Barriers to Access Health Care Services among Rural Adolescent Girls in Raina I Block, Purba Bardhaman, West Bengal

Adolescence in girls is a crucial transition phase during which they experience biological and psychological changes along with changes in social outlook. This phase provides an opportunity to lay the foundation for their future health. But, in rural areas, adolescent girls are often deprived of better nutrition and proper health care guide, resulting in serious health issues like malnutrition, stunting, wasting, and anaemia. Moreover, their access to health care services is subjected to various constraints as infrastructural and societal barriers such as regressive norms, social stigma, gendered family structure, etc. Thus, the present study attempts to explore the perceived barriers that prevent rural adolescent girls from accessing health care services at the micro-level. A community-based cross-sectional study was carried out after randomly selecting 120 adolescent girls in the age cohort of 10-19 years in the Raina-I block of Purba Bardhaman district. The results suggested that societal barriers have a significant influence over health-related decision-making. Besides, lack of quality health care services and economic burden are some of the other significant obstacles observed here.

Under nutrition and associated factors among adolescent girls attending school