Rural Areas Of Northern India Research Articles

Respectful Maternity Care during Childbirth among Women in a Rural Area of Northern India

Respectful Maternity Care during Childbirth among Women in a Rural Area of Northern India

Barriers of household toilet utilization among toilet owners in a rural area of Northern India: An analytical cross-sectional study.

Open defecation continues to prevail among toilet owners despite effective implementation of the Swachh Bharat Mission (Gramin). We conducted this study to determine toilet utilization rates and learn about the barriers to toilet use in the rural areas. By understanding the barriers, physicians can provide targeted education and become better equipped to manage their patients' conditions and advocate for their demands. We conducted a cross-sectional study on the households of the rural field practice areas of the department in central Uttar Pradesh by the census method. House listing was procured from the departmental records. The questionnaire was directed at both the household level and individual level. The proportion of households with access to a toilet was found to be 91.1% of which 504 households were included in the study. Among the toilet owners, 115 (22.8%) households were not using toilets exclusively by all the members. At the individual level, age groups (of 20-59 years, and ≥60 years) and female gender were found to be significantly associated with open defecation. At the household level, government assistance for toilet construction and livestock keeping was found to be associated with open defecation. Major barriers to toilet use were childhood habits, dearth of toilets in the farming grounds/workplace, women during menstruation and having a non-functional toilet. This study indicates that merely installing a household toilet does not ensure exclusive utilization of toilet and the practice of open defecation might continue to be prevalent if corrective measures are not undertaken.

Determinants of depression and coping strategies among nursing students after the second wave of the COVID-19 Pandemic

Background: COVID-19 pandemic led to the emergence of mental health problems such as depression and the use of maladaptive coping strategies among nursing students. This study is planned to assess the prevalence of depression and coping strategies adopted by nursing students after the second wave of the COVID-19 pandemic. Methods: A descriptive cross-sectional survey was carried out among 164 nursing students in a selected nursing institution in a rural area of Northern India. Depression was assessed using the patient health questionnaire-9, whereas coping was assessed by the brief-coping orientation of problem experienced scale. Results: Mean age of the participants was 20.80±2.35 years. The mean depression score of nursing students was 6.43±4.28. Majority of the nursing students had mild depression (43.9%) and belonged to the non-depressed group (78.7%) with a PHQ-9 score <9. Maladaptive coping mechanisms were chiefly utilized by male nursing students. Coping mechanisms substance use (β=0.223, p<0.013) had more impact on depression, after controlling for sociodemographic variables and COVID-19-related information of nursing students. Conclusions: Minimal or mild depression is common among nursing students after the second wave of the unprecedented pandemic with adaptive coping strategies more commonly used.

An autopsy-based study of poisoning cases in a medical college situated in a rural area of northern India

An autopsy-based study of poisoning cases in a medical college situated in a rural area of northern India

Assessment of drinking water quality and various household water treatment practices in rural areas of Northern India

Assessment of drinking water quality and various household water treatment practices in rural areas of Northern India

Risk factors of severe anemia among the pregnant women from an underprivileged rural area of northern India: a multivariate analysis

Background: India serves as a home to 45.7% of anemic pregnant women (aged 15-49) with anemia of any grade during the course of their pregnancy. This study aims to estimate the prevalence of anemia and associated risk factors of severe anemia among pregnant women.Methods: Eligible antenatal women irrespective of period of gestation were screened for presence of anemia with help of hemoglobin (Hb) value at the time of admission. Typing of anemia was done. Detailed history was followed by physical examination. Univariate and multivariate analysis was done to study the risk factors of severe anemia among the study subjects.Results: Of total, 22.1% women were found to be severely anemic. Severely anemic women having residence in a rural area without road had odds more than twice (AOR=2.14) compared to severely anemic women having residence in a rural area connected with road (p=0.018). Similarly, severely anemic women aged <25 years (AOR=2.70), Illiterate (AOR=3.12), marriage age <18 years (AOR=2.33), having age at 1st pregnancy as <19 years (AOR=1.93), undergone ≤3 ANC visits (AOR=3.95). Anemic women with gravida score ≥4 had more than 4 times risk (AOR=4.15).Conclusions: The significant risk factors of severe anemia among pregnant women as observed in this study were having residence in a rural area without road, age <25 years, illiteracy of mother, marriage age (<18 years in completed years), age at 1st pregnancy as <19 years, ≤3 ANC visits, gravidity ≥4 and non-sanitary type toilet facility at home.

