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Context: With the ageing of Indian society, providing a healthy life among older people is a public health precedence. Therefore, beforehand discovery and possible forestalment of frailty may help promote healthy ageing and dwindle the social, mental and financial burden of their families and caregivers. Aims: The study aimed to assess the proportion of frailty and its associated factors among the elderly aged 65 years and above in a rural community of West Bengal. Settings and Design: A community-based cross-sectional study was conducted among 270 elderlies selected from 15 villages out of a total 64 villages of Singur under the Hooghly District of West Bengal from January 2019 to February 2020. Materials and Methods: Cluster sampling technique was used. Data was collected using a pre-designed, pre-tested structured schedule including Fried frailty phenotype (FFP), geriatric depression scale short form (GDS 15) and mini nutritional assessment (MNA) tool. Statistical Analysis Used: Associated factors of frailty were assessed by univariate and multivariable logistic regression using SPSS version 16 software and MS Excel 2019. Results: The proportion of frailty was observed to be 23.7% and that of prefrailty 40.7%. Frailty was significantly associated with increasing age [AOR(CI) 1.2(1.1-1.3)], decreasing years of schooling [AOR(CI) 1.3(1.1-1.5)], loss of spouse [AOR(CI) 4.2(1.2-15.2)], financial dependency [AOR(CI) 19.3(2.7-139.0)], staying at home [AOR(CI) 16.3(2.7-98.2)], presence of anaemia [AOR(CI) 3.6(1.3-9.5)], at risk of malnutrition [AOR(CI) 6.5(1.9-22.3)], increasing number of falls in the last 1 year [AOR(CI) 4.3(1.2-15.6)], presence of 3 or more chronic diseases [AOR(CI) 154.7(12.1-1981.9)] and depression [AOR(CI) 8.3(2.5-27.0)]. Conclusion: The burden of frailty among the study population is relatively high. It’s an intimidating situation that needs bettered screening provisions for early discovery with special stress on nutritive upliftment. Screening for depression should also be done regularly.

Introduction: Globally, one-third of current health expenditure had been out-of-pocket expenditure (OOPE). The health system financing of almost all low- and middle-income countries including India rely heavily on out-of-pocket (OOP) payments for health care. OOPE on health payments is particularly hard on any community, especially the poor leading to incomplete or even no treatment during their ill health. This study estimated OOPE among residents of a rural community in West Bengal and explored the associated factors with high OOP expenses. Methods: A community-based cross-sectional study was conducted in a rural community in Singur, West Bengal from June 2019 to February 2020. The study was done among 398 villagers selected from 15 clusters or villages. Households were randomly selected in each village. All members of the selected households were interviewed. SPSS was used for data analysis both for descriptive and inferential statistics. Results: Only 14.6% of morbid persons had catastrophic expenditure. The incidence of catastrophic expenditure was higher among those who opted for private practitioners and or ayurveda, yoga and naturopathy, unani, siddha, and homeopathy (AYUSH) facilities. There was zero catastrophic expenditure for the unqualified sector. There was an increasing trend of OOP payments among the lower socioeconomic groups. Again, low-income individuals had a higher share in cumulative expenditure (Gini coefficient of 0.35). Most of the participants (78.4%) had no health insurance coverage. Conclusion: Promotion for higher utilization of public health facilities may reduce the burden of OOP expenses. Government health insurance schemes must be widened with the inclusion of coverage of outpatient services. Integrating AYUSH services in the public sector is another option to reduce OOP expenses.

Maintaining the purity of pig breeds is an essential task for their economic value. The traditional breed identification methods through coat colour are prone to error due to huge intra-breed variation. This paper uses principal component Analysis (PCA) to classify the pig breeds using their images. Individual images of five different pure breeds were captured from organized farms in India under both controlled and uncontrolled environments. Three different image sets were created, containing images in the controlled, uncontrolled, and mixed environment image sets. With 80:20 training to testing datasets, 93% accuracy was found in the proposed method of principal component analysis. Finally, two performance-based comparative analyses of our method were done with PCA-based methods and other renowned techniques used for animal breed identification, wherein our PCA method outperformed others in both comparative scenarios.

