Behavior Change Communication Research Articles

Relationship Education during Pregnancy and Postpartum: In-Person versus Virtual Delivery of MotherWise

Ample research attests to the effectiveness of in-person relationship education, including education delivered to women who are pregnant or have just had a child. Relationship education delivered virtually may also be effective and hold advantages of accessibility and affordability. Few studies have compared outcomes for the same program delivered virtually and in-person, or prior to versus during the COVID-19 pandemic. The present study analyzed enrollment characteristics, satisfaction with the program, and pre-post changes in communication behaviors, relationship satisfaction, and psychological distress for women who participated in the evidence-based MotherWise program in-person and prior to the COVID-19 pandemic versus those who participated virtually after the pandemic began. The virtual and in-person programs enrolled demographically similar participants who received roughly the same amount of content. Perceptions of the program were positive across modalities and participants in both modalities demonstrated significantly reduced psychological distress from before to after the program. In-person participants reported finding the program more helpful than virtual participants on only one indicator, their ability to handle relationship conflict. Thus, while the current study does not establish equivalency across treatment modalities in efficacy, it does demonstrate the feasibility of transitioning relationship education for individuals from an in-person to a virtual setting.

Utilization of Contraceptives and Associated Factors among Students of Kampala International University-Western Campus Ishaka, Bushenyi District, Uganda

The aim of this study was to determine the utilization of contraceptives and associated factors among students of Kampala International University-Western Campus Ishaka, Bushenyi District, Uganda. A descriptive crosssectional study design was used. A structured questionnaire was used to collect data from 136 final-year students from the School of Allied Health Sciences, School of Engineering and Applied Sciences and Faculty of Business and Management. The majority 112 (82.4%) of the respondents reported that they had ever used contraceptives and 95 (69.9%) reported that they were currently using contraceptives. The majority 118(86.6%) of the participants have ever had sex and among them, half 59(50.0%) had their first sex when they were above 20 years. The majority 81(68.6%) reported that they first used contraceptives when they were above 20 years and the type of contraceptives they used was condoms (52.5%). Most 66(48.5%) of the participants always use contraceptives while 59 (43.4%) seldom use and 56 (41.1%) of them stated that they use contraceptives when their partners are in their unsafe days. Concerning the knowledge about contraceptives, most 51(37.5%) reported that contraceptives are important to prevent pregnancies, and STDs and to promote child spacing. Most 51(37.5%) of the participants preferred to use condoms while 37(27.2%) preferred to use safe day methods. Regarding their reasons for their preferred contraceptives, 55(40.4%) said because they were affordable and 15(36.6%) indicated that their reason for not using contraceptives is to enjoy sex. Stakeholders should design, launch and implement inclusive youth-friendly services, adolescent sexual and reproductive health programs prioritizing the use of contraceptives, students’ empowerment in regard to sexual rights and reproductive health, behavioural change communications, and create an enabling environment for contraceptive use. Keywords: Sexual intercourse, Unintended pregnancy, Contraceptives, Condoms

The Williams and McCoy model of motivational spirited cognitive behavioral change communication

PurposeThe Williams and McCoy Motivational Spirited Cognitive Behavioral Change Communication (MIS-CBC) is an innovative model combining the spirit of motivational interviewing (MI) communication, and cognitive behavioral therapy (CBT) as a patient-centered care model to improve continuity of care while enabling patients to progress during therapy. ConclusionsIncorporating this model into Psychiatric Mental Health Advance Practice Nurse practice allows for provision of best practice with populations experiencing low motivation and subject to dropout. The model aims to improve patient motivation and engagement of CBT to achievement “full dose” CBT with more flexibility to significantly improve patient outcomes, particularly with patient populations subject to interruptions in psychotherapy. Practice implicationsThe Williams and McCoy MIS-CBC model has implications in areas of both practice and academia addressing episodic psychotherapy in populations where interruptions and dropout frequently occur.