The Brief 35-Item ARQ: Validation of the Adolescent Resilience Questionnaire in India

India is home to the largest proportion of adolescent population in the world. However, there is a dearth of psychometrically and conceptually robust instruments to measure their resilience. Hence, the present study aimed at assessing the psychometric properties and factor structure of the original English and the translated Hindi version of the Adolescent Resilience Questionnaire (ARQhttps://doi.org/10.1186/1471-2288-11-134) in a sample of Indian adolescents. It also examined the role of select socio-demographic variables (age, sex, place of residence and type of schooling) on their resilience levels. Data were collected from 1290 adolescents aged between 12 and 18 years studying in public and private schools in urban and rural areas of Northern India. A brief 35-item (English and Hindi) version of the ARQ having five domains (individual, family, peer, school and community) with a single-factor structure each, was found to be an adequate fit in the Indian context. It is a reliable instrument with good convergent validity, and no floor and ceiling effects. Additionally, the multivariate results revealed a significant main effect for all the socio-demographic factors. The effect sizes, however, were small.

Association of birth weight with risk factors of cardiovascular diseases: A birth cohort analysis from a rural area of Northern India.

Fetal origin of cardiovascular diseases (CVD) hypothesis has been explored mostly in retrospective studies. A prospective study was conducted to find the association of birth weight with CVD risk factors. A cohort of 243 babies born in 1992-1993 in ten villages of Raipur Rani Block in India, were followed-up in 2016-2017. WHO STEPS methods were used to assess the risk factors of CVDs. A total of 213 (87.8%) participants were examined; blood samples were collected from 207. Multivariable regression analysis was done to adjust for the confounding variables. Study participants were 22-24 year old, 27.7% were exposed to tobacco and 24.8% consumed alcohol, 3.3% were taking >5 servings of fruits and vegetables per day, 35.7% were physically inactive, 28.6% were overweight (body mass index [BMI] ≥23 kg/m2), 12.2% had hypertension, 16% had high cholesterol (≥200 mg/dl), 16.4% had insulin resistance (IR) (Homeostatic Model Assessment-IR >3), and 20.7% were born with low birth weight (<2.5 kg). Multivariable regression analysis revealed inverse relationship between birth weight and systolic blood pressure (regression coefficient ‒3.72 mmHg, 95% confidence interval ‒7.249; ‒0.183, P < 0.05). Birth weight has inverse relationship with blood pressure. Effect of birth weight on CVDs should also be studied in future follow-ups.

Knowledge, attitudes and practices regarding infant feeding among mothers of children with severe acute malnutrition in the rural areas of Northern India

Introduction: Malnutrition has been identified as one of the principal causes limiting India’s globaleconomic potential. The infant and young child-feeding practices determine the nutritional status,growth and ultimately the survival of infants and young children. The study aimed to assess theknowledge, attitude and practices of rural mothers with children diagnosed with severe acutemalnutrition (SAM) regarding infant feeding. Methodology: A hospital-based cross-sectionaldescriptive study on 116 mothers from the rural area of Northern India with children diagnosed withSAM. Assessment of knowledge, attitude and practice of mothers regarding infant feeding was donethrough face to face interviews using a structured questionnaire containing 32 questions. Results:The mean age of admitted children was 14.48 ± 4.71 months. The majority of mothers (81.9%)studied till only primary school or were illiterate. The appropriate knowledge about early initiation ofbreastfeeding and the ideal time to start complementary feeding was found in 42.4% and 45.6% ofmothers respectively which was suboptimal. The attitude towards ideal breastfeeding practices waspositive in most mothers. However in practice only 59.4% of mothers exclusively breastfed theirbabies till 6 months and 54.3% delayed initiation of complementary feed beyond 9 months of age.The frequency of complementary feeding was inadequate in the 6-8 months age group as stated by88.6% of mothers and minimum dietary diversity was not followed by 68.1% of mothers.Conclusion: The knowledge and positive attitude towards infant feeding are not applied in practiceby mothers. Efforts should be made to improve knowledge, attitude and practice with an emphasison complementary feeding indicators to reduce the burden of malnutrition in the rural population.67