Background and Objectives: Pregnancy, an altered physiological state, is specifically vulnerable to psychological distress (PD), more so during the coronavirus disease 2019 (COVID-19) pandemic. This can impart detrimental consequences to both mother and child. This study assessed the magnitude of PD and associated factors among pregnant women in rural West Bengal. The proportion of pregnant women with COVID-19 symptomatology and its relationship with PD was also determined. Methods: This cross-sectional study was done among 130 pregnant women availing antenatal care in health centers during August–October 2020. Patient Health Questionnaire (PHQ-4) was used to assess PD and a “Perception on COVID-19 Pandemic” (PCP) Scale was used to assess the perception of the COVID-19 pandemic (Cronbach's alpha = 0.75). Statistical analyses were done in SPSS Inc., SPSS for Windows, Chicago, USA. Results: The proportion of study participants with PD was 49.2%. Unsatisfactory antenatal care (AOR = 19.4, CI = 2.5-152.7), COVID-19 case within family/neighborhood (AOR = 6.3, CI = 1.2-34.9), strenuous spousal relationship (AOR = 7.3, CI = 1.1-50), increasing score in perceived susceptibility domain of PCP Scale (AOR = 1.3, CI = 1.1-1.6), and decreased daily sleep duration (AOR = 2.8, CI = 1.6-4.9) were found to be associated with PD. 38.5% of participants reported COVID-19 related symptoms. Conclusion: The magnitude of PD among pregnant women in the study area is high. Thus, proper counseling of pregnant mothers during antenatal visits by public health nursing personnel to alleviate fears about the pandemic would go a long way to reduce the negative impact of PD on mother and child.

The health insurance industry requires a secure data management architecture characterized by reliable information processing and fast response. Classical health insurance management system runs on a manually controlled centralized architecture which leverages a vulnerable single point failure and requires frequent human intervention. This makes the model prone to human errors and security attacks. The existing system also lacks the flexibility to choose appropriate health insurance policies for different consumers. To this end, we propose an Ethereum blockchain-based framework, ChainSure, to address this problem. With the power of TOPSIS and smart contracts, ChainSure provides an automated, tamperproof, transparent, scalable system that takes care of all the major functional blocks in a medical insurance environment. We have used the TOPSIS method in this proposed model to help the users to find an insurance policy that best suits their needs. ChainSure works in a decentralized environment and provides an interactive interface for the user. The proposed model is implemented on the Ethereum test network and its performance has been compared empirically with other state-of-art models. ChainSure is found to outperform others in terms of service integrity, latency and cost.

A healthy and diversified diet is essential for preventing several non-communicable diseases (NCDs). Given the increasing evidence of diet-related health burdens and the rising prevalence of NCDs among Indian adults, the present study aims to explore dietary diversity patterns among adult men in India and their association with non-communicable diseases (NCDs). For this purpose, the study used the fourth round of the National Family and Health Survey (NFHS-4) to analyze adult male samples (n = 1,12,122). Dietary Diversity Scores (DDS) were computed by the weighted sum of the number of different food groups consumed by an individual. The prevalence of diabetes, heart disease, and cancer among adult men is considered a non-communicable disease. Bivariate and logistic regression was carried out to examine the association between DDS and NCDs by estimating chi-squared tests (χ2-test), odds ratio (OR), and 95% confidence interval (CI). The prevalence of diabetes, heart disease, and cancer among adult men in India is 2.1 percent, 1.2 percent, and 0.3 percent, respectively. Results show a positive association between dietary diversity score and the prevalence of the non-communicable disease. High-level dietary diversity scores increase to two times the likelihood of diabetes (OR 2.15 with p

Monitoring biosignals is crucial for intelligent health applications. Internet of Health Things (IoHT) provides a new path for monitoring the biosignals. Environment adaptive data dissemination is the primary requirement for the deployment of time and space-efficient monitoring systems. Existing dew-based systems lack an opportunistic architecture of data-synchronization with the cloud. This paper proposes a model that makes efficient use of IoT and cloud-dew architecture for a sustainable health monitoring system. Wireless sensor nodes are used to monitor the biosignals dynamically. All accrued data is temporarily stored in the dew layer. It is synchronized with the cloud at a subsequent phase to achieve seamless accessibility and optimal scalability of the data. Data synchronization plays an essential role in the cloud dew framework. We have used the Gini index and Shannon entropy to ensure intelligent data synchronization with the cloud. Sometimes sensors produce erroneous data, which poses a significant threat to the sustainable health monitoring system. Fuzzy normal distribution with a triangular membership function has been used to clean up the data and filter out the outliers. Further, we compared the proposed MedGini model with the existing models and analyzed the system performance. MedGini is found to outperform others concerning cost and power consumption.

