Demographic and socio-economic correlates of knowledge of the ovulatory cycle among tribal women in India: Evidence from the nationally representative survey (NFHS-5)

BACKGROUND

The knowledge of ovulatory cycle (KOC) is the basis for natural family planning methods. The absence of knowledge is a notable issue since the ovulatory cycle plays a crucial role in reproductive health and empowers women to make informed decisions that influence their lives. This study examines the knowledge of the ovulatory cycle among reproductive tribal women in India and its demographic and socio-economic determinants.

METHODS

The data were derived from the National Family Health Survey conducted in 2019-2021. The effective sample size for the present study was 1,01,914 tribal women aged 15-49 years in India. Descriptive statistics along with bivariate analysis were conducted to find the preliminary results. Additionally, multivariable binary logistic regressions were conducted to determine the likelihood of KOC among tribal women across different characteristics. We conducted statistical analysis in STATA 17.0 (StataCorp) and used ArcGIS 10.8.2 for spatial mapping.

RESULTS

Out of 1,01,914 tribal women, 78.8 per cent lack correct knowledge of the ovulatory cycle. Notably, Education level significantly influences KOC, with secondary education showing higher odds of KOC (AOR: 1.24, 95% CI:1.006-1.528) compared to no education. Christian women exhibit lower odds of having KOC (AOR: 0.749, 95% CI:0.564-0.996) compared to Hindu women. Husband/partner's education level shows a strong association, with higher-educated partners correlating with higher odds of KOC (AOR: 2.501, 95% CI: 1.807-3.461) for higher education. Knowledge of any contraceptive method and current contraceptive use type are strongly associated with KOC. Additionally, rural residence negatively influences KOC (AOR: 1.545, 95% CI: 1.236-1.932), while exposure to mass media has a positive effect (AOR: 1.152, 95% CI: 0.975-1.362) albeit modest.

CONCLUSION

The study highlights the need for targeted educational and awareness programs to improve KOC among tribal women in India. By addressing factors such as education, religious influences, and place of residence, we can empower these women to make informed decisions about their reproductive health, ultimately enhancing their overall well-being and quality of life. This knowledge is not only a foundation for natural family planning but also a key driver of women's agency and autonomy in shaping their lives.

Genetic counseling in sickle cell disease: Insights from the Indian tribal population

Sickle cell disease (SCD) is an inherited disorder of hemoglobin. With an overall prevalence of 4.3%, India is the second-largest hub of SCD after Africa. Genetic counseling (GC) is the most cost-effective intervention to reduce the burden of a genetic disease including SCD. Even though GC's role in reducing SCD birth prevalence is well established, it is still not incorporated into Indian national policy and is unavailable to most Indians approaching their marriageable age and childbirth. GC perception and efficacy have also not been explored yet among young adults, especially in Indian tribal communities. Counseling in these communities requires careful consideration of their socioeconomic, cultural, and ethical values. Community engagement with local tribes and healthcare infrastructure in a multitier approach is essential for an effective GC. This review aims to provide healthcare providers and genetic counselors with the essentials of GC in the prevention and management of SCD among tribal communities based on the author's counseling experience in South India.

Traditional medicinal knowledge and practices among the tribal communities of Thakht-e-Sulaiman Hills, Pakistan

BACKGROUND

Little is known about the medical material and practices of tribes in the western border areas of Pakistan. The local population has inhabited this remote and isolated area for centuries, and gained medicinal knowledge with personal experiences and knowledge learned from forefathers. Due to the geographical isolation of the communities in the Sulaiman hills of Pakistan and their unique culture, the area is of importance for exploration and assessment.

METHODS

A total of 116 informants were interviewed in five foothill villages and the associated migratory mountain villages during 2010-2012 and 2015. Information was gathered mainly through semi-structured interviews and freelisting. Local diseases were categorized based on symptoms and affected organs. Descriptive statistics were used for data analysis.

RESULTS

Depending on the type of illness, typically a pulse diagnoser or a religious specialist is consulted. Medicinal plant knowledge and use is mostly known and advised by elders within the family. A total of 44 plant species from 32 families (588 use reports), 7 animal species and 6 minerals and other sources (384 use reports) were documented as materia medica. Among the plants, the Lamiaceae is the most dominantly used plant family, followed by Pinaceae. The most frequently reported single species was Teucrium stocksianum. The most often mentioned diseases and treatments fall into the categories of gastrointestinal, ritual, and musculoskeletal diseases. The use of goat and sheep skin as medicine was pivotal in the local medicinal system. Remedies from animal parts and other biological and non-biological sources were mainly used for musculoskeletal ailments and ritual treatments. Overall, people rely on both traditional and biomedical medication and treatments and combination of these systems.

CONCLUSION

This paper provides insight into the pluralistic medication system of rural communities of northwest Pakistan. It highlights the materia medica most commonly in use. A considerable part of the documented materia medica and local practices is part of an oral tradition and cannot be found in written sources or scientific articles. The gaining of new medicinal knowledge in the area was the good sign of continuation of traditional medicinal practices.

Inclusion of American Indians and Alaskan Natives in Large National Studies: Ethical Considerations and Implications for Biospecimen Collection in the HEALthy Brain and Child Development Study

This manuscript is the result of an interdisciplinary team approach to examine the ethical and cultural considerations of biospecimen collection among American Indian and Alaskan Native (AIAN) communities for the planned Healthy Brain and Child Development (HBCD) study. We begin by reviewing a brief history of the treatment of AIAN communities by the US government and within research studies. Based in part on this history, we highlight the overlapping and intersecting vulnerabilities of AIAN communities, including historical trauma, poverty, lack of healthcare access, and environmental hazards. After consideration of ethical and legal implications, we introduce our recommendations for biospecimen collection/biobanking with AIAN communities in the context of population-representative, multi-site, national studies. We recommend the following key considerations: (1) authentic partnership development; (2) beneficence to the community; (3) culturally respectful research design; (4) meaningful consent to support enrollment and retention; (5) culturally appropriate data management. Adherence to a culturally aware approach for inclusion of underrepresented communities assures external validity in the national studies and increases likelihood of bidirectional value exchange.

Oral Health Status and Treatment Needs of Paniya Tribes in Kerala

INTRODUCTION

The tribal communities of Kerala have been largely left out of the gains of the Kerala model of development.

AIM

The study was aimed to obtain baseline data of oral health status and treatment needs of Paniyas, in Kerala, India.

MATERIALS AND METHODS

A descriptive population based survey of adult Paniya belonging to index age groups of 35-44 years and 65-74 years was conducted. The study population comprised of 420 subjects drawn from three talukas by stratified cluster sampling. Modified version of WHO Oral Health Assessment Form (1997) was used to assess the oral health status.

RESULTS

Caries prevalence was 40%. The mean DMFT in the 35-44 years age group was 1.52±1.95 and in 65-74 age group it was 18.47 ± 13.10. Oral mucosal lesions were seen in 4.52% and 76.9% had periodontal disease. Tooth brushing was reported by 55.5% of the subjects. Paan chewing, with tobacco or without tobacco, habit was reported by 89.3%. Bi-variate analyses between the CPI scores and age groups showed high statistical significance. The maximum mean treatment requirement was for extraction (1.37 ± 4.01) and was observed in 65-74 age groups.

CONCLUSION

The lack of basic oral health care access is important for high oral disease burden in these populations. Efforts are to be done for basic oral health care facility to these marginal populations.

Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment

INTRODUCTION

A competent health system is of paramount importance in delivering the desired health services in a particular community.

AIM

The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India.

MATERIALS AND METHODS

A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area.

RESULTS

There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district.

CONCLUSION

Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.