Patient’s Knowledge and Satisfaction Regarding Nursing services and Physical Infrastructure of a Tertiary Care Hospital Situated in Rural area of Northern India (Haryana)

Background: Nowadays health care quality is a universal concern. The health sector is changing rapidlydue to the escalating requirements and desires of patients. The most appropriate method to measure a client’sexperiences about available hospital services is a patient satisfaction survey. Present study aimed to assesspatient’s knowledge and satisfaction regarding nursing services and physical infrastructure. Methods: 330patients were selected by purposive sampling technique attending various indoor departments of the selectedhospital. Self-structured checklist and three-point rating scale each containing a total 90 sets of items usedto assess knowledge and satisfaction. The reliability coefficient for the knowledge tool was 0.87 by KR 20and satisfaction was found 0.85 by Cronbach’s Alpha. Result: Study results showed that more than half(59.7 %) patients had very good level of knowledge regarding availability of services. 72.4% & 69.7% ofpatients were satisfied with Nursing services and physical infrastructure facilities respectively. Item wisedistribution of level of satisfaction among patients regarding nursing services reveals that “nurses hearyou carefully(64.5%)”, “explain patient’s condition to the family (64.5%),” and “Adequate space in ward(75.5%)” was found ranked 1st with the highest satisfaction, whereas “provide psychological counseling”,“Toilet facility and cleanliness(32.1%)” was found ranked lowest. A significant low positive correlation foundbetween mean knowledge and satisfaction scores regarding nursing services and physical infrastructure asevident by computed ‘r’ value (0.38)Conclusion: Using these necessary responses from the patients, various shortcomings can be pointed outand notify to hospital administration for improvement of the nursing care services & physical infrastructure.

Patient’s Knowledge and Satisfaction with health Care of a Tertiary Care Hospital Situated in Rural area of Northern India (Haryana)

Background: Nowadays health care quality is a universal concern. The most appropriate method to measurea client’s experiences about available hospital services is a patient satisfaction survey. Present study aimedto assess patient’s knowledge and satisfaction regarding health care.Method: 330 patients were selected by purposive sampling technique attending various outdoor and indoordepartments of the selected hospital. Self-structured checklist and three-point rating scale each containing atotal 50 sets of items used to assess knowledge and satisfaction. The reliability coefficient for the knowledgetool was 0.87 by KR 20 and satisfaction was found 0.85 by Cronbach’s Alpha.Result: Study results showed that more than half (52.4%) and (60.6%) patients had very good level ofknowledge and 76.4% &amp; 67.5% of patients were satisfied with overall health care. Item wise distributionof satisfaction among patients reveals that “physician gave follow up instructions to the patient properly(78.2%)”, “OPD card facility (78.2%),” and “hospital food facility for patients (75.2%)” was found ranked1st with the highest satisfaction, whereas “Free of cost availability of drugs”, “long queues during OPD cardregistration process” was found ranked lowest. A significant low positive correlation found between meanknowledge and satisfaction scores regarding health care services as evident by computed ‘r’ value (0.38).Conclusion: Using these necessary responses from the patients, various shortcomings can be pointed outand notify to hospital administration for improvement of the health care.

Clinical Profile of Ulcerative Colitis Patients in a Tertiary Care Center: An Experience from Rural India

Ulcerative colitis is a chronic idiopathic inflammatory condition of the colon, characterized by relapsing and remitting course. This study was done to look at the clinical profile of ulcerative colitis patients in a tertiary care hospital, located in rural area of northern India. All patients with ulcerative colitis and age above 18 years who attended outpatient clinics from November 2019 to January 2020 were included in the study. A total of 45 patients were included in the study. There were 19 males (42.22%) and mean age of the patients was 37.08 (± 11.58) years. The most common presenting complain was blood in stools (88.88%). The majority of the patients (62.22%) had pancolitis. Family history of proven IBD was found in 1 (2.22%) patient only. Extra-intestinal manifestations were seen in 7 patients (15.55%) commonest being arthralgia. Thirty-three patients (73.33%) were on oral mesalazine, 20 patients (44.44%) were on azathioprine, and 9 patients (20%) were on oral corticosteroids. None of the patients was on biologics. Slight female predominance, fewer EIM, less family history of IBD, higher percentage of pancolitis, and significant percentage of patients on oral immunosuppressant (azathioprine) are the key features observed in this study from rural India.