Introduction: Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. Thus, regular and accurate measurement of Blood Pressure (BP) is essential for its early diagnosis and follow-up. There is a surge in popularity of digital sphygmomanometer due to its convenience of use and functionality. In contrast, the traditional universally accepted sphygmomanometer is aneroid type, hence there arise a need for comparison of digital and universally accepted Aneroid Sphygmomanometer in terms of agreement and correlation. Aim: To evaluate the agreement and correlation between blood pressure measurement by digital and aneroid sphygmomanometer. Materials and Methods: The clinic based cross-sectional study was conducted in the Out Patient Department (OPD) of Urban Heath Centre, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India. Adults visiting the OPD on two chosen days of the week, between June 2019 to July 2019 were selected using systematic random sampling. A total of 400 participants were included. Agreement and correlation between BP measurements by digital and aneroid sphygmomanometer was analysed by Cohen’s Kappa, Bland Altman Plot along with sensitivity, specificity and predictive values using Microsoft Excel and Statistical Package for the Social Sciences (SPSS) version 16.0. the p-value

Background: World Health Organization (WHO) declared vaccine-hesitancy (VH) as an emerging threat to global health. There are limited studies from developing countries, especially from Eastern India, addressing parental VH's determinants and its impact on childhood immunization. Current study aims to assess the prevalence of incomplete immunization in children and parental VH, explore the socio-demographic determinants, and delineate their interconnections. Material and methods: In this hospital-based, cross-sectional study vaccination cards or parents’ recall method were used to inquire about immunization status and the Likert-vaccine hesitancy scale (VHS) developed by WHO Strategic Advisory Group Experts on Immunization (SAGE) was utilized as an instrument to measure VH. Multivariate analyses were performed to identify the independent predictors. Results: The prevalence of incomplete immunization and VH were 18.9% and 41.6% respectively. Significant predictors of incomplete immunization were maternal education, socioeconomic status, gender, and place of delivery. Most responders believed vaccines are effective (99%), important for child's health (98%) and most vaccines offered by the government are beneficial (95%) but were also concerned about serious adverse effects (41%) and feared about new vaccines carrying more risk than old vaccines (16%). Maternal education and family type were significant determinants of VH. Incomplete immunization was significantly prevalent among children with vaccine-hesitant caregivers, though it was not found to be an independent predictor in multivariate analysis. Conclusions: This study emphasizes the magnitude of the issue of incomplete immunization, VH, and unravels its contributing factors which will help public-health care providers with a roadmap to prioritize resources and focus on preventable measures like health education, ensuring institutional births, and free health-service delivery expansion to increase immunization coverage. Caregivers’ VH is a major roadblock to attaining better immunization coverage which can be tackled through proper counselling to improve their health literacy.

Various training algorithms are used in artificial neural networks for updating the weights during training the network. But, the selection of the appropriate training algorithm is dependent on the input–output mapping of dataset for which the network is constructed. In this paper, a framework has been proposed consisting of five modules to select the optimal training algorithm for predicting pig breeds from their images. The individual pig images from five pig-breeds have been captured using inbuilt camera of mobile phone and the contour of pig has been segmented from each captured image by HUE-based segmentation algorithm. In Statistical Parameter and Color Component retrieval module, parameters like entropy, standard deviation, variance, mean, median, and mode and color properties like hue, saturation, value (HSV) extracted from the content of each segmented image. Values of all extracted parameters have been transferred into Training Algorithm Selection Module. In this module, a fitting neural network with different numbers of hidden neurons has been executed by feeding all extracted values from pig images for mapping their breeds. Ten training algorithms have been applied on the same extracted dataset separately for five epochs each keeping other network parameters constants. The mean square error (MSE) and correlation coefficient (R) for the validation set have been calculated after adjustment of weights and biases in each connection of the neurons. One training algorithm among 10 and its suitable number of hidden neurons has been selected based on comparative analysis for getting lower MSE and higher R in the validation set. Then, the fitting network with selected training algorithm has been run on the same extracted datasets until the stopping condition is reached. Then the test set images are fed into the network and the network output has been categorized to class which has been assigned to each breed of pig in Breed Prediction Module. The proposed framework has been able to predict breeds with 96.00% accuracy, achieved by the trial with 50 images of the test set. It may be concluded that the Neuro Statistic Neural Network model may be used for breed prediction of pigs by using images of individual pigs.

