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Objective To investigate delays in first and third dose diphtheria-tetanus-pertussis (DTP1 and DTP3) vaccination in low-birth-weight infants in Ghana, and the associated determinants. Methods We used data from a large, population-based vitamin A trial in 2010-2013, with 22 955 enrolled infants. We measured vaccination rate and maternal and infant characteristics and compared three categories of low-birth-weight infants (2.0-2.4 kg; 1.5-1.9 kg; and < 1.5 kg) with infants weighing ≥ 2.5 kg. Poisson regression was used to calculate vaccination rate ratios for DTP1 at 10, Hand 18 weeks after birth, and for DTP3 at 18, 22 and 24 weeks (equivalent to 1, 2 and 3 months after the respective vaccination due dates of 6 and 14 weeks). Findings Compared with non-low-birth-weight infants (n = 18979), those with low birth weight (n = 3382) had an almost 40% lower DTP1 vaccination rate at age 10 weeks (adjusted rate ratio, aRR: 0.58; 95% confidence interval, 0:0.43-0.77) and at age 18 weeks (aRR: 0.63; 95% CI: 0.50-0.80). Infants weighing 1.5-1.9 kg (n = 386) had vaccination rates approximately 25% lower than infants weighing ≥ 2.5 kg at these time points. Similar results were observed for DTP3. Lower maternal age, educational attainment and longer distance to the nearest health facility were associated with lower DTP1 and DTP3 vaccination rates. Conclusion Low-birth-weight infants are a high-risk group for delayed vaccination in Ghana. Efforts to improve the vaccination of these infants are warranted, alongside further research to understand the reasons for the delays. Objectif Examiner les retards d'administration de la premiere et de la troisieme dose de vacan diphterie-tetanos-coqueluche (DTP1 et DTP3) chez les nourrissons au faible poids de naissance au Ghana, ainsi que les determinants associes. Methodes Nous avons utilise les donnees issues d'un vaste essai sur la vitamine A, mene dans la population en 2010-2013, et qui portait sur 22 955 nourrissons. Nous avons determine le taux de vaccination ainsi que les caracteristiques des meres et des enfants et avons compare trois categories de nourrissons au faible poids de naissance (2,0-2,4 kg; 1,5-1,9 kg; et < 1,5 kg) avec des nourrissons pesant ≥ 2,5 kg. Une regression de Poisson nous a permis de calculer les ratios des taux de vaccination pour le DTP1 a 10,14 et 18 semaines apres la naissance et, pour le DTP3, a 18, 22 et 24 semaines (ce qui equivaut respectivement a 1, 2 et 3 mois apres l'age normal de vaccination qui est de 6 et 14 semaines). Resultats Compares aux nourrissons n'ayant pas un faible poids de naissance (n = 18 979), ceuxau faible poids de naissance (n=3382) avaient un taux de vaccination DTP1 presque 40% plus faible a l'age de 10 semaines (ratio des taux ajuste, RTa: 0,58; IC 95%: 0,43-0,77) et a l'age de 18 semaines (RTa: 0,63; IC 95%: 0,50-0,80). Les nourrissons pesant de 1,5 a 1,9 kg (n=386) avaient un taux de vaccination a ces ages environ 25% plus faible que ceux pesant ≥ 2,5 kg. Des resultats similalres ont ete observes pour le DTP3. Le plus jeune age des meres, leur niveau d'instruction et les distances plus longuesjusqu'a l'etablissement de soins le plus proche etaient associes a de plus faibles taux de vaccination DTP1 et DTP3. Conclusion Les nourrissons au faible poids de naissance sont un groupe a haut risque en matiere de retard de vaccination au Ghana. Des efforts devraient etre entrepris pour ameliorer la vaccination de ces enfants, parallelement a d'autres recherches permettant de comprendre les raisons de ce retard. Objetivo Investigar los retrasos de la primera y tercera dosis de la vacuna contra la difteria, el tetanos y la tos ferina (DTP1 y DTP3) en recien nacidos con insuficiencia ponderal en Ghana, asi como los determinantes relacionados con las mismas. Metodos En 2010-2013, se utilizaron datos de un ensayo poblacional de vitamina A a gran escala basado en la poblacion con 22 955 recien nacidos Inscritos. Se midio la tasa de vacunacion y las caracteristicas tanto de las madres como de los' recien nacidos, y se compararon tres categorias de recien nacidos con insuficiencia ponderal (2,0-2,4 kg; 1,5-1,9 kg; y < 1,5 kg) con recien nacidos con un peso de ≥ 2,5 kg. Se utilizaron modelos de regresion de