A digital media literacy intervention increases discernment between mainstream and false news in the United States and India

Widespread belief in misinformation circulating online is a critical challenge for modern societies. While research to date has focused on psychological and political antecedents to this phenomenon, few studies have explored the role of digital media literacy shortfalls. Using data from preregistered survey experiments conducted around recent elections in the United States and India, we assess the effectiveness of an intervention modeled closely on the world's largest media literacy campaign, which provided "tips" on how to spot false news to people in 14 countries. Our results indicate that exposure to this intervention reduced the perceived accuracy of both mainstream and false news headlines, but effects on the latter were significantly larger. As a result, the intervention improved discernment between mainstream and false news headlines among both a nationally representative sample in the United States (by 26.5%) and a highly educated online sample in India (by 17.5%). This increase in discernment remained measurable several weeks later in the United States (but not in India). However, we find no effects among a representative sample of respondents in a largely rural area of northern India, where rates of social media use are far lower.

Assessment of clean cooking technologies under different fuel use conditions in rural areas of Northern India

The study was conducted to assess the performance of improved and traditional cookstoves using wood as a fuel and three combinations of other fuel mixes – (i) wood and cow dung, (ii) wood and mustard stalks, and (iii) cow dung and mustard stalks). Energy and emission parameters such as specific energy consumption (SEC), emission factors (EFs) of carbon monoxide (CO), particulate matter (PM) and black carbon (BC) were used to compare four different types of cookstoves. These included top-feed forced draft (TF-FD), top-feed natural draft (TF-ND), front-feed natural draft (FF-ND) and front-feed traditional (FF-TR) cookstoves. Controlled cooking test (CCT) was used as the test protocol. The results showed the performance of improved cookstove technologies can vary based on the fuel used for cooking. It was observed that emission factors for PM and CO increased by 67–96% and 45–90% respectively when all three improved cookstoves were tested with three fuel combinations against wood as cooking fuel. Among the tested cookstoves, a marked difference was observed between performance of forced draft and natural draft cookstoves. Forced draft cookstoves emitted higher amount of all pollutant emissions compared to natural draft cookstoves when used with mustard stalks in combination with either wood or cowdung. The results are of critical importance given that forced draft cookstoves have been promoted in geographical regions where fuel mix use is prevalent. Therefore, forced draft cookstove might not be the right choice when the goal is climate mitigation and reduction in impact on human health. It is imperative to study comprehensively the influence of various field variables on performance of cookstoves, which have severe implications on the performance of cookstoves.

Seismic fragility reduction of an unreinforced masonry school building through retrofit using ferrocement overlay

The Himalayan region is one of the major seismic areas in the world. However, similar to many other seismically active locations, there are substantial numbers of unreinforced masonry (URM) buildings; the majority of which have not been designed for seismic loads. Past seismic events have shown that such buildings are highly vulnerable to earthquakes. Retrofitting of these URM buildings is an important concern in earthquake mitigation programs. Most government school buildings in rural areas of northern India are constructed of unreinforced masonry. These school buildings are socially important structures and serve as a crucial resource for rehabilitation during any disaster. The effectiveness of ferrocement (FC) to create a URM-FC composite is described in this study by estimating the performance and fragility of a URM school building before and after a retrofit. Analytical models, based on the equivalent frame method, are developed and used for nonlinear static analysis to estimate the enhancement in capacity. The capacity enhancement due to retrofitting is presented in terms of the maximum PGA sustained and damage probabilities at the expected level of earthquake hazard.

Adding life to years: Role of gender and social and family engagement in geriatric depression in rural areas of Northern India.