Improving health indicators of mothers and newborns by empowering communities in urban slums of Mumbai, Maharashtra, India

Abstract Background: Newborns represent the most vulnerable segment of our society, constituting nearly 30% of all under-5 mortality cases. Despite well-established healthcare systems in metropolitan areas, urban slum dwellers, comprising approximately 50%–60% of the population, often lack access to these services. The Society for Nutrition, Education, and Health Action (SNEHA) operates within urban slums, aiming to enhance health outcomes for mothers and children. At SNEHA, we firmly believe that a healthy society starts with the well-being of mothers and infants. Our organization is dedicated to empowering communities to improve the health status of newborns in urban slums. Material and Methods: As part of the intervention, 7819 households with a population of 35,000 were targeted. SNEHA’s field workers conducted regular visits to these households, providing counseling on breastfeeding immunization and identifying potential health risks. Married women of reproductive age were specifically identified and consistently educated about the significance of early pregnancy registration. Pregnant women received support for registering their pregnancies, attending regular antenatal care (ANC) check-ups, adhering to ANC visit schedules, and maintaining adequate iron, calcium, and nutrition intake. Additionally, they were informed about the advantages of institutional delivery and encouraged to prepare for childbirth. Mothers of children under 2 years were urged to bring them to primary health centers for routine immunizations. Furthermore, they were advised on contraception methods to ensure proper spacing between children. Results: Our endeavors have resulted in a 34% rise in early pregnancy registration, a 22% increase in the number of women attending four antenatal check-ups, an 11% uptick in institutional deliveries, a 24% improvement in exclusive breastfeeding rates, and a notable 67% surge in the prevalence of contraception. Conclusion: Our intervention has proven that it is possible to improve the health indicators of women and children through behavior change communication, regular home visits, and community awareness.

Mapping the Role of Digital Health Interventions to Enhance Effective Coverage of Antenatal Care: A Scoping Review.

Antenatal care (ANC) is a core component of maternal health services. However, only half of the pregnant women in LMICs obtain WHO recommended minimum of four antenatal contacts. In addition, ANC 4+ is a commonly used indicator in monitoring ANC utilization. However, contact coverage alone provides no indications of service quality. In recent years, digital health interventions bring opportunities to provide quality maternal health care. Yet, there are few reviews on how digital health interventions contribute to improving effective coverage of antenatal care. A rigorous review that examines the role of digital health interventions in improving effective coverage of antenatal care is needed to examine how digital health solutions were rapidly deployed to support quality antenatal care service delivery. This review aimed to map evidence on the role of digital health solutions on quality of antenatal care service to enhance effective ANC coverage. A scoping review approach was used and four Databases (PubMed, Cochrane Library, Scopus and Embase) as well as search engines like Advanced Google Search and Google Scholar were searched from September 1 to 8, 2022. Thematic content analysis was used to present the findings. A total of 1701 articles were searched. A total of 27 full-text studies were included in the final analysis. The most reported use of digital health was for client education and behavior change communication. Most studies showed that digital health interventions have proven effective in improving antenatal care. However, most of the studies did not address to assess the quality of ANC services. In this review, we found out that digital health solutions targeted at pregnant women can improve antenatal care services. There is body of evidence showing the effectiveness of digital health interventions on a range of maternal health outcomes. Few pieces of literature exist on the use of digital health interventions on the quality of antenatal care services. There is a need for more trial and program evaluation studies that examine the role of digital health interventions on the quality of ANC.

A Review: Evaluating Nutrition Interventions on Maternal and Infant Health in Low and Middle-Income Countries

Severe nutrition inequalities disproportionately hurt mothers and their children. Different nutrition interventions are conducted to address these inequalities and to improve maternal and infant health, and their efficacy needs examining to maximize impact and cost-effectiveness. This study gives an overview of nutrition interventions by categorizing nutrition interventions to three main types, cash transfer, nutrition supplements, and social and behavior change communication (SBCC), reviewing previous studies based on categories, comparing benefits, and discussing associated social and cultural factors that might affect the efficiency. This study focuses on these three categories of interventions based on the scale of application and global impact. This research will help to provide guidance for improving maternal and infant health and conducting nutrition programs in a real world setting, which will be especially meaningful within a postpandemic and conflict context.

Behaviour change communication influences on food consumption behaviours and the demand for diverse nutritious foods in the Makoni District, Zimbabwe.

This study evaluated the effectiveness of nutrition behavioural change communication interventions and food consumption behaviours and demand for nutritious foods in Makoni district, Zimbabwe. The study employed an observational and cross-sectional design using mixed-methods. The population was smallholder farmers' households with children six to twenty-four months old. Secondary data was obtained from the main intervention reports. The total sample size of this project comprised of five personnel participating in the implementation of the intervention for key informant interviews; forty participants for the in-depth interviews; and a total of 81 participants for eight focus group discussions. Participants indicated that the Livelihoods and Food Security Programme intervention successfully increased their nutrition knowledge, enhanced their ability to diversify crop production, and improved their access to varied foods, including some new crops. Local markets had little influence on the demand for nutritious foods by the intervention population. The interventions were effective in stimulating demand for diverse and nutritious foods in Makoni District.

