The Government of India has started a new scheme aimed at offering sanitary pads at a subsidized rate to adolescent girls in rural areas. This paper addresses menstrual health and hygiene practices among adolescent girls in a rural, tribal region of South Gujarat, India, and their experiences using old cloths, a new soft cloth (falalin) and sanitary pads. Qualitative and quantitative data were collected in a community-based study over six months, with a pre-and post- design, among 164 adolescent girls from eight villages. Questions covered knowledge of menstruation, menstrual practices, quality of life, experience and satisfaction with the different cloths/pads and symptoms of reproductive tract infections. Knowledge regarding changes of puberty, source of menstrual blood and route of urine and menstrual flow was low. At baseline 90% of girls were using old cloths. At the end of the study, 68% of adolescent girls said their first choice was falalin cloths, while 32% said it was sanitary pads. None of them preferred old cloths. The introduction of falalin cloths improved quality of life significantly (p<0.000) and to a lesser extent also sanitary pads. No significant reduction was observed in self-reported symptoms of reproductive tract infections. Falalin cloths were culturally more acceptable as they were readily available, easy to use and cheaper than sanitary pads.

Background:The Innovative Mobile-phone Technology for Community Health Operation (ImTeCHO) is a mobile-phone application that helps Accredited Social Health Activists (ASHAs) in complete registration through the strategies employed during implementation that is linking ASHAs’ incentives to digital records, regular feedback, onsite data entry, and demand generation among beneficiaries.Objective:To determine the proportion of pregnancies, deliveries, and infant deaths (events) being registered through the ImTeCHO application against actual number of events in a random sample of villages.Materials and Methods:Five representative villages were randomly selected from the ImTeCHO project area in the tribal areas of Gujarat, India to obtain the required sample of 98 recently delivered women. A household survey was done in the entire villages to enumerate each family and create a line-listing of events since January 2014; the line-listing was compared with list of women registered through the ImTeCHO application. The proportion of events being registered through the ImTeCHO application was compared against the actual number of events to find sensitivity of the ImTeCHO application.Result:A total of 844 families were found during household enumeration. Out of actual line-listing of pregnancies (N = 39), deliveries (N = 102), and infant deaths (N = 5) found during household enumeration, 38 (97.43%), 101 (99.01%), and 5 (100%) were registered by ASHAs through the ImTeCHO application.Conclusion:The use of mobile-phone technology and strategies applied during the ImTeCHO implementation should be upscaled to supplement efforts to improve the completeness of registration.

The majority of adolescent girls in rural India lack awareness regarding menstrual hygiene management (MHM), access to sanitary absorbents and necessary facilities in schools, homes, and workplaces. This study evaluated an intervention to strengthen a public health programme aimed to increase the use of safe, sanitary absorbents and knowledge of MHM among tribal adolescent girls. This project was implemented in 202 villages of two sub-districts of Narmada district in Gujarat, India, for one year (2018–2019). The intervention consisted of capacity building of 892 government frontline health workers and teachers, followed by supportive supervision. Convergence with concerned departments was achieved through meetings with stakeholders. “MHM-corners” and “MHM-Committees” were created at schools and Anganwadi-centres to improve access to menstrual absorbents and information. Household surveys of adolescent girls were conducted at baseline ( n = 507) and end-line ( n = 550) in 27 randomly selected villages to evaluate outcomes. Of 550 girls at the end-line, mean age 16.3 years, 487 (88.5%) were tribal, and 243 (44%) were out-of-school. The primary outcome of interest, the proportion of adolescent girls using safe, sanitary absorbents, increased from 69% to 90.5% (OR: 5.19, CI: 3.61–7.47). Their knowledge of the uterus as the origin of menstrual blood and hormonal changes as the cause for menstruation improved from 6.3% to 66% ( p -value < 0.001) and 7.5% to 73% ( p -value < 0.001), respectively. School absenteeism during menstruation reduced from 24% to 14% ( p -value < 0.001). It is possible to improve MHM knowledge and practices among adolescent girls from tribal communities by utilising existing government systems. Awareness and access to safe absorbents can lead to safe and hygienic MHM practices.

India has the world's largest cataract backlog, with approximately 7 million individuals in need of cataract surgery (1). This is after the launch of the National Programme for the Control of Blindness, and of Vision 2020the right to sight programmewhich lead to a considerable improvement in the situation. Currently, 5 million cataract surgeries are performed every year, up from only 0.5 million in 1976. This is a big achievement, particularly with the scarce human resources and poor physical infrastructure available in the country. But though the number of operations has gone up, the quality still needs improvement. Still, surgical complications arising from cataract surgery are the cause of just a fraction of blindness according to surveys conducted across the country (1).Due to the huge backlog, we try to do as much work as possible, and as fast as possible. And every now and then, we hear about cluster infections. Recently, four episodes of cluster infections were reported. One was reported from a government hospital in Assam in January 2008, and another from Valsad district, Gujarat, at an NGO hospital in February 2008. The third was reported from a surgical camp conducted by an NGO in Barabanki district, Uttar Pradesh, in February 2008 and the fourth occurred at an NGO hospital in Trichy, Tamilnadu, in September 2008.

In this article, we explore real-time translation work undertaken by frontline healthcare professionals as they interact with marginal tribal communities in Western India. Our 1-year ethnographic study of a healthcare organization delivering obstetric and gynaecological care to tribal communities helps us understand how obstetric counsellors translate allopathic medical expertise across epistemological boundaries to the tribal community they serve, in localized comprehensible forms. We identify four distinct mechanisms of translation work—Interpreting, Annotating, Norming, and Justifying—which differentially deploy and integrate elements of tribal vocabulary, symbols, knowledge, and imaginations of health and body with specific aspects of clinical diagnosis and prescription, making the latter meaningful and actionable in the process. Furthermore, we use configurational approach—Qualitative Comparative Analysis—to investigate how the type of space where the interaction between the counsellors and tribal women patients happens influences the translation work undertaken. We find that counsellors engage in spatially differentiated translation work. They predominantly use justifying and norming in clinical space (hospital); interpreting and annotating in community space (village or school); and interpreting and norming in the overlapping in-between space (outdoor patient department). Our study contributes to translation literature by showing how real-time translation is undertaken in practice, especially in a setting representing high-stakes institutional translation, and how translation work is influenced by the type of space in which interactions happen.