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Objective: Anaemia is a health problem for adolescents in India. This paper examines the nuanced transformations triggered by a multi-pronged, community-based anaemia intervention with adolescents and their families, seeking meaningful insights for future nutrition and anaemia programmes. Design: Qualitative study rooted in critical theory. Setting: Three slum communities -- Dharavi and Kandivali (in Mumbai) and Kalwa (in Thane) in Maharashtra, India. Methods: Data were collected through focus-group discussions and in-depth interviews with young people, parents and other stakeholders. Content analysis of drawings of a nutritious food plate by participants supplemented discussion and interview data. Thematic analysis was undertaken manually using a grounded theory approach. Findings: Nutrition education with adolescents and parents led to reduced junk food consumption although reinforcement of the information provided was necessary to sustain the change. Parental support was a crucial factor in ensuring anaemia treatment compliance but was affected by a lack of awareness regarding the consequences of anaemia and the nutritional requirements of anaemic adolescents. Other factors, including the pampering of boys, the neglect of girls and the heavy workload of mothers influenced treatment compliance. Awareness and agency among adolescents contributed to a supportive environment in terms of raised consciousness and better sanitation within families and the community. Conclusion: Findings highlight the need for a holistic approach to address anaemia among young people. While nutrition and health education are important to address treatment noncompliance, this approach should also focus on factors such as socioeconomic status, gender equity, health prioritisation, family involvement and engaging young people as agents of change to promote an enabling environment.

This qualitative study explores how comprehensive sexuality education located within a broader positive youth development approach informed transformations among young people from informal urban communities in India. A thematic analysis of data obtained from the young people, their parents, and frontline workers revealed that securing the cooperation of families was possible for the program because sexual and reproductive health education was not a stand-alone intervention, but a part of a larger approach seeking to build capacities of young people. The strategic introduction of sexual and reproductive health communication helped the participants to overcome inhibitions about the topic. Enhanced awareness of gender, pubertal changes, gender-based violence, and child sexual abuse was evidenced post participation. Improved agency was manifest through decision making, critical thinking, confidence, mobility, and articulation, especially among girls. Program interventions to enhance sexual and reproductive health awareness of parents and communities and to improve health services and facilities were bolstered through youth engagement. Such contribution by the young reinforced their knowledge and skills, strengthened agency, and cemented family and community support. A holistic program situated within the positive youth development approach thus seemed a pragmatic vehicle to promote comprehensive sexuality education for young people in vulnerable urban communities. [ABSTRACT FROM AUTHOR]

Context: The National Nutrition Mission (POSHAN Abhiyaan) intends to "converge" nutrition-related program components across sectors (nutrition, health, water, and sanitation). In this study, we have examined the perspectives of Anganwadi workers (AWWs), the frontline workers of the Integrated Child Development Services, on working in convergence with the public health sector. Methods: This exploratory qualitative study was done between June 2018 and June 2019 in two urban informal settlements in Mumbai. We conducted in-depth interviews with 26 AWWs and their supervisors, purposively sampled and diversified in terms of age, education, and years of experience. We used the software NVivo version 12 to aid analysis. Results: Most AWWs acknowledged that a convergent framework of action between "nutrition" and "health" was likely to be beneficial to the community. However, they also shared that cross-sector convergence was currently limited due to technical unfamiliarity with "health-sector" issues in the frontline, discomfort with data sharing, and lack of meaningful incentives for joint work. Broader organizational challenges such as poor infrastructure and lack of supervision, as well as challenges in the urban context (migration and cultural barriers) further hindered joint activities. Conclusions: The findings indicate that critical structural gaps in the urban setup of ICDS need to be addressed and AWWs need to be better familiarized with the changing roles expected from them under POSHAN Abhiyaan. To work better with the health sector, the work timings of AWWs need to be aligned with those of the health sector and meaningful financial incentives need to be put in place for cross-sector activities. [ABSTRACT FROM AUTHOR]