Poisson para calcular los coeficientes de la tasa de vacunacion para DTP1 las semanas 10,14 y 18 despues del nacimiento, y para DTP3 las semanas 18,22 y 24 (lo que equivale a 1, 2 y 3 meses tras las fechas de vencimiento de las vacunaciones correspondiente de las semanas 6 y 14). Resultados En comparacion con los recien nacidos sin insuficiencia ponderal (n=18 979), los que nacieron con bajo peso [n=3 382) tenian una tasa de inmunizacion sistematica de DTP1 casi un 40% Inferior a la edad de 10 semanas (razon de tasa ajustada, aRR: 0,58; 1C del 95%: 0,43-0,77) y a la edad de 18 semanas (aRR: 0,63; 1C del 95%: 0,50-0,80). Los recien nacidos con un peso de 1,5-1,9 kg (n=386) tenian unas tasas de vacunacion de alrededor de un 25% Inferior ajos que pesaban ≥ 2,5 kg a la misma edad. Para DTP3 se observaron los mismos resultados. Se asociaron la juventud maternal, el bajo nivel educativo y la larga distancia hasta la instalacion sanitaria mas cercana con las bajas tasas de vacunacion de DTP1 y DTP3. Conclusion Los recien nacidos con Insuficiencia ponderal se encuentran en un grupo de alto riesgo para sufrir un retraso de la vacunacion en Ghana. Se han garantizado esfuerzos para mejorar la vacunacion de estos recien nacidos, junto con una investigacion mas profunda para comprender las razones de dichos retrasos., Introduction Approximately 14% of infants born in low- and middleincome countries have a low birth weight (weighing < 2.50 kg at birth). (1) It has been reported that in high-income [...]

Coercive control behaviors central to the abuse of power appear more frequent than other types of domestic violence, but little is known about its frequency, features, and consequences for women in India. We aimed to examine the prevalence of domestic coercive control and its association with physical, sexual, and emotional domestic violence in the preceding year and symptoms of depression, anxiety, and suicidal thinking. In a cross-sectional survey, we interviewed 4,906 ever-married women aged 18-49 years living in urban informal settlements in Mumbai, India. We developed a 24-item scale of coercive control, assessed physical, sexual, and emotional violence using existing questions, and screened for symptoms of depression with the Patient Health Questionnaire (PHQ9), anxiety with the Generalized Anxiety Disorder (GAD7) questionnaire, and suicidal thinking with questions developed by the World Health Organization. Estimates involved univariable and multivariable logistic regression models and the prediction of marginal effects. The prevalence of domestic coercive control was 71%. In total, 23% of women reported domestic violence in the past 12 months (emotional 19%, physical 13%, sexual 4%). Adjusted models suggested that women exposed to controlling behavior had greater odds of surviving emotional (aOR 2.1; 95% CI 1.7, 2.7), physical (1.4; 1.0, 1.9), and sexual (1.8; 1.1, 3.0) domestic violence in the past 12 months; and higher odds of a positive screen for moderate or severe depression (1.7; 1.3, 2.2), anxiety (2.1; 1.3, 3.1), and suicidal thinking (1.7; 1.2, 2.3), and increased with each additional indicator of coercive control behavior. When women reported 24 indicators of coercive control, the adjusted predicted proportion with moderate or severe depressive symptoms was 60%, anxiety 42%, and suicidal thinking 17%. Inclusion of coercive control in programs to support domestic violence, would broaden our understanding of domestic abuse to resemble most victims experience and improve interventions. [ABSTRACT FROM AUTHOR]

Past failures to mobilize communities in collective action against violence against women (VAW) have been ascribed to contextual challenges, but researchers have not systematically mapped community capacity for collective action against VAW. We conducted a mixed methods study in Mumbai, India using quantitative data from a household survey (n = 2,642) and qualitative data from 264 community meetings. We found attitudes supporting gender inequality and violence coexisted with significant enthusiasm and support for collective action against VAW. These findings open up avenues for policymakers to treat communities as less vulnerable and more capable of changing situations and problems that affect them. [ABSTRACT FROM AUTHOR]