection. Out of 130 respondents, 49% were unemployed at the time of the study and 39% had monthly household income < Rs. 10,000 per month. A notable decrease in the monthly household income after the lockdown period was reported by 76.2% of the study participants while 46% of the study participants reported a decrease in monthly expenditure on food. About 24% of the study participants gave a history of selling personal belongings to meet monthly expenses during the lockdown period. Conclusion: COVID-appropriate behavior was adequately practiced by the study participants during COVID restrictions. A significant decrease in household income coupled with a change in trends of monthly expenditure affected the slum population. These transitions need to be further deliberated to understand the shift in administrative and economic policies needed to combat the effects of the pandemic.

Background: Smokeless tobacco users receive levels of nicotine known to be addictive, and clinical symptoms of dependency and withdrawal for smokeless tobacco are identical to those for cigarettes. Smokeless tobacco usage patterns share significant parallels with patterns of use of other addictive drugs. Because everyone spits after using oral tobacco, there are more persons who spit in public due toits use. Use of smokeless tobacco during pregnancy increases the chance of low-birth-weight babies by two to three times and is linked to stillbirths. Other negative health implications of smokeless tobacco use include dental decay, gum recession, high blood pressure, oral sub-mucous fibrosis (OSF), a crippling disorder, and mouth and food pipe malignancies. This warrants the study of patterns of oral tobacco use and its determinants in urban slum areas. Objective: To estimate the prevalence and patterns of oral tobacco use and assess the motivating and demotivating factors associated with it amongst urban slum inhabitants. Methods: A community-based cross-sectional study will be conducted in the urban field practice area of a tertiary care hospital. A semi-structured questionnaire assessing the socio-demographic profile, prevalence and pattern associated factors for oral tobacco use among the study participants will be implemented. Study implications: This study will help to determine the prevalence and pattern of oral tobacco use, as well as the motivating and demotivating factors that contribute to oral tobacco use. Insights gained shall be useful to implement focussed prevention strategies.

Abstract Background In low- and middle- income countries such as Bangladesh, urban slum dwellers are particualry vulnerable to hypertension due to inadequate facilities for screening and management, as well as inadequate health literacy among them. However, there is scarcity of evidence on hypertension among the urban slum dwellers in Bangladesh. The present study aimed to determine the prevalence and factors associated with hypertension among urban slum dwellers in Bangladesh. Methods Data were collected as part of a large-scale cross-sectional survey conducted by Building Resources Across Communities (BRAC) between October 2015 and January 2016. The present analysis was performed among 1155 urban slum dwellers aged 35 years or above. A structured questionnaire was adminstered to collect data electronically and blood pressure measurements were taken using standardised procedures. Binary logistic regression with generalized estimating equation modelling was performed to estimate the factors associated with hypertension. Results The prevalence of hypertension was 28.3% among urban slum dwellers aged 35 years and above. In adjusted analysis, urban slum dwellers aged 45–54 years (AOR: 1.64, 95% CI: 1.17–2.28), 55–64 years (AOR: 2.47, 95% CI: 1.73–3.53) and ≥ 65 years (AOR: 2.34, 95% CI: 1.47–3.72), from wealthier households (AOR: 1.94, 95% CI: 1.18–3.20), sleeping

Introduction Despite Pakistan’s stringent tobacco control policy, its effective implementation has always been a challenge, leading to rising tobacco consumption. The aim of the study is to determine the prevalence of tobacco consumption and associated risk factors in the adult population of deprived urban areas. Methods A community-based, cross-sectional survey was conducted from February to July 2019, comprising 607 adults residing in the urban squatter settlement of Lahore using a standardized questionnaire, the WHO STEPwise approach. The outcome was current use of tobacco and/or smokeless tobacco daily. Multivariable logistic regression was applied to determine factors associated with smoking and smokeless tobacco consumption. Results Among 607 participants, about 64% were females, 49.3% were illiterate, 64.9% were currently unemployed, and 47.1% belonged to the low-income group. The prevalence of tobacco smoke was 10.5% (95% CI: 8.07–12.93), and smokeless tobacco consumption was 8.6% (95% CI: 6.38–10.82). Multivariable logistic regression found that smokeless tobacco was more likely among the aged 50–59 years (AOR=4.1; 95% CI: 1.1–13.8) and unemployed (AOR=3.6; 95% CI: 1.1–12.2). Whereas tobacco smoking was more likely among the aged 30–39 years (AOR=5.5; 95% CI: 1.8–16.7), Urdu ethnicity (AOR=2.9; 95% CI: 1.2–7.3), unemployed (AOR=6.6; 95% CI: 2.9–14.9), and never exposed to any media (AOR=3.2; 95% CI: 1.8–17.4). Participants exposed to health warnings were less likely to smoke (AOR=0.02; 95% CI: 0.01–0.05). Conclusions This study reports a high prevalence of tobacco consumption among adults and calls for effective policy implementation using a multi-pronged approach, including health professionals and media, to spread awareness about the harmful effects of tobacco and endorsement of health warnings on tobacco packaging.