Undernutrition and its determinants among under-five children in a tribal community of Meghalaya.

Malnutrition among under-five children is a rampant and major public health problem in developing countries. The paucity of studies on undernutrition among tribals made it imperative to determine the prevalence and the factors associated with undernutrition among the tribal under-five children. A community-based cross-sectional analytical study was conducted among 196 under-five children residing in the village under the rural field practice area of North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Meghalaya. Sociodemographic and clinical data were collected using a pretested semi-structured questionnaire, and burden of food insecurity was collected using the Food Insecurity Experience Scale Survey Module (FIES-SM). Anthropometric measurements, such as height, weight, and mid-upper arm circumference, were measured for all the children, and Z-scores were calculated for weight for age, height for age, and weight for height. Of the 196 children, the mean age of the children was 36.7 (15.3) months. The prevalence of underweight, stunting, and wasting was 9.2% (95% confidence interval (CI): 5.7%-14.3%), 28.6% (95% CI: 22.5%-35.5%), and 6.1% (95% CI: 3.3%-10.7%), respectively. There was a significant association for girls, birth weight, and age of the mother during first childbirth and immunization status with underweight. Similarly, there was a significant association for girls with wasting and education of the mother and birth weight with stunting. The prevalence of underweight wasting and stunting was lesser with an observable enhancement in the nutritional status of the children; however, the undernutrition status is still alarming, which warrants health and nutritional education along with behavioral change communication.

Uro-pathogens: Multidrug resistance and associated factors of community-acquired UTI among HIV patients attending antiretroviral therapy in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia.

Urinary tract infections are common bacterial and fungal infections in humans, occurring both in the community and in immunocompromised patients in healthcare settings. Urinary tract infections have a significant health impact on HIV-infected patients. Nowadays, drug-resistant pathogens are widespread poses a serious clinical risk, and causes urinary tract infection. The common agents of bacteria and fungi that cause urinary tract infection are Escherichia coli followed by Klebsiella pneumonia, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococcus, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida. albicans. This study aimed to investigate uro-pathogen, multidrug resistance pattern of bacteria, and associated factors of community-acquired urinary tract infection among HIV-positive patients attending antiretroviral therapy in Dessie comprehensive specialized hospital, Northeast Ethiopia from February 1, 2021, to March 30, 2021. An institutional-based cross-sectional study was conducted at Dessie Comprehensive Specialized Hospital. Socio-demographic and clinical data were collected by using structured questionnaires from HIV patients suspected of community-acquired urinary tract infections. About 10 ml of clean-catch midstream urine was collected and inoculated into Blood agar, MacConkey, and Cysteine lactose electrolyte deficient media. Yeasts were identified by using Gram stain, germ tube test, carbohydrate fermentation, assimilation tests, and chromogenic medium. Gram stain and biochemical tests were performed to identify isolates and an antimicrobial susceptibility pattern was performed on disc diffusion techniques. Data were entered and analyzed using SPSS version 25. Both bivariate and multivariable logistic regression analysis was performed and a P value of < 0.05 with an adjusted odds ratio with their 95% confidence interval (CI) was used as statistically significant associations. From the total 346 study participants, 92 (26.6%) were culture positive 75 (81.52%) were bacterial and 17 (18.48%) were fungal pathogens. From a total of 75 bacteria isolates 51(68%) were Gram-negative bacteria and the most commonly isolated bacteria were E. coli 16 (21.33%) followed by K. pneumoniae 11(14.67%) and enterococcus species 10(10.87. Of the 17 fungal isolates of fungi, 8(47.1%) were represented by C. tropicalis. Of the isolated bacteria, 61(81.3%) were resistant to three and above classes of antibiotics (drug classes). About 13 (81.3%) of E. coli, 9(81.8%) of K. pneumoniae, 8(80%) of Enterococcus species, 7 (77.8%) of P. aeruginosa, and CoNs 7(87.5%) were the most frequently exhibited three and above classes of antibiotics (multi-drug resistance). Amikacin and gentamicin were effective against Gram-negative Uro-pathogens. Participants aged>44year, female, being daily labor, being farmer, unable to read and write, patients with CD4 count of ≤ 200 cells/mm3 and CD4 count of 201-350 cells/mm3, who had chronic diabetics, patients having a history of hospitalization and who had urgency of urinations were statistically significant association with significant urinary tract infections. The burden of community-acquired urinary tract infections among HIV patients is alarmingly increased. Therefore, behavior change communications might be considered for promoting the health status of HIV patients. Moreover, CD4 level monitoring and therapeutics selection based on microbiological culture are quite advisable for the management of urinary tract infections of HIV patients.

