Introduction:In India, mortality rate in breast cancer is high because more than half are diagnosed late at locally advanced or metastatic stages. This might be due to presentation delay (recognition of symptoms to first provider consultation) and treatment delay (first provider consultation to initiation of treatment), together known as overall delay. We aimed to estimate the overall delay in diagnosis and treatment in breast cancer and the associated factors, describe pathway of care and explore the reasons for delay from a patients' and providers' perspective. Methods: Explanatory sequential mixed-methods study with a quantitative component (retrospective cohort study including breast cancer patients registered at Dr. Borooah Cancer Institute (BBCI), Guwahati during February-June 2019) followed by descriptive qualitative component (in-depth interviews with 15 patients and 10 care providers). Results: Of 269 breast cancer patients, median (Inter Quartile Range) overall delay was 203 (110-401) days, presentation delay was 35 (10-112) days and treatment delay was 130 (75-258) days. Majority of patients approached private sector (190, 70.6%) as the first care provider. Nearly half of all patients (136, 50.6%) visited one health care provider before reaching the BBCI and another one-third (90, 33.5%) visited two providers. Reasons for presentation delay were misconception about the disease, perceived stigma, fear and denial of cancer, attribution of symptoms to trivial conditions, family responsibilities and embarrassment of breast examination by a male doctor. Treatment delay was due to initial visit to, misclassification of disease severity, dissatisfaction with care at public facilities, poor accessibility and affordability, fear of treatment and its side effects. Conclusion: Treatment delay was the major contributor to overall delay. Private providers need to be sensitized and trained in screening of breast cancer and referral of suspected cases of cancer. More awareness is needed about warning symptoms of breast cancer and misconceptions regarding the disease.

Architecture and planning play an important role in ensuring good light and ventilation to provide a healthy and livable environment. To investigate the strength of association between structural factors of slum resettlement colonies buildings and the burden of tuberculosis (TB), a questionnaire-based semi-quantitative survey of 4080 households was carried out in three resettlement colonies (Lallubhai Compound, Natwar Parekh Compound and PMG colony) with questions on architectural patterns, socioeconomic details as well as occurrence of TB in any member of the household. Computational modelling for Sky View Factor, Daylight Autonomy and Natural Ventilation in the houses of all three colonies was also performed. The results show that lower floors do not have access to sufficient light and ventilation in the living area. Occurrence of TB was strongly associated with lower floor of the house, closed or only partially openable windows, lack of exhaust fans as well as the built environment of the houses. The study also traced back the poor conditions of light and ventilation to the relaxations in development control regulations given to rehabilitation buildings. The study recommends better planning and architecture measures to bring improvements in housing and avert a public health crisis.

BACKGROUND: Breast cancer is the most common cancer among women in India. Jhpiego, a not-for-profit health organization, is providing technical assistance for developing an evidence-based model of breast health care in the states of Uttar Pradesh and Jharkhand in India. METHODS: A situational assessment of breast health care services using validated tools was conducted in the 2 states. RESULTS: Findings of the assessment were presented to the Breast Health Technical Advisory Committee comprised of subject experts and government functionaries. The committee, guided by Breast Health Global Initiative resource-stratified guidelines, developed a conceptual framework for integration of breast health services into the existing health system. This conceptual framework was presented to the Technical Advisory Groups (TAGs) of the respective state governments. Each TAG then developed an operationally feasible, contextually appropriate implementation plan in alignment with the national guidelines for noncommunicable diseases. This implementation plan guided the rollout of the breast health care program in the Lucknow (Uttar Pradesh) and Ranchi (Jharkhand) districts. CONCLUSIONS: Early results from the implementation suggest that it is feasible to integrate the breast health care pathway with the ongoing National

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With rapid urbanization and large-scale development activities going on in Indian cities, a large population is displaced, which need to be resettled. Although shelter is provided, but the Project Affected People (PAP) are often neglected, they don't have access to promotive and preventive health services such as immunization, family planning services and general health checkup. This is the cost of development; such displaced groups have to pay. Immunization is often cited as being one of the greatest public health achievements of the 20 th century which has resulted in dramatic decrease in morbidity and mortality due to vaccine preventable diseases. 1 However, effective protection against these diseases requires 90-95% immunization coverage. 2 Immunization coverage refers to information on the proportion of children who have received specific vaccines or are up to date with the recommended vaccine schedule. This information is essential for planning immunization programs, identifying the vulnerable groups that require ABSTRACT Background: With the rapid urbanization and numerous infrastructure projects going on in cities, large number populations are affected by these development projects. Such Projects Affected People (PAP) is resettled in colonies where critical health services are often lacking. Immunization is one such preventive and promotive health services, which is often cited as one of the greatest public health achievement of 20 th century and has resulted in dramatic decrease in morbidity and mortality due to vaccine preventable diseases. However, effective protection against these vaccine preventable diseases requires 90-95% immunization coverage. This study was conducted to assess the immunization coverage in PAP resettlement area of urban slum in Mumbai and associated responsible factors. Methods: Immunization coverage was assessed with the help of the WHO's 30cluster sampling method with a sample size of 210 children in the 12-23 months age group. Results: 90% children were completely immunized. The immunization coverage was highest for BCG (98.1%) and least for measles (90%). The most common reason for noncompliance was child's illness at the time of scheduled vaccine dose. Conclusions: The Universal Immunization Programme (UIP) goal of 85% immunization coverage can be achieved by community based awareness activities, supplemented by patient friendly immunization services at the health centre.