This study determined the past-year prevalence of physical, sexual and psychological intimate partner violence (IPV) and associated factors among young women in urban slums and non-slums of Ibadan, Nigeria. A cross-sectional study, using a multistage cluster sampling method was used to select 1050 ever-partnered young women aged between 18 and 24 years from the five Local Government Areas (LGAs) in Ibadan municipal. All localities were classified into slums and non-slums using the UN-Habitat 2003 criterion. Independent variables were respondents' and partners' characteristics. Dependent variables were physical, sexual and psychological IPV. Data were analysed using descriptive statistics and binary logistic regression model (α0.05). Prevalence of physical (31.4%, 13.4%), sexual (37.1%, 18.3%), and psychological IPV (58.6%, 31.5%) were significantly higher in the slum than non-slum communities. Multivariate analysis showed that secondary education (aOR:0.45, 95%CI: 0.21 – 0.92) reduced IPV experience while being unmarried (aOR:2.83, 95%CI: 1.28 – 6.26), partner's alcohol use (aOR:1.97, 95%CI: 1.22 – 3.18), and partner's relationship with other women (aOR:1.79, 95%CI: 1.10 -2.91) increased IPV experience in slum communities. In non-slum communities, having children (aOR:2.99, 95%CI: 1.05–8.51), non-consensual sexual debut (aOR: 1.88, 95%CI: 1.07–3.31) and witness of abuse in childhood (aOR:1.82: 95%CI: 1.01 – 3.28) increased experience of IPV. Acceptance of IPV and partner's witness of abuse in childhood increased experience of IPV in both settings. This study confirms that IPV is common among young women in Ibadan, Nigeria, but higher among women in slum communities. Findings also showed different factors associated with IPV in slum and non-slum communities. Therefore, targeted interventions for each urban stratum are recommended. [ABSTRACT FROM AUTHOR]

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This study aims at a descriptive epidemiological survey of prevailing disease burden not readily detected or suspected by formal medical service of Governments and other stake holders as well as detection of the etiology of the identified disease in the area under investigation. The problem statement is informed by the clear recognition that the urban slum dwellers have a unique characteristic in the social, spatial, economic and demographic attributes which demands a careful assessment of their social ecology and the impact thereon. Objectives were therefore formulated to elicit the needed information that will underscore the very essence of determinants of diseases prevalent in the area. Plausible justification for the study was sufficiently elaborated from the point of view of epidemiological and social benefits derivable from the findings of the study. The methodology clearly expostulated such key frameworks as area of study, study design, study population/sampling techniques, instruments for data collection and procedure for collection of data which was analyzed by method of Analysis of Variance (ANOVA). The output of the findings showed that the calculated F-value is greater than the F-critical value at (0.05). Therefore, there was appreciable evidence to reject the null hypothesis and accept the alternative hypothesis which states that there is a significant variation or difference in the incidence of disease burden prevalent in the areas investigated. The research concluded that there is a critical need for a new method of health evaluation and characterization of social-cluster determinants of health in Urban Slum. [ABSTRACT FROM AUTHOR]

Background: Out of Pocket Expenditure (OOPE) are expenditures directly made by households at the point of receiving health care. In Telangana State the average OOPE per delivery in public health facility is Rs. 3846. The study helps to know the OOPE among mothers undergoing institutional deliveries and emphasise on the expenditure even after utilising the government financial assistance. Objectives: To estimate the OOPE among women undergoing institutional delivery and to find its association with government financial assistance utilization and socio-demographic factors. Methodology: A community based cross sectional study was done among 200 mothers who delivered recently residing in an urban slum under our health and training centre. Ethical clearance was taken before the conduct of study. Results: The median direct out of pocket expenditure among mothers in our study was Rs.500 i.e., 6.6 $ (0 to 1600). OOPE was present among 68.5% of mothers. Availability of government financial assistance, age and occupation of the mother and type of delivery was found to be significantly associated with p value

Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare.

