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Background: In order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India. Methods: A mixed-method, pragmatic, quasi-experimental trial design was used. HPV screening on self-collected cervical samples was offered to women aged 30–60 years. Implementation strategies were 1) Assessment of contextual factors using both qualitative and quantitative methods like key informant interviews (KII), focus group discussions (FGDs), pre-post population sample surveys, capacity assessment of participating departments 2) enhancing provider capacity through training workshops, access to HPV testing facility, colposcopy, thermal ablation/cryotherapy at the primary health care centers 3) community engagement, counselling for self-sampling and triage process by frontline health care workers (HCWs). Outcomes were assessed using the RE-AIM (Reach, Effectiveness, adoption, implementation, maintenance) framework. Results: Screening rate in 8 months' of study was 31.0%, 26.7%, 32.9%, prevalence of oncogenic HPV was 12.1%, 3.1%, 5.5%, compliance to triage was 53.6%, 45.5%, 84.6% in tribal, urban slum, rural sites respectively. Pre-cancer among triage compliant HPV positive women was 13.6% in tribal, 4% in rural and 0% among urban slum women. Unique challenges faced in the tribal setting led to programme adaptations like increasing honoraria of community health workers for late-evening work and recalling HPV positive women for colposcopy by nurses, thermal ablation by gynaecologist at the outreach camp site. Conclusions: Self-collection of samples combined with HCW led community engagement activities, flexible triage processes and strengthening of health system showed an acceptable screening rate and better compliance to triage, highlighting the importance of identifying the barriers and developing strategies suitable for the setting. Trial registration: CTRI/2021/09/036130. [ABSTRACT FROM AUTHOR]

Background: Poor entry in the Census or health information system, nomadic tendency, low education and unhealthy lifestyle poses the Gypsy population to many illnesses and health problems. objective: This study was aimed to assess the morbidity pattern and health seeking behaviour of the Gypsy Community residing in Vellore district. Methodology: A quantitative cross sectional research design was used to assess the morbidity pattern and health seeking behaviour. A total of 40 families with 135 subjects were selected by convenience sampling method. The morbidity pattern and health seeking behaviour was assessed using a survey format and questionnaire, constructed by the investigator. Results: Findings showed that majority of the population 101(74.8%) had at least one illness (chronic/ acute) of which 66(65.3%) had taken treatment. Private sector was mostly 37(51.2) used by the people. The perceived morbidities were expressed by them where 10(33.3%) had non-communicable diseases, 31(23%) cough and cold, 12(9%) diarrhea, 27(20%) aches and pains, 11(5.4%) skin problems and 12(9%) had worm infestation. Obese Class 1 was found among 16(18.8%) of the adults assessed and 41(51.8%) were high risk for developing diabetes according to the Indian Diabetes Risk Score. From the findings it was clear that there was a significant association between age (p<0.003), education (p<0.08), and type of house (p<0.008) with the presence of chronic illness. Association was also significant with age (p<0.002), religion (p<0.016) and education (p<0.046) with the choice of taking treatment for chronic illness. Conclusion: The findings suggest that the majority of the people of Gypsy community had poor health seeking behavior and was ignorant about the services available in the government sector. There is a great need to strengthen health services emphasizing on the promotional activities and offer health care services to prevent morbidities. [ABSTRACT FROM AUTHOR]

Background: The satisfaction of antenatal women to antenatal services has rarely been studied in India. In a nation with a maternal mortality ratio of 178/100,000 live births, it is crucial to explore all avenues to reduce it. Aims: Our study aims to assess the pregnant women's satisfaction with regard to antenatal care services provided by nurse-midwives in an urban health center in South India. Methods: We administered a satisfaction of care questionnaire to 200 consecutive antenatal women attending the nurse run antenatal clinics from April 2014 to November 2014. The date entry was done using Epi-Data system and the analysis by SPSS version 16. Statistical Analysis Used: The absolute distribution of each of the question in the satisfaction of care questionnaire was calculated as proportions. The relationship between satisfaction of care and parity, number of visits, years of experience of the care provider and mother's education was tested using Mann-Whitney test for two independent groups. Results: The mean age of the mothers was 23.5 years. More than 95% of the mothers expressed satisfaction with the number of antenatal visits components of antenatal care. Only 31.8% of the mothers were satisfied with the health education on family planning. There was no significant relationship between satisfaction of care and parity of mothers or years of experience of care provider. Conclusions: Pregnant women attending a nurse run antenatal care service have positively expressed satisfaction of care provided therein. [ABSTRACT FROM AUTHOR]