This article discussed some of the important issues regarding the effect of epidemics like COVID-19 on the migrant population. These impacts are most troubling for low-income households, which are less well positioned to cope with earnings losses during a recession, have no alternative earnings and have no social security available. Most of these workers earn little more than a subsistence wage and have no other means to protect their incomes if they lose their jobs. Migrant workers constitute quite a large proportion of such vulnerable population. Millions of migrant workers are anticipated to be left unemployed in India due to the lockdown and subsequent fear of recession. Many of the migrant workers have returned to their villages, and many more are just waiting for the lockdown to be lifted. The risk is particularly higher for those who are working in unorganised sectors, and those who do not have writer contracts, or those whose contracts are at the verge of completion. The lockdown and the subsequent recession are likely to first hit contract workers across many of the industries. On the one hand, lockdowns and social distancing measures are drying up jobs and incomes, whereas they are likely to disrupt agricultural production, transportation systems, and supply chains on the other. This poses a challenge of ensuring food security and controlling already rampant malnutrition, particularly among children, which is likely to result in increased infant and child mortality. There is a need to relook at the national migration policies, which should accommodate the assistance and protection of migrants arriving from, or faced with the prospect of returning to, areas affected by health crises. Also, there is a need to establish resilient food systems that could reduce food insecurity and the pressure to return to origin among migrants.

This article sheds light on some important issues related to menstrual practices and its association with reproductive morbidity among girls. The study indicates that a significantly large proportion of girls were not aware of menstruation when they first experienced it. Mothers, sisters and friends were found to be the major source of information. Much of this information imparted to a young girl is in the form of restrictions on her movements and behaviour. More than three-fourths reported using old cloth during menstruation, and a large proportion of them were reusing the same during subsequent periods. Regression analysis in this study identified schooling, residential status, occupation of father, caste and exposure to media to be the major predictors of safe menstrual practices among adolescent girls in Rajasthan. Importantly, this study found a significantly strong relationship between practices during menstruation and prevalence (reported symptoms) of RTIs. The prevalence of RTIs was more than three times higher among girls having unsafe menstrual practices. The article makes a strong case that ignorance, false perceptions and unsafe practices regarding menstruation are not uncommon among adolescents in the study area, having serious implications for reproductive and sexual health. Further, the study demonstrates that among the determinants for reproductive morbidity, practices during menstruation appear to be the most dominant factor. These findings reinforce the need to bring them out of traditional beliefs, misconceptions and restrictions, and encourage safe and hygienic practices.

Background Monitoring abortion rates is highly relevant for demographic and public health considerations, yet its reliable estimation is fraught with uncertainty due to lack of complete national health facility service statistics and bias in self-reported survey data. In this study, we aim to test the confidante methodology for estimating abortion incidence rates in Nigeria, Cote d’Ivoire, and Rajasthan, India, and develop methods to adjust for violations of assumptions. Methods In population-based surveys in each setting, female respondents of reproductive age reported separately on their two closest confidantes’ experience with abortion, in addition to reporting about their own experiences. We used descriptive analyses and design-based F tests to test for violations of method assumptions. Using post hoc analytical techniques, we corrected for biases in the confidante sample to improve the validity and precision of the abortion incidence estimates produced from these data. Results Results indicate incomplete transmission of confidante abortion knowledge, a biased confidante sample, but reduced social desirability bias when reporting on confidantes' abortion incidences once adjust for assumption violations. The extent to which the assumptions were met differed across the three contexts. The respondent 1-year pregnancy removal rate was 18.7 (95% confidence interval (CI) 14.9–22.5) abortions per 1000 women of reproductive age in Nigeria, 18.8 (95% CI 11.8–25.8) in Cote d’Ivoire, and 7.0 (95% CI 4.6–9.5) in India. The 1-year adjusted abortion incidence rates for the first confidantes were 35.1 (95% CI 31.1–39.1) in Nigeria, 31.5 (95% CI 24.8–38.1) in Cote d’Ivoire, and 15.2 (95% CI 6.1–24.4) in Rajasthan, India. Confidante two’s rates were closer to confidante one incidences than respondent incidences. The adjusted confidante one and two incidence estimates were significantly higher than respondent incidences in all three countries. Conclusions Findings suggest that the confidante approach may present an opportunity to address some abortion-related data deficiencies but require modeling approaches to correct for biases due to violations of social network-based method assumptions. The performance of these methodologies varied based on geographical and social context, indicating that performance may be better in settings where abortion is legally and socially restricted.

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BackgroundThe most ambitious sanitation campaign to end open defecation (OD) in India came to a close on 2 October 2019 and there are limited independent, robust data to measure its success. We aimed to evaluate Rajasthan’s claim of open defecation free status in March 2018 under the Swachh Bharat Mission (SBM) or ‘Clean India Mission’ by measuring OD trends from 2016 to 2018.MethodsWe used publicly available data from Performance Monitoring and Accountability 2020, a representative survey with two-stage stratified cluster sampling. Enumeration areas were the primary sampling units selected by the probability proportional ­to ­size method. The repeated cross-sectional surveys independently collected household water and sanitation data in Rajasthan (n=20 485). Among households reporting toilet access, the data were pooled across the four rounds for an observational analysis using logistic regression. The primary outcome measure was regular OD among households with access to toilet facilities.FindingsBetween October 2016 and July 2018 main OD practices in rural Rajasthan households decreased from 63.3% (95% CI 57.0% to 69.6%) to 45.8% (95% CI 38.4% to 53.2%) and in urban households from 12.6% (95% CI 6.0% to 19.1%) to 9.4% (95% CI 4.0% to 14.7%). Households with regular OD occurring despite access to a toilet made up 21.7% (95% CI 16.9% to 26.6%) of rural and 12.1% (95% CI 3.6% to 20.7%) of urban Rajasthan as of July 2018. The multivariate logistic regression revealed that factors related to water stress and sanitation sharing were associated with household members regularly practising OD.ConclusionsThese data highlight the importance of a continued focus on constructing toilets that are affordable with low water requirements during the next phase of SBM. An independent survey that can provide robust estimates of OD is needed to monitor progress of toilet construction and use.