Context: Tobacco smoking is one of the preventable causes of death. Global Adult Tobacco Survey 2 report showed that 19% Indian males were current smokers. It is important to find out factors which help smokers on smoking cessation, ultimately to prevent of lung and other morbidities. There are few community-based studies on intention and attempt to quit smoking in rural area. Aims: The present study aimed to determine the factors associated with intention and attempt to quit smoking among current smokers. Settings and Design: A cross-sectional study was conducted from June to September 2019 among 198 male daily smokers residing in the rural field practice area of AllH and PH, Kolkata. Subjects and Methods: After cluster sampling, data were collected by predesigned schedule by the face-to-face interview. Results: 151 (76.3%) study subjects intended to quit smoking. 63 (31.8%) study subjects attempted to quit in last 1 year. Thirty-one (47.5%) showed high-to-medium nicotine dependence. There was a significant association of intention to quit with agriculture as occupation (acquisitive crime [AOR]-2.17, confidence interval [CI]-1.01–4.63), low nicotine dependence (AOR-2.98, CI-1.43–6.21), doctor's advice (AOR = 2.84, CI-1.27–6.33), and family pressure (AOR = 2.16, CI-1.07–4.38). Attempt to quit was significantly associated with low nicotine dependence (AOR = 5.85, CI-2.85–12.00), family pressure (AOR = 2.94, CI-1.47–5.91). Conclusion: Along with counseling to reduce nicotine dependence, comprehensive approach both from family members as well as health care providers, is vital to escalate the quitting behaviour in smoking habit.

Background: Village Health and Nutrition Day (VHND) is a community participation program focusing on pregnant women, lactating mothers, children (0–5 years), and adolescent girls. Objectives: To assess the status of VHND functioning in the rural areas, and to determine the facilitators and barriers of health care service utilization among the beneficiaries. Also, to explore the challenges faced by the front-line workers while conducting the program. Methods: A cross-sectional descriptive study with a mixed-methods approach was conducted among the beneficiaries and the service providers in twelve selected VHND sessions from March to July 2019 in Singur, Hooghly district, West Bengal. Both quantitative and qualitative methods of research were applied to assess the status of the functioning of 12 VHNDs. Results: Among the beneficiaries who attended the sessions; 28.57% were pregnant women, 16.53% were lactating mothers and 17.44% were under-five children. Nonavailability of line-list of adolescent girls and nonavailability of Vitamin A in oil were major observations. Barriers leading to poor service utilization among beneficiaries were the long-distance of the VHND session site, lack of counseling on proper lifestyle practices, poor and inadequate infrastructure. House visits by the Accredited Social Health Activists regarding the information on VHND sessions found to be an important facilitating factor for beneficiaries. Major challenges identified among the healthcare workers were lack of logistics supply, inadequate workforce, and improper the maintenance of the VHND session site. Conclusion: Proper resource mobilization, maintenance and cleanliness of the session sites, appropriate and wholesome counseling can vastly improve the quality of VHND with the concurrent improvement of maternal and child health.

Introduction: Diabetes is one of the major disease burdens in the world. Globally around 463 million people (at a prevalence of 9.3%) suffered from diabetes recently. Apart from morbidity and mortality, diabetes poses high economic burden on healthcare systems, especially on national economies in developing countries like India. Estimation of the cost burden of diabetes can help decision-makers to understand the magnitude of the problem, prioritize research efforts and interventions, and plan resource allocation, especially in resource-poor settings. The focus of our review was to summarize cost burden of diabetes and its determinants from existing literature in the last 10 years in India. Materials and Methods: All literatures published in the period 2010–2020 were accessed through two databases: PubMed and Google Scholar. Reference lists of the article were again searched for further literatures. Cost calculated in different times was converted to current price in 2020 for ease of comparison. Results: Studies reported a wide range of expenditures in different settings of care. Inequity of expenses across income quintiles among patients was found. Complication of diabetes, insulin therapy, treatment in private facility, and events of hospitalization were the factors associated to high expenditure burden. Conclusion: Financial risk protection for vulnerable people and control over medicine market price will reduce out-of-pocket expenditure for diabetes. Comprehensive strategy to delay onset of complication as well as its early detection can be an opportunity to cut down diabetes-related economic burden.