Determinants of early initiation of breastfeeding following birth in West Africa: A multilevel analysis using data from multi-country national health surveys.

Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa. This study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and <0.05 in the final analysis were considered significantly associated with EIBF. The pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa. The incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.

Relationship between home garden ownership and the consumption of fruits and vegetables.

This study assessed the extent to which access to home gardens associate with the frequency of fruit and vegetable (FV) consumption. The study was carried out in fifty rural communities in Northern Ghana where food insecurity and malnutrition including micronutrient deficiencies are prevalent. A community-based comparative analytical cross-sectional study. A sample of 847 randomly selected rural households. The proportion of households that consumed FV at least 3 d in a week was 45 %. Members in households who owned a home garden were 1·5 times more likely to consume FV at least 3 d in a week (adjusted OR (AOR) = 1·46 (95 % CI 1·06-2·0)), compared with their counterparts who had no home gardens. Furthermore, households in which mothers had a positive attitude towards FV consumption were 1·6 times more likely to consume FV (AOR = 1·63 (95 % CI 1·17-2·27)) compared with mothers who were less positive. Our results suggest that food and nutrition policy measures that promote home gardens can improve consumption of diversified diets including FV among vulnerable rural households in Northern Ghana. Additionally, households with lower income may benefit from nutrition behaviour change communication campaigns directed towards increasing a positive attitude to FV intake.

The role of algae, fungi, and insect-derived proteins and bioactive peptides in preventive and clinical nutrition.

The current global trend in the nutrition, epidemiologic and demographic transitions collectively alarms the need to pursue a sustainable protein diet that respects ecosystem and biodiversity from alternative sources, such as algae, fungi and edible insects. Then, changing the nutrition reality is extremely important to impede the global syndemic of obesity, undernutrition and climate change. This review aims to synthesize the published literature on the potential roles of alternative proteins and their derived bioactive peptides in preventive and clinical nutrition, identify research gaps and inform future research areas. Google Scholar and PubMed databases from their inception up to 30 June 2024 were searched using keywords to access pertinent articles published in English language for the review. Overall, proteins derived from algae, fungi, and edible insects are high-quality proteins as animal sources and demonstrate significant potential as a sustainable source of bioactive peptides, which are metabolically potent and have negligible adverse effects. They show promise to prevent and treat diseases associated with oxidative stress, obesity, diabetes, cancer, cardiovascular disease (especially hypertension), and neurodegenerative diseases. Given the abundance of algae, fungi and insect peptides performed in vitro or in vivo animals, further clinical studies are needed to fully establish their safety, efficacy and practical application in preventive and clinical nutrition. Additionally, social and behavioral change communication strategies would be important to increase health awareness of nutritional benefits and promote consumer acceptance of alternative protein sources.

Impact of Behaviour Change Communication on Uptake of Hepatitis B Vaccination among Health Workers in Fako Division, Cameroon

Impact of Behaviour Change Communication on Uptake of Hepatitis B Vaccination among Health Workers in Fako Division, Cameroon

Socio-cultural Practice: A Case Study on Personal Hygienic Behavior in the Hindu Society

Hindu culture and religion has its own idea regarding what constitutes excellent physical, mental, and spiritual purity. It would be interesting to learn more about whether or not the Hindu society of today adheres to the same practices. All Hindus view maintaining personal hygiene, including cleanliness of the body, hands, clothes, hygienic toilet, and menstrual hygiene management, as a duty and a fundamental principle. Personal hygiene is considered to be a key component of Hindu society. The major objective is to comprehend the level of awareness and personal hygienic behavior in Hindu society. The study primarily takes into account two cultural and social aspects of personal hygiene. The study used hand washing behaviors, trimming and combing procedures, menstrual hygiene management, usage of safe toilet, brushing, bathing, and cleaning practices as the main areas of the study. The necessity of hygienic habits for happiness, social status, and cultural continuity was also well understood in Hindu society. More Hindus now practice personal hygiene than during the Vedic Hindu era. Hygiene habits may be improved by affecting the attitudes of the society. A social and behavior change communication approach for hygiene behaviors should be implemented by the society. The improvement of daily personal hygiene routines and behavior adjustment are required to raise a better social status and cultural practices. The Hindu community is also adopting a novel viewpoint on the connection between personal hygiene and Hindu culture.

