Background: The primary objective of this study was to intervene with vitamin D supplementation in rural-based women with pre-diabetes (impaired fasting glucose or impaired glucose tolerance) to prevent development of type 2 diabetes (T2DM). Methods: This was an open-label randomized placebo-controlled trial conducted in rural women with pre-diabetes and vitamin D deficiency (Clinicaltrials.gov NCT02513888). Women aged 20-60 years with pre-diabetes were selected from rural Haryana (north India) and followed up for two years. A semi-structured questionnaire was used to collect information on socio-demographic and behavioral details, like sun exposure, dietary habits, etc., The intervention group received vitamin D supplementation while control group received lactose granules as placebo. Equal doses of calcium carbonate were given to both the groups. Results: A total of 132 participants were recruited in the study (58 each in the intervention and control groups). It was observed that there was no statistical significance in the incidence of diabetes in the control group as compared to the intervention group at the end of 2 years ( P = 0.701). Conclusion: Though during the first year there was some delay in development of DM in the intervention group but at the end of two years there was no significant effect of vitamin D supplementation in delaying the incidence of diabetes in these women after two years. Trial registration: (Clinicaltrials.gov NCT02513888).

Background: The Antenatal care and institutional delivery to improve maternal and child health is the prime focus of the time. India, with its large economic diversity, the health care utilization may depend on type of service provider i.e. public or private. The present study estimates the trends in the utilization of public and private maternal health care services and the associated socio-demographic factors, the major focus being Antenatal care and skilled delivery. Methodology: The present population based cross-sectional analysis is performed on the secondary data of India from three rounds of District Level Household Survey (DLHS) conducted in 1998-99, 2002-04 and 2007-08. Indicators for maternal health care utilization are based on full antenatal check up (FANC) as defined by RCH program and skilled institutional delivery attendance (SID) as defined by WHO by the mode of service provider (Public vs Private). Multinomial logistic regression was used for statistical analysis by considering these indicators as the outcome variables treating various socio-demographic factors as independent variables. Result: The urban area, other than SC/ST caste, higher wealth index and more than 10 years of mother's & father's education have high proportion of maternal health care utilization. Lower parent's education have shown lower relative risk ratio of FANC and SID accessibility throughout the survey periods. Wealth indices as a factor of FANC and SID are observed higher in private sectors as compared to public sectors during second and third survey. Women with more pregnancy related problem have chosen private sector for their institutional delivery during all the survey periods. Maternal health programme related initiatives such as when health worker visit for antenatal care and women counselled to go for institutional delivery have shown improvement in terms of accessibility. Conclusion: This study used multinomial logistic regression which attempts to integrate the different socioeconomic and demographic factors as well as maternal health related program initiatives by mode of service provider. The analysis strongly brings out the preference for public sector and private sector for seeking maternal services mainly depends on the various socioeconomic characterises. Program initiatives clearly demonstrate that accessibility is higher for public sector. However,the improvement in the public sector is stagnating beyond a point across India. Public-private partnership needs to be explored by keeping in mind that the efforts are to be directed more for deprived section of the society.

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The WHO recommends HIV self-testing (HIVST) as an innovative strategy and an additional testing approach to attain UNAIDS targets to end HIV by 2030. HIVST is a process whereby a person collects his or her own specimen (either oral fluid or blood), performs an HIV test, and interprets the result. It has been described as a discreet and convenient way to reach the hidden, unreached key populations (KPs) who do not know their HIV status or do not get tested. Among the KPs, men who have sex with men (MSM) is one such group that by far remains hidden due to feared stigma and discrimination associated both with their sexuality and HIV. Fear of pain and blood while HIV testing also deters MSM from getting tested. In this review, we assessed the effect of oral HIVST on the uptake and frequency of testing and risk behavior as compared to standard HIV testing.For this review, we systematically searched various electronic databases for clinical trials comparing HIVST to standard HIV testing from January 1, 2011, to December 31, 2021. A meta-analysis of studies was conducted using a random-effects model for relative risks (RRs) and 95% confidence intervals (CIs). The protocol was registered with PROSPERO, and PRISMA guidelines for systematic reviews and meta-analyses were followed. The quality of the clinical trials was assessed using Cochrane's risk of bias tool version 2.0 (RoB 2.0).We identified eight studies comparing HIVST to standard HIV testing services (HTSs). The eight randomized controlled trials (RCTs) enrolled 5,297 participants, of which 5,212 were MSM and 85 were transgender (TG) women. Seven RCTs were conducted in high-income countries (HICs): four in the USA, two in Australia, and one in Hong Kong. One was conducted in a low-middle-income country (LMIC) in Myanmar. In all the studies, HIVST intervention was provided with oral HIVST kits, except for one study in which both bloodbased and oral HIVST kits were used. Meta-analysis (five RCTs) showed that HIVST increased the uptake of HIV testing by 1.43 times compared to standard of care (SoC) (RR = 1.43; 95% CI = 1.25, 1.64). Meta-analysis (four RCTs) found that HIVST increased the mean number of HIV tests by 2.34 during follow-up (mean difference = 2.34; 95% CI = 1.66, 3.02). Meta-analysis (four RCTs) showed that HIVST doubled the detection of new HIV infections among those tested (RR = 2.10; 95% CI = 1.35, 3.28) and reported higher repeat testing as compared to the control arm (RR = 2.04; 95% CI = 1.22, 3.42). A meta-analysis of three trials found no significant difference in risk behavior in respect of condomless anal intercourse (CAI) (odds ratio (OR) = 0.90; 95% CI = 0.67, 1.22) and multiple male partnership (RR = 0.89; 95% CI = 0.83, 0.94).Oral HIVST could increase the HIV testing and detection of new HIV infections among MSM who may not otherwise test, as compared to standard testing services alone. However, further research from low-middleincome countries is required for generalizability.