Background:Depression among elderly population is a major public health issue affecting nearly 5% to 7% of the world's elderly. In the coming years, a major share will be contributed by developing countries like India. In the rural areas of Allahabad district of Uttar Pradesh, there is scarce data on the depression.Methodology:A community-based cross-sectional study was conducted in rural Allahabad. A total of 411 elderly persons were selected from 2 blocks—Jasra and Bahadurpur—through multistage random sampling method. Short form of geriatric depression scale (GDS) was used to assess depression.Results:The prevalence of depression among elderly was 19.7%. On binary logistic regression, depression had significant association with female sex [aOR = 2.4, 95% CI 1.1–5.1], having less-than-good relationship with family members [aOR = 2.7, 95% CI 1.2–6.0], not being cared for during illness by family members [aOR = 3.9, 95% CI 1.2-12.9], not being involved in leisure time activities [aOR = 2.5, 95% CI 1.3–4.9], and not regularly meeting relatives and friends [aOR = 4.7, 95% CI 1.9–11.6].Conclusions:The prevalence of depression in elderly was high in rural areas of Allahabad. Female sex and social and family engagement are the important predictors of depression among them.

Need of Palliative Care Services in Rural Area of Northern India.

Background:Palliative care is comprehensive care that provides symptomatic relief and enhances the quality of life for people experiencing serious health-related suffering. There is an increasing need for palliative care services in India. Estimates for population requiring these services are essential in order to meet the increasing need for palliative care services.Objectives:The objective was to assess the proportion of population requiring and receiving palliative care services.Materials and Methods:A descriptive cross-sectional research design was adopted for the study. The study was carried out in the village, Dhanas, Chandigarh. All the residents residing in the selected rural area were included in the study. Tools used for data collection were a screening questionnaire consisting of three questions, a sociodemographic sheet, a clinical profile, the Barthel Index of activities of daily living (ADL), and a pain rating scale. Analysis of the data was done using SPSS version 19 (IBM SPSS Statistics for Windows, Version 19.0.: IBM Corp).Results:A total of 10,021 people from 884 households were screened in the study. The results revealed that the prevalence of need for palliative care services was 2/1000 population. None of the 19 participants with unmet palliative care needs were receiving any home- or institutional-based palliative care services at the time of assessment. Nearly, one-fourth of the participants had total dependency on caregivers for ADL.Conclusion:The study concluded that there is a need of palliative care services in the studied rural community of Chandigarh. These data can be used for planning and implementing community-based palliative care services in the studied area.

Prevalence of and risk factors for chronic kidney disease of unknown aetiology in India: secondary data analysis of three population-based cross-sectional studies

ObjectivesTo assess whether chronic kidney disease of unknown aetiology (CKDu) is present in India and to identify risk factors for it using population-based data and standardised methods.DesignSecondary data analysis of...

Anxiety Disorders among Adolescents in a Rural Area of Northern India using Screen for Child Anxiety-Related Emotional Disorders Tool: A Community-based Study.

Background:Anxiety disorders are the most frequent mental disorders encountered in childhood and adolescent years. The number of epidemiological studies done in this area within India is limited.Objectives:We determined the prevalence of anxiety disorders among adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. Secondarily, we also assessed sociodemographic and other factors associated with anxiety disorders among adolescents.Materials and Methods:This community-based cross-sectional study was conducted among 729 adolescents (10–19 years). Screen for Child Anxiety-Related Emotional Disorders tool was used for assessing prevalence and type of anxiety disorders. Sociodemographic and personal factors were included in the logistic regression multivariable model to establish associations. Adjusted odds ratios (AOR) along with 95% confidence intervals (CI) are computed.Results:The prevalence of anxiety disorders among adolescents was (22.7%; 95% CI: 19.7–26.0). Girls (27.6%) had higher prevalence than boys (18.3%) (P < 0.01). Social anxiety disorder (14.3%; 95% CI: 11.7–16.9) was the most common form of anxiety disorder. Female sex (AOR 1.8; 95% CI 1.2–2.6; P < 0.01), lower-middle socioeconomic status (AOR 1.96; 95% CI 1.2–3.1; P < 0.01), and presence of stressful event within the past 1-year (AOR 2.48; 95% CI: 1.12–5.06; P = 0.01) were found to be associated with the presence of anxiety disorders.Conclusions:Anxiety disorders are common among adolescents in rural settings of India. Tackling them will require appropriate health systems response. Adequate interventions should be incorporated at primary care level to address the mental health concerns of adolescents.

A Study of Topical Honey versus Povidone in Diabetic Wounds in a Medical College in Rural Area of Northern India

A Study of Topical Honey versus Povidone in Diabetic Wounds in a Medical College in Rural Area of Northern India