Mamta Health Institute for Mother and Child

Introduction: Poor dietary practices, unhealthy eating habits, and a lack of awareness about anemia remain significant public health challenges in India, especially among women of the reproductive age group. Sociocultural norms, limited access to information, and poor behavior practices further aggravate the issue. Therefore, addressing these challenges requires community-based interventions that not only disseminate knowledge but also aim to transform attitudes, social norms, and behaviors. Objectives: This study aimed to assess the effectiveness of the community-based intervention in improving knowledge, attitudes, practices, and social norms among adult women in selected blocks of the Gorakhpur district, Uttar Pradesh, India. Methods: The intervention was implemented across 120–150 villages, reaching around 25,000 women and girls from two intervention blocks. Cross-sectional baseline and endline surveys were conducted with randomly selected samples of 412 and 479 women, respectively. Data were collected using similar semi-structured questionnaires at both time points. A multivariate analysis of variance test was conducted to assess changes in key outcomes (knowledge, attitude, norms, and practices) and predictors (baseline or endline, age, ration cards, education, and family type). Data analysis was performed using STATA 16.0, with P < 0.05 considered statistically significant. Results: The mean age of participants was 27 years at the baseline and 32 years at the endline. Significant improvements ( P < 0.0001) were observed in knowledge, attitudes, descriptive norms, intentions, injunctive norms, and perceived behavioral control scores at endline compared to baseline. Conclusions: This study demonstrates that community-based interventions can significantly enhance nutrition-related knowledge and behaviors among women. Future programs should focus on shifting norms and beliefs through long-term interventions to improve sustainability.

Despite advancements in maternal health in India, disparities in service coverage persist, particularly in rural and challenging regions. This study evaluates the maternal health service coverage index (MHSI) in Himachal Pradesh, a predominantly hilly state with a largely rural population. By calculating this composite index, the study aims to identify disparities in service utilization across districts. The findings will inform targeted interventions to improve maternal health outcomes and address inequalities within the state. A retrospective analysis was conducted using maternal health indicators from the health management information system (HMIS) report of Himachal Pradesh from March 2020 to April 2024. Separate indices for antenatal, perinatal, and postnatal services were calculated which were then combined into a composite index (MHSI) using arithmetic mean method. The analysis revealed significant disparities in maternal health service coverage across districts. Districts like Bilaspur, Mandi, and Shimla consistently showed high composite indices, indicating robust maternal health services. In contrast, remote districts such as Lahul and Spiti, Kinnaur, and Chamba faced challenges in service coverage, particularly in antenatal care (ANC) and perinatal care. The findings highlight significant disparities in maternal health service coverage across Himachal Pradesh, particularly in remote districts (Lahaul-Spiti and Kinnaur). These disparities underscore the need for targeted interventions to improve access to and utilization of maternal health services in underserved regions.

This chapter presents a research study on contraception among young and low-parity couples in India. It used the community scorecard method to understand their knowledge, attitude, perception, and use of contraception, and the barriers they face in accessing and obtaining contraceptive methods. The study also examined partner involvement and inter-spousal communication. The study reported higher awareness of FP methods among women than among men but poor knowledge of FP method availability and accessibility among both. Further, there was a positive perception of CHW’s role and a high perception of barriers in terms of social norms, lack of knowledge, and limited access to services among women. A bidirectional relationship between spousal support and method satisfaction was observed. The inter-spousal communication and decision-making by women were moderately reported by women. Findings provide insights for policymakers to address family planning needs. Focusing on young couples is important due to their higher unmet need for family planning. The study emphasizes the role of men in family planning decision-making highlighting the need for improved communication between partners. In summary, this chapter presents a scientifically rigorous study on contraception among young couples in India, offering insights to address their family planning needs using robust research methods.

Purpose: Happiness is the inner feeling, joy and satisfaction state of the all living beings. The young and growing children percept and feel their surroundings with curiosity. The research aims to illustrate that the components of school environment play an important role in happiness of school children.Design/methodology/approach: For this study, 300 students from various junior high schools were selected randomly from class 6th, 7th and 8th of basic Shiksha parishad district Ghazipur, Uttar Pradesh, India. The tool for the study was self-made attitude scale consisting of 50 items in which five dimensions of the school environment were taken, each dimension having 10 items related to that dimension. Quantitative research technique has been used for the data analysis, t-test was done to test the null hypotheses whether they are significant or not.Findings: The data analysis revealed that most of the (90.09%) students feel happy with various dimensions of the school environment. Various dimensions of school environment are School Infrastructure, Behaviour of Teaching and Non-teaching staffs, Students related variables, Curricular and Co-curricular activities, among which Students related variables contribute most in the happiness of the students.Educational Implications: Happiness is an important construct which is related with the well-being of the school children, so the present study will be significant for the school administrators, teachers and policy makers to enrich the school environment with curricular and co-curricular activities to increase the happiness level of the students.Originality/Value of the work: The study contributes to the existing knowledge about the school environment and student`s happiness. The students of Basic Siksha Parishad of class 6th, 7th and 8th were from weaker section and deprived of the basic resources. Reflection obtained from the real data provides a vast view about the components of the school environment and their role in the happiness of school students.

