The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.

Background:Pregnant women inhabiting urban slums are a “high risk” group with limited access to health facilities. Hazardous maternal health practices are rampant in slum areas. Barriers to utilization of health services are well documented. Slums in the same city may differ from one another in their health indicators and service utilization rates. The study examines whether hazardous maternal care practices exist in and whether there are differences in the utilization rates of health services in two different slums.Materials and Methods:A cross-sectional study was carried out in two urban slums of Aligarh city (Uttar Pradesh, India). House-to-house survey was conducted and 200 mothers having live births in the study period were interviewed. The outcome measures were utilization of antenatal care, natal care, postnatal care, and early infant feeding practices. Rates of hazardous health practices and reasons for these practices were elicited.Results:Hazardous maternal health practices were common. At least one antenatal visit was accepted by a little more than half the mothers, but delivery was predominantly home based carried out under unsafe conditions. Important barriers to utilization included family tradition, financial constraints, and rude behavior of health personnel in hospitals. Significant differences existed between the two slums.Conclusion:The fact that barriers to utilization at a local level may differ significantly between slums must be recognized, identified, and addressed in the district level planning for health. Empowerment of slum communities as one of the stakeholders can lend them a stronger voice and help improve access to services.

Background: Hypertension is a global public health issue. Hypertensive heart disease is one of the top ten leading causes of death in the world. It was responsible for an estimated 1.1 million deaths worldwide in 2012. To prevent some of the complications of hypertension regular intake of the prescribed treatment in the form of medicines (pills) is essential. Poor compliance to anti-hypertensive therapy is usually associated with bad outcome of the disease and wastage of limited health care resources. With these viewpoints the study aimed to assess the level of compliance of hypertensive patients to their anti-hypertensive medications and to determine the socio-demographic correlates of compliance. Methods: This was community based cross sectional study conducted in urban and rural areas in Aligarh. A total of 350 hypertensive patients were selected using simple random sampling. A pretested semi-structured questionnaire was used. Compliance was measured by Morisky 8-item Medication Adherence scale. Analysis was done using proportions and Chi-square test. Results: The overall compliance of study population was 23.7%. It was found to be significantly associated with gender, education, social class and associated co morbidities. Education, higher social class and duration of hypertension were found to be the main facilitators to adherence. The barriers to adherence were cost of drug and more number of pills per day. Conclusions: Patient education, family counselling and social support networks should be strengthened in health promotion programs in order to enhance compliance of hypertensive patients with the therapeutic regimen and to improve their quality of life.

Background: Utilization of antenatal care (ANC) services is poor in the peri-urban areas, causing increased maternal morbidity and mortality. Objective: (i) To determine the current status of utilization of ANC services and (ii) to asses factors affecting utilization of ANC services. Materials and Methods: A community-based cross-sectional study was conducted in peri-urban field practice area of urban health training center, J N Medical College, Aligarh, India. The data were collected by home visit using a pretested, structured, semi-open questionnaire from 200 recently delivered women, who utilized ANC services. Data were tabulated and analyzed by using SPSS-20. Proportion, frequencies, and χ 2-tests were used to interpret the data. Result: Full utilization of ANC services was found to be 59%. Home deliveries were 23% and all were conducted by untrained persons. Utilization of ANC services was significantly associated with education, socioeconomic status, parity, and age at marriage. Main reasons for inadequate (partial/no) utilization of ANC services were financial constrains (34.14%) and lack of awareness (30.48%), whereas for home deliveries it was tradition (23.91%) and financial constrains (21.74%). Conclusion: Utilization of ANC services was not satisfactory and home deliveries by untrained person were still present. Prevailing barriers to utilization of ANC services and institutional deliveries must be identified and taken into consideration in planning and policy making.

Background:Making perinatal care accessible to women in marginalized periurban areas poses a public health problem. Many women do not utilize institutional care in spite of physical accessibility. Home-based care by traditional birth attendants (TBA) is hazardous. Inappropriate early neonatal feeding practices are common. Many barriers to perinatal care can be overcome by social mobilization and capacity building at the community level.Objectives:To determine the existing perinatal practices in an urban slum and to identify barriers to utilization of health services by mothers.Study Design:This is a cross-sectional descriptive study.Setting and Participants:The high-risk periurban areas of Nabi Nagar, Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers (Community Mobilization Coordinators or CMCs) already working in an NGO in the area. A total of 92 mothers were interviewed at home. Current perinatal practices and reasons for utilizing or not utilizing health services were the topics of inquiry.Statistical Analysis:Data was tabulated and analyzed using SPSS 12.Results:Analyses revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices as more than 60% of the women had home deliveries conducted by traditional untrained or trained birth attendants. Reasons for preferring home deliveries were mostly tradition (41.9%) or related to economics (30.7%). A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, the umbilical cord was cut using the edge of a broken cup. Although breast-feeding was universal, inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 hours in 8% of the cases. Several mothers had breastfeeding problems.Conclusion:Barriers to utilization of available services leads to hazardous perinatal practices in urban slums.