Mili Roopchand Sahay

Background: The HIV and AIDS (Prevention and Control) Act 2017, implemented in 2018, is a central legislation that aims to prevent and control the spread of HIV and AIDS while protecting the legal and human rights of people living with HIV (PLHIV), as well as the rights of healthcare workers (HCWs). However, evidence on HCWs’ knowledge, attitude and practices (KAP) related to the Act and rights of PLHIV remains limited in Eastern India. This study aimed to assess the KAP of HCWs regarding the rights of PLHIV as mandated under the Act. Methods: A hospital-based cross-sectional study was conducted during a one-day sensitization workshop on the HIV and AIDS (Prevention and Control) Act, 2017 in March 2024. All registered participants aged 20 years or more (doctors, nurses, laboratory technicians, counsellors and hospital attendants) were included (N = 170). Data were collected using a pre-tested, semi-structured, self-administered questionnaire covering baseline attributes and 11 knowledge, 11 attitude and 22 practice items. Each correct response was scored as one and incorrect response was scored as ‘zero’; domain scores were dichotomized at 50% into good or poor knowledge and practice and positive or negative attitude. Data were analysed in SPSS v26.0 using descriptive statistics, chi-square tests and binary logistic regression. Results: Of the 170 HCWs, 70 (41.2%) participants had ever heard of the HIV and AIDS (Prevention and Control) Act 2017, and 65 (38.2%) demonstrated good knowledge. Positive attitude towards PLHIV was observed in 169 (99.4%) participants, and good practices were reported by 138 (81.2%). Participants without prior experience of working with PLHIV had significantly lower odds of good knowledge (AOR = 0.40; 95% CI: 0.21–0.77) and good practices (AOR = 0.25; 95% CI: 0.10–0.64). Conclusion: Despite positive attitudes, significant gaps exist in HCW’s knowledge of the Act, necessitating systematic sensitization and periodic refresher training of HCWs on Act for stigma-free care to PLHIV.

Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthes...

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37–0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08–0.24), non-adherence to face masks was 0.27 (95% CI 0.0–0.81), and access to shared community toilets was 0.59 (95% CI 0.11–1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Introduction: Ensuring accessible and quality health care for women and children is an existing challenge, which is further exacerbated during pandemics. There is a knowledge gap about the effect of pandemics on maternal, newborn, and child well-being. This systematic review was conducted to study maternal and child health (MCH) services utilization during pandemics (Zika, Ebola, and COVID-19) and the effectiveness of various interventions undertaken for ensuring utilization of MCH services. Methodology: A systematic and comprehensive search was conducted in MEDLINE/PubMed, Cochrane CENTRAL, Embase, Epistemonikos, ScienceDirect, and Google Scholar. Of 5643 citations, 60 potential studies were finally included for analysis. The included studies were appraised using JBI Critical appraisal tools. Study selection and data extraction were done independently and in duplicate. Findings are presented narratively based on the RMNCHA framework by World Health Organization (WHO). Results: Maternal and child health services such as antenatal care (ANC) visits, institutional deliveries, immunization uptake, were greatly affected during a pandemic situation. Innovative approaches in form of health care services through virtual consultation, patient triaging, developing dedicated COVID maternity centers and maternity schools were implemented in different places for ensuring continuity of MCH care during pandemics. None of the studies reported the effectiveness of these interventions during pandemic-related health emergencies. Conclusion: The findings suggest that during pandemics, MCH care utilization often gets affected. Many innovative interventions were adopted to ensure MCH services. However, they lack evidence about their effectiveness. It is critically important to implement evidence-based appropriate interventions for better MCH care utilization.