Introduction/Background: The nationwide lockdown enforced due to the devastating effect of the coronavirus disease -2019 had a definite impact on sleep health. Objective: To look out for any change in the duration, pattern and quality of sleep among pharmacy students that can be attributed to the lockdown. Methods: A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the institutional ethics committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the volunteer informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analysed using STATA version 16.0. Results and Discussion: Out of the total 310 participants, majority of the respondents were females 242 (78.06%). The study revealed an increase in the time needed to fall asleep (p-value<0.001) and in the total duration of sleep (p-value<0.001). A delay in the time of sleep in the morning (p-value<0.001) and at night (p-value<0.001) was also one among the many significant results. Well known reasons or consequences of disturbed sleep such as jerky leg movements (p-value<0.001), snoring (p-value<0.001), frequent nightmares (p-value<0.001) and anxiety (p-value<0.001) were also increased as a direct effect of the lockdown. Conclusion: The study has been able to establish the incidence of significant disturbances in the sleep architecture of pharmacy students due to the lockdown.

Under Rashtriya Kishor Swasthya Karyakram (RKSK), adolescent friendly health centers (AFHC) entail a whole gamut of clinical, counseling and referral services on diverse adolescent health issues ranging from sexual and reproductive health to nutrition, substance abuse, injuries, violence, non-communicable diseases and mental health issues at various level of health care facilities. These facilities are also providing de-addiction services; hence State proposed the name of these facilities as Nayi Disha Kendra (NDK). A total of 99 facilities are notified as NDKs in the state. These are established at medical college/ zonal hospital/ district hospital/ community health centre. NDK is established in a separate room. In case of non-availability of separate room, the available room is sub-divided to create space. The physical appearance of NDK is important for creating an environment where beneficiaries feel comfortable. A typical health setup might not attract adolescents; a simple makeover is done with wall paint, colorful furniture, bright posters, IEC with appropriate health messages etc. Basic amenities like sitting arrangement clean drinking water and clean toilets are made available for the adolescents visiting the Kendra. All the clinical, counselling and referral services are provided by the trained staff of NDK. The timings of NDK are 9:30 to 4:00 pm (Monday to Saturday).

India has made significant progress in improving maternal and child health. However, there are persistent disparities in maternal and child morbidity and mortality in many communities. Mistreatment of women in childbirth and gender-based violence are common and reduce women’s sense of safety. Recently, the Government of India committed to establishing a specialized midwifery cadre: Nurse Practitioners in Midwifery (NPMs). Integration of NPMs into the current health system has the potential to increase respectful maternity care, reduce unnecessary interventions, and improve resource allocation, ultimately improving maternal–newborn outcomes. To synthesize the evidence on effective midwifery integration, we conducted a desk review of peer-reviewed articles, reports and regulatory documents describing models of practice, organization of health services and lessons learned from other countries. We also interviewed key informants in India who described the current state of the healthcare system, opportunities, and anticipated challenges to establishing a new cadre of midwives. Using an intersectional feminist theoretical framework, we triangulated the findings from the desk review with interview data to identify levers for change and recommendations. Findings from the desk review highlight that benefits of midwifery on outcomes and experience link to models of midwifery care, and limited scope of practice and prohibitive practice settings are threats to successful integration. Interviews with key informants affirm the importance of meeting global standards for practice, education, inter-professional collaboration and midwifery leadership. Key informants noted that the expansion of respectful maternity care and improved outcomes will depend on the scope and model of practice for the cadre. Domains needing attention include building professional identity; creating a robust, sustainable education system; addressing existing inter-professional issues and strengthening referral and quality monitoring systems. Public and professional education on midwifery roles and scope of practice, improved regulatory conditions and enabling practice environments will be key to successful integration of midwives in India.

Early adolescence is the period of the emergence of most mental disorders contributing significantly to the mental health burden globally, including India. The major challenges in India are early identification of mental health problems, treatment gap, lack of professionals, and interventions that address the same. Our review aimed to assess the effectiveness of mental health interventions among adolescents in India. We systematically searched PubMed, PsycINFO, and Cochrane databases and used cross-referencing to review the interventions published from 2010 to 2020. Eleven interventions were included in this review; nine were school-based, one community, and one digital. Most of the school-based programs used a life skills curriculum. Additionally, coping skills and resilience curricula showed improvement in depressive symptoms, cognitive abilities, academic stress, problem-solving, and overall mental well-being. The multi-component whole-school intervention was quite promising and helped in improving the overall school climate and various other mental health outcomes. Hence, school-based programs should be implemented as an entry point for screening mental health problems. However, there is a need for a more comprehensive mental health program in the country for adolescents. Additionally, there is a need to address the gap by conducting more interventions for early and out-of-school adolescents.