Background: Postnatal period is the most vulnerable time, because the majority of neonatal and maternal death deaths occur during this period, especially within the first month after birth. In spite of its importance, this period is generally neglected. Objectives: To estimate utilization of postnatal care services and to study the factors associated with utilization of postnatal care among the postnatal mothers of urban slums of Jorhat town. Methods: Community based cross-sectional study was carried out in urban slums of Jorhat town. 94 postnatal mothers, who delivered during the time period of 16th October, 2018 to 15th October, 2019 were included from two randomly selected urban slums. Collected data were analysed using SPSS16. Results: Out of 94 mothers, 24.5% were illiterate, 26.6% were educated up to high school standard and only 6.4% of subjects were graduate. We observed 91.5% of the study subjects availed postnatal check-up (PNC), whereas only 23.4% had complete PNC (≥ 3 PNC) and 8.5% did not have any PNC. Multivariate analysis showed education as a strong predictor (AOR: 1.463, CI: 1.054-2.030) of utilization of postnatal care services. Conclusion: Education was found to be strong predictor in complete utilization of postnatal check-up. Other factors affecting the utilization of complete PNC were adequate birth spacing, primigravida and age at marriage above eighteen years.

Background: Changing life styles have increase chance of common mental disorders (CMD) which may lead to disability. Aims and Objectives: The aim of the study was (1) to assess CMD in urban slum community and (2) to gain attention of policy makers toward the mental health and its need of the community to address unmet care. Materials and Methods: A crosssectional study was conducted in which 423 people were screened with the help of a pretested questionnaire by Self Reporting Questionnaire (SRQ-20). All the subjects who scored 7 and more in SRQ-20 were further evaluated using Sheehan disability scale. Results: Out of 423 subject, 76.12% reported typical response within 7 in SRQ-20 scoring. Common mental disorder was found in 16.07% with SRQ-20 scoring between 7 and 13. Severe distress was found in 7.80% of the population with SRQ-20 score >14. Among psychological distress group, females scored higher with 10.63%. In the severe distress group, again females scored higher with 4.96%, although this was not statistically significant. A total of 101 subjects were found to have CMD after screening the population and its prevalence come to 238.77 per thousand. Mild disability was found in 59.41% of the people with CMD and 34.65% moderate disability and 5.94% reported severely disability, which was not statistically significant. Conclusion: On the basis of our study findings, we conclude that their mental health requires attention, which is an essential part of an individual’s health. It is essential to design intervention that aim at allaying their distress which can improve their mental health, however, being of a descriptive nature and the study population coming from only one slum the above mentioned finding cannot be generalized.

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Abstract Background The prevalence of elder abuse in various parts of the world has been reported between 2.2 and 90.4%. According to some studies conducted in India, elder abuse prevalence ranges between 9.6 to 61.7%. Yet, elder abuse is an underreported issue. Most available evidence shows the involvement of close family members and caregivers in the abuse of older adults. Several factors associated with various forms of elder abuse need to be studied further. This study has attempted to capture the prevalence, pattern and associated factors of elder abuse in urban slums. Methods This study was a cross-sectional community-based study conducted between August 2019 to August 2020 in an urban field practice area of the All India Institute of Medical Sciences, Bhubaneswar. It covers four wards of the Bhubaneswar Municipal Corporation, served by the Urban Primary Health Centre, IRC Village, Nayapalli. A total of 360 participants aged 60 years and above were included in this study. They were interviewed using various semi-structured interview schedules. Validated study tools such as Activities of Daily Living (ADL- Barthel Index), Hindi Mental Scale Examination (HMSE), Geriatric Depression Scale (GDS), and Vulnerability to Abuse Screening Scale (VASS) were also used to assess various factors. Results Approximately one in five (19.4%) older adults reported some form of abuse. The types of elder abuse reported were physical abuse in 12 (3.3%), verbal abuse in 25 (6.9%), emotional abuse in 40 (11.1%), and financial abuse in 15 (4.2%) older adult participants. The sons and daughters-in-law of the older adult participants were the main perpetrators of abuse reported. Depression and past history of abuse were found significantly associated with any type of abuse. Conclusions The prevalence of elder abuse in this study was considerably high, with 70 (19.4%) out of the 360 participants reporting some form of abuse. Emotional abuse was the most reported, and physical abuse was the least reported type. The most common perpetrators were those on whom the older adults depended, like their sons and daughters-in-law.

Water, Sanitation and Hygiene (WASH) practices are important factors in preventing diarrhoea. The objectives of this study were to assess the behaviour of the mothers of under-five children with regard to WASH practices, water quality, incidence rate of diarrhoea and the WASH predictors responsible for diarrhoea and water contamination, using multivariate regression analysis. The present study was conducted in households (n=55) having under-five children (n = 88) based in an urban slum pocket of Mumbai city, India. Key satisfactory practices included (percent household following them in parenthesis) boiling of water (63.6%) and daily cleaning of storage containers (74.5%). Households followed unsatisfactory practices during water transfer (72.7%), handwashing (58.2%), defaecation location (96.4%) and disposal of children's faeces (98.2%). The incidence rate of diarrhoea among