This article explores how women front-line workers engage with domestic and gender-based violence in the urban informal settlements of Dharavi in Mumbai, India. We conducted in-depth interviews with 13 voluntary front-line workers, along with ethnographic fieldwork in Dharavi, as a part of a pilot study. Our findings contribute to literature on context-specific approaches to understanding gender-based violence and �models� to prevent domestic violence in urban micro-spaces. Furthermore, we also discuss notions of �change� (badlaav) that the front-line workers experience. Finally, this article presents implications for socially engaged ethnographic research, as well as contextual and grounded insights on ways to reduce gender-based and domestic violence. [ABSTRACT FROM AUTHOR]

The question of how urbanisation and poverty are linked in sub-Saharan Africa is an increasingly pressing one. The urban character of the HIV epidemic in sub-Saharan Africa exacerbates concern about the urbanisation—poverty relationship. Recent empirical work has linked urban poverty, and particularly slum residence, to risky sexual behaviour in Kenya’s capital city, Nairobi. This paper explores the generalisability of these assertions about the relationship between urban poverty and sexual behaviour using Demographic and Health Survey data from five African cities: Accra (Ghana), Dar-es-Salaam (Tanzania), Harare (Zimbabwe), Kampala (Uganda) and Nairobi (Kenya). The study affirms that, although risky behaviour varies across the five cities, slum residents demonstrate riskier sexual behaviour compared with non-slum residents. There is earlier sexual debut, lower condom usage and more multiple sexual partners among women residing in slum households regardless of setting, suggesting a relatively uniform effect of urban poverty on sexual risk behaviour. [ABSTRACT FROM PUBLISHER]

Research on adolescent mental health in low and middle-income countries cites the paucity of human resources and emphasises non-specialist worker (NSW)-led counselling intervention within school and health-system platforms. This pilot study aimed to evaluate the feasibility and acceptability of a transdiagnostic stepped care model, for delivering preventive psychological treatment to adolescents through NSWs in urban vulnerable community settings. Conducted in three such settlements in Mumbai and Thane districts of Maharashtra in India, this mixed-methods study engaged 500 young people, their parents and 52 NSWs. Quantitative data, obtained through monitoring indicators, fidelity checklists and the Strengths and Difficulties Questionnaire (SDQ), revealed key stressors for adolescents, including poverty, structural inequity, cultural conformity pressures, academic anxieties and communication gap within families. Post-intervention, adolescents exhibited an enhanced capacity for positive emotions and agency. The qualitative component, incorporating observations, focus group discussions (FGDs) and in-depth interviews (IDIs) with various stakeholders, highlighted reduced stigma around mental health, yet identified barriers like time commitment, lack of incentivisation for NSWs, lack of privacy in densely populated communities and societal stigma. This implementation research underscores that adolescent mental health stressors often originate from social determinants, exacerbated by insufficient awareness and stigma. Such stepped care models offer a pathway for communities to establish enduring support networks., Competing Interests: The authors declare that no competing interests exist., (© The Author(s) 2024.)

The question of how urbanisation and poverty are linked in sub-Saharan Africa is an increasingly pressing one. The urban character of the HIV epidemic in sub-Saharan Africa exacerbates concern about the urbanisation - poverty relationship. Recent empirical work has linked urban poverty, and particularly slum residence, to risky sexual behaviour in Kenya's capital city, Nairobi. This paper explores the generalisability of these assertions about the relationship between urban poverty and sexual behaviour using Demographic and Health Survey data from five African cities: Accra (Ghana), Dar-es-Salaam (Tanzania), Harare (Zimbabwe), Kampala (Uganda) and Nairobi (Kenya). The study affirms that, although risky behaviour varies across the five cities, slum residents demonstrate riskier sexual behaviour compared with non-slum residents. There is earlier sexual debut, lower condom usage and more multiple sexual partners among women residing in slum households regardless of setting, suggesting a relatively uniform effect of urban poverty on sexual risk behaviour.