Context: Anemia is a serious public health concern especially in women of reproductive age (WRA) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle. As most of the risk factors are preventable, a thorough understanding of its risk factors is necessary to design better interventions. Aims: Current study aimed to estimate the burden of anemia as well as explore determinants of various grades of anemia among WRA in a rural area. Settings and Design: A community-based cross-sectional study was conducted among non-pregnant, non-lactating women of reproductive age in rural field practice area of All India Institute of Hygiene and Public Health. Methods and Materials: House to house visit was conducted for interviewing with pre-designed pre-tested questionnaire along with blood hemoglobin and anthropometric measurement. Statistical Analysis Used: Descriptive statistics and test of significance like multinomial logistic regression and Kruskal-Wallis test (with post-hoc) were used. Results: Majority (70.8%) of participants were anemic. Proportion of mild, moderate, and severe anemia were 24.16%, 37.5%, and 9.16%, respectively. Different levels of anemia were significantly associated with higher age, lower education, poor iron-rich food intake, lack of dietary diversity, and adiposity. Significantly low hemoglobin level in both underweight and obesity was noticed suggesting U shaped relationship between BMI and anemia. Conclusion: Periodic screening for anemia among WRA especially in both extremes of malnutrition, i.e., undernutrition and obesity should be considered at the policy level. Year-round behaviour change communication campaigns must be carried out for the promotion of necessary food groups in diet.

Context: In India, despite implementation of the strategies under National Tobacco Control Programme [NTCP], women are easily exposed to tobacco consumption that is smokeless (SLT) and smoking tobacco along with second-hand smoke [SHS], making them highly susceptible to tobacco hazards. Aims: This study aimed to assess the exposure of women to tobacco use and SHS at home and to elicit predictors of tobacco exposure in a rural community of West Bengal. Methodology: A community based, cross-sectional study was conducted among 176 women aged 18 years and above. Data was collected by cluster sampling technique (16*11) using predesigned pretested structured schedule. Tobacco exposure was measured using a composite score including tobacco consumption and SHS at home. Results: Tobacco use (SLT and smoking tobacco) was significantly associated with educational attainment [AOR = 2.12], occupation [AOR = 2.13] and knowledge [AOR = 1.22]. There was significant association between SHS at home with knowledge [AOR = 1.16] and attitude of the study subjects. [AOR = 1.93]. Overall tobacco exposure (SLT, smoking tobacco, and SHS), was found to be 79.5%. Significant association was found between high tobacco exposure with age group [AOR = 3.82], educational attainment [AOR = 1.74] and knowledge regarding hazards of tobacco [AOR = 1.31]. Conclusion: Prevalence of SLT use as well as exposure of women to SHS at home is unexpectedly high in the study population. Women specific information and education campaigns focusing on tobacco hazards (both tobacco use and SHS) through existing primary health care infrastructure should be strategized under NTCP.

Context: With the aging of Indian society, maintaining salubrious cognitive health in late life is a public health priority. Early detection and possible prevention of cognitive impairment (CI), thus, will help in increasing the quality of life of elderly people and decreasing the social, psychological, and economic burden of their families and caregivers. Aims: The study aimed to assess proportion of CI and its predictors. Settings and Design: This community-based cross-sectional study was conducted among 135 elderly people selected from 15 villages out of a total 64 villages in rural field practice area Singur of AIIH&PH, Kolkata. Methods and Material: Cluster sampling technique was used and villages were selected according to probability proportional to size method. Data was collected using a predesigned, pretested structured schedule, which included sociodemographic and behavioral variables, Montreal cognitive assessment tool, Geriatric depression scale short form (GDS 15), and mini nutritional assessment tool. Statistical Analysis Used: Predictors of CI were assessed by univariate and multivariable logistic regression using MS-Excel 2016 and SPSS version 16 software. Results: Mean age of the study participants was 67.03 ± 6.7 years with 51.9% of them being females. Proportion of CI was observed to be 48.1% which was significantly associated with increasing age [AOR = 1.1 (1.02–1.13)], decreasing years of schooling [AOR = 1.1 (1.01–1.2)], depression [AOR = 2.7 (1.3–5.8)], and malnourished group [AOR = 4.5 (1.01–20.3)] Conclusion: The burden of CI among the study population was found to be quite high. It is an alarming situation which needs improved screening facility for early detection. Nutritional upliftment and screening for depression should also be done on a regular basis.

Introduction: Adolescent Hypertension (HTN) is one of the most alarming public health problems and is a potential risk factor for non-communicable diseases as asymptomatic, mostly remain undiagnosed. Simple anthropometric indicators acting as preliminary screening tool to predict HTN among adolescents is the need of hour. Aim: To find out the magnitude of pre HTN and HTN among adolescent school students of North 24 Parganas and to find out the variation of blood pressure with different anthropometric parameters. Materials and Methods: A cross-sectional study was carried out from June to September, 2019 among 369 adolescent school students of class VIII to XII in two Government higher secondary schools, selected conveniently, in North 24 Parganas. Data was collected by face to face interview, blood pressure recording and anthropometric measurements in the selected schools was done. Data was analysed using SPSS version 16.0. Results: Among 369 participants, 189 (51.2%) were boys and 180 (48.8%) were girls. Mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) among boys were 110.2 (±14.9), 68.0 (±9.3) and among girls 113.1 (±14.3), 71.2 (±9), respectively. Overall HTN was found to be 7.0% (6.3% in boys and 7.8% in girls) and pre HTN was 13.8% (12.2% in boys and 15.6% in girls). There were significant (p

Introduction: Alzheimer Questionnaire (AQ) and Montreal Cognitive Assessment (MoCA) are tools for assessment of cognitive impairment. MoCA is a common tool for screening of cognitive impairment but it requires trained personnel. AQ questionnaire is informant-based, simple and less time consuming with or without the involvement of trained personnel. Aim: To estimate the prevalence of cognitive impairment and to find out the accuracy of AQ compared to MoCA in Cognitive Impairment screening among elderly population in an urban area of West Bengal. Materials and Methods: The Prospective cross-sectional study was conducted in urban field practice area of All India Institute of Hygiene and Public Health, Kolkata among 140 randomly selected elderly population from June to September 2019. Accuracy of AQ with MoCA tool as gold standard in screening cognitive impairment was analysed by Cohen’s Kappa, Receiver Operating Characteristics (ROC) Curve, Spearman rho Coefficient along with sensitivity, specificity, predictive values and likelihood ratio was obtained. Results: Prevalence of cognitive impairment using MoCA and AQ was 40% (95% CI=31.8-48.6) and 36.4% (95% CI=28.5- 45.0), respectively. AQ and MoCA showed good agreement (Cohen’s kappa, κ=0.834; 95% CI=0.739-0.928). The AQ and MoCA showed a strong negative correlation (spearman’s Rho=-0.709; 95%CI=0.764-0.884, p-value

INTRODUCTION:“Gender” denotes the differences in the social roles of different sexes. This interaction results in variable health outcomes and care-seeking behavior. The present study was conducted to find out the attitude of school-going adolescents regarding gender equity and also to explore teachers' perceptions in this context in a school of tribal belt of West Bengal. MATERIALS AND METHODS:A cross-sectional, mixed-method study was conducted among the students of classes eight to twelve, chosen by complete enumeration technique, with a predesigned, pretested validated questionnaire. The questionnaire was based on Gender Equitable Men scale and International Men and Gender Equality Survey questionnaire, comprising the following domains: 'Gender restrictions', 'Gender attributes', and 'Gender domination'. The respondents were categorized into 'high', 'moderate', and 'low' groups as per their domain-wise attitude scores. In-depth interviews (IDIs) were conducted among seven teachers chosen purposively. Thematic analysis was done with the qualitative data. RESULTS:Out of 191 students, 112 were girls (58.6%) and 47 belonged to scheduled tribe category (24.6%). Overall, 170 (89.0%), 80 (41.9%), and 96 (50.3%) students had a high gender-equitable attitude regarding the domains of 'gender restrictions', 'gender attributes', and 'gender domination' respectively. Girls had higher percentage of high gender-equitable attitude in all the three domains (92.0%, 57.1%, and 50.9%, respectively). Regarding 'gender restrictions', 91.2% had high gender-equitable attitude in lower age group, compared to 81.4% in higher age group. Among the lower and higher age groups, 52.7% and 41.9% respectively, had high gender-equitable attitude on 'gender domination'. Gender inequality amidst poverty, women deprived of health care, and gender violence were the major themes derived from the IDIs. CONCLUSION:Girls had a better attitude toward gender equity. Laws regarding gender dominance and violence should be focused. Conducting intensified awareness campaigns on gender equity and addressing women's right to health is a much-needed timely intervention for the health of womenfolk.