Impact of Digital Learning Platforms on Behaviour Change Communication in Public Health Education

This conceptual research explores the transformative potential of digital learning platforms in the realm of behaviour change communication within the context of public health education. With the rapid advancement of digital technology, the traditional methods of health communication are being reimagined, offering new opportunities and challenges for promoting healthier behaviours and lifestyles. The research seeks to understand the evolving landscape of digital learning platforms and their integration into public health education programs. It investigates how these platforms can be leveraged to design and disseminate behaviour change communication interventions effectively. The study examines the theoretical foundations that underpin behaviour change communication and the ways in which digital learning platforms can enhance these foundations. Furthermore, the research addresses the critical issue of accessibility and inclusivity, as digital platforms have the potential to bridge the gap between diverse populations in terms of health literacy, socio-economic status, and geographical location. By employing a conceptual framework that combines elements of health communication theory, pedagogy, and technology adoption models, this study aims to provide insights into the effective utilization of digital learning platforms for behaviour change communication. Findings indicate that the use of digital learning platforms has led to increase engagement in public health education. This exploration is expected to shed light on the potential of these platforms to drive positive health behaviour change among diverse populations and pave the way for more informed strategies in the field of public health education. Ultimately, this research aims to encourage further exploration and development of digital learning tools for behaviour change communication in public health, with the potential to make a significant impact on global health outcomes.

Social norms, diffusion, and women's risk of intimate partner violence in Nepal: Impact assessment of a social and behavior Change communication intervention (Change Starts at home)

IntroductionIntimate partner violence (IPV) is a significant public health, human rights, and development issue. While existing evidence posits that addressing social norms is key to IPV prevention, successful IPV interventions that include a norms approach are limited in number and methodological rigor and rarely include a formal investigation of the diffusion of intervention impact. We contribute novel findings to this intellectual and programmatic space with evidence on a social and behavior change communication (SBCC) intervention (Change Starts at Home) in Nepal designed to prevent IPV and shift social norms towards greater gender equity. MethodsParticipants included 442 married women across 13 communities assessed at three timepoints: before intervention (baseline), at the completion of the core couple's curriculum and edutainment (midline), and at the conclusion of the diffusion curriculum (endline). Generalized estimating equations with propensity-score adjustments were used to determine change in outcomes at midline and endline for two intervention conditions (direct beneficiary, N = 173; and resident of the intervention community, (N = 178) relative to control (N = 91). ResultsIPV victimization significantly decreased in both intervention conditions at midline, with larger reductions in direct beneficiaries. At endline, direct beneficiaries had sustained reduction in IPV relative to control participants. Positive injunctive norms also significantly improved by midline for both intervention groups, whereas improvements in descriptive norms for intervention groups were matched by improvements in the control group at both midline and endline. Several secondary outcomes showed significant improvements for both intervention groups at midline and/or endline, including in-law violence, financial decision-making, communication, and relationship quality, with additional improvements for the direct beneficiaries in attitudes, leadership, GBV advocacy, and diffusion. ConclusionThis study sheds light on the effectiveness of the Change intervention, the role of addressing social norms in IPV prevention efforts, and the benefits of organized diffusion.

Correction to “The effect of nutrition and health behavior change communication through community‐level actors on the nutritional status of pregnant women in the Ambo district, Ethiopia: A randomized controlled trial”

Correction to “The effect of nutrition and health behavior change communication through community‐level actors on the nutritional status of pregnant women in the Ambo district, Ethiopia: A randomized controlled trial”

Utilization of HIV Pre-exposure Prophylaxis and Associated Factors Among Female Sex Workers in Bahir Dar City, North-West Ethiopia, Cross-sectional Study, 2022.

This study aimed to assess the utilization of HIV pre-exposure prophylaxis and associated factors among commercial female sex workers in Bahir Dar City, Northwest Ethiopia, in 2022. An institution-based cross-sectional study was conducted in Bahir Dar City from November 1 to 30, 2022. The random sampling technique was used to select 396 commercial female sex workers. Kobo Collector was used to gather the data, which was then exported to STATA 14 for analysis. In bivariate regression analysis, all variables with a P-value of <0.2 were entered into multivariable logistic regression. Multivariable logistic regression variables with P-values ≤0.05 at a 95% confidence interval were declared to be significantly linked with the utilization of HIV pre-exposure prophylaxis. In this study, 183 (46.2%) (95%CI: 41.33-51.16) of respondents utilized HIV pre-exposure prophylaxis. Educational status: secondary and above (AOR: 2.18, 95%CI: 1.05-4.53). Age of sex workers 26-36 (AOR: 0.20, 95%CI: 0.17-0.84); experience of sex work 3-5 years (AOR: 0.25, 95%CI: 0.24-0.83); and having good knowledge (AOR: 4.98, 95%CI: 3.90-10.65) were significantly associated with the utilization of HIV pre-exposure prophylaxis. In this study, HIV pre-exposure prophylaxis was not widely used by commercial female sex workers. Therefore, social and behavioral change communication strategies focus on creating awareness and building knowledge on HIV pre-exposure prophylaxis utilization.

Prevalence and correlates of multimorbidity among patients attending AYUSH primary care settings in Delhi-National Capital Region, India

IntroductionIndia has a multifaceted healthcare system and recognizes complementary and alternative systems of medicine (AYUSH) that cater to the healthcare needs of people. Multimorbidity requires frequent visits to physicians and long-term use of medications, due to which people tend to prefer AYUSH systems as they provide holistic patient-centered treatment. Hence, we aimed to estimate the prevalence of multimorbidity and assess its correlates among patients attending AYUSH primary care clinics in Delhi.MethodsA cross-sectional study was conducted among 943 patients aged ≥ 18 years attending various AYUSH primary care clinics in Delhi from September 2021 to February 2022, employing a stratified random sampling technique. Descriptive statistics such as frequency and proportion were used to report the prevalence of multimorbidity (two or more chronic conditions in an individual out of the 33 conditions listed as per the Multimorbidity Assessment Questionnaire for Primary Care). A multivariable logistic regression assessed the association between various socio-demographic characteristics and multimorbidity, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI).ResultsThe prevalence of diabetes (14.7%) was found to be the highest (out of all included chronic conditions) among the patients attending various AYUSH primary care settings. The overall prevalence of multimorbidity was observed to be around 39.4%. We observed a higher likelihood of having multimorbidity among participants aged ≥ 70 years [AOR: 9.19 (95% CI: 3.75–22.54)], females [AOR: 1.57 (95% CI: 1.04–2.37)], and middle class [AOR: 2.23 (95% CI: 1.45–3.43)].ConclusionMultimorbidity was evidently prevalent across AYUSH primary care settings, which cannot be overlooked. The results suggest behavioral change communication may be aimed at older individuals, females, and the middle class.

Supporting Preparedness and Response to Cyclone Freddy In Madagascar- A Contribution from the Social and Behaviour Change Communication

Social and Behaviour Change Communication (SBC) is one of the vital strategic programs that aim to empower people to be resilient in preparation and response to emergencies. This paper outlines steps undertaken by SBC partners in Madagascar as a contribution towards preparation and response initiatives to cyclone Freddy, and discusses observations and lessons learnt to inform future programming in the country and other cyclone-affected regions. It bases its conceptual framework around the emergency prevention, preparedness, response and recovery (PPRR), the Emergency Risk Management Framework (ERM) as well as the UNICEF Framework on Accountability to Affected Population (AAP) to define the interventions based on three major phases of the intervention i.e., before, during and after. An SMS-based survey was used as a feedback mechanism and as a tool to assess SBC interventions 3 days after the passage of cyclone Freddy. The survey used a structured questionnaire where 450 respondents participated from 13 regions of the country. Scouts (youth mobilisers) and other NGO partners in the emergency network conducted phone calls, entered data into a Kobo-Collect template and analysed the data using simple percentiles in excel sheets. Analysis of the processes and results of the survey indicated that there was adequate utilisation of systematic steps in emergency preparedness. These included strategic planning and prepositioning of communication materials in all the 23 regions of the country, coordination and partnership at national, regional and district levels, implementation of a mixture communication and engagement methods and efforts to collect and respond to feedback. Three days from the onset of Freddy, the affected people were highly exposed to life saving messages (86%) but needed more exposure to life improving messages i.e., health (29.6%), child stimulation (29.3%), WASH (29.3%), nutrition (18%), Gender-based Violence (10.2%) and Violence against Children (4%). SBC interventions showed positive results in the use of bed nets to prevent malaria (85.7%), hand washing with soap to prevent diarrheal diseases and COVID-19 (95.6%) and reporting of cases on gender-based violence and violence against children (31.6%). 50.9% of the interviewed individuals acknowledged having been well informed about humanitarian interventions.