Background: Isoniazid preventive therapy (IPT) has been shown to reduce the risk of tuberculosis (TB) among people living with HIV (PLHIV). In 2017, India began a nationwide roll-out of IPT, but there is a lack of evidence on the implementation and the challenges. Objectives: Among PLHIV newly initiated on antiretroviral therapy (ART) from January 2017 to June 2018, to: (i) assess the proportion who started and completed IPT and (ii) explore reasons for non-initiation and non-completion from health-care providers' and patients' perspectives. Methods: An explanatory mixed-methods study was conducted in two selected districts of Karnataka, South India. A quantitative phase (cohort analysis of routinely collected program data) was followed by a qualitative phase involving thematic analysis of in-depth interviews with providers (n = 22) and patients (n = 8). Results: Of the 4020 included PLHIV, 3780 (94%) were eligible for IPT, of whom, 1496 (40%, 95% CI: 38%-41%) were initiated on IPT. Among those initiated, 423 (28.3%) were still on IPT at the time of analysis. Among 1073 patients with declared IPT outcomes 870 (81%, 95% CI: 79%-83%) had completed the six-month course of IPT. The main reason for IPT non-initiation and non-completion was frequent drug stock-outs. This required health-care providers to restrict IPT initiation in selected patient subgroups and earmark six-monthly courses for each patient to ensure that, once started, treatment was not interrupted. The other reasons for non-completion were adverse drug effects and loss to follow-up. Conclusion:The combined picture of 'low IPT initiation and high completion' seen in our study mirrors findings from other countries. Drug stock-out was the key challenge, which obliged health-care providers to prioritize 'IPT completion' over 'IPT initiation'. There is an urgent need to improve the procurement and supply chain management of isoniazid.

Background: “Rain Water Harvesting” is one of the identified strategies to replenish the ground water system in India. Household level of rain water harvesting could serve as an indicator for assessment of participation of local community. Objectives: To assess the proportion of household rainwater harvesting and factors associated with it and to find the reasons behind adoption of this practice in a rural area of Kolar district, Karnataka. Methods: An exploratory sequential mixed methods study design with an initial cross-sectional quantitative study followed by qualitative in-depth interviews was done to assess the factors affecting household rain water harvesting and reasons behind the practice. Household survey with interview of one person from each household was done. Quantitative data were reported using proportions and qualitative data were reported using categories and verbatim quotes. Results: Of the 82 households surveyed, 31 (37.8%, 95% CI: 27.8–48.6) had adopted at least crude method of rain water harvesting. Household belonging to either joint or three-generation family type was practicing rain water harvesting higher compared with nuclear family type. Reasons for adoption were included under the categories - purity, fresh, tradition, less work, passion , and why waste ? Conclusion: About one in three households practiced rain water harvesting in the rural area under study with households belonging to joint or three-generation family practicing more compared with nuclear families. The reason for adoption was mostly based on beliefs and also felt needs by families.

Background: In developing countries, monitoring and assessing the change in water, sanitation and hygiene (WaSH) practices still remains to be a challenge especially in rural areas. The objective of the study was to assess the practices related to WaSH and factors associated with good WaSH practices among rural adult women belonging to Kolar district of Karnataka, India.Methods: A community based cross-sectional study was conducted in a village of Kolar district during July - October 2018. Socio-demographic details and water related characteristics were collected from an adult female of the household using a pre-tested semi-structured interview schedule. The WaSH practices were captured using a set of 15 questions designed after a thorough literature search. WaSH score was categorised into good practice or not based on cut-off value of WaSH score ≥third quartile.Results: Out of total 108 households enlisted a total of 82 households (76%) comprising of 464 individuals was surveyed. The number of people reporting good WaSH practices was 40 (48.8%). Multivariable logistic regression model containing all independent variables studied showed statistical significance with respect to family type alone (nuclear family having statistically significance compared to three generation family; Odds ratio (95% Confidence Interval) =11.9 (2.7-52.0).Conclusions: One in two women had good WaSH practice and among the individual components use of soap after defecation was practiced in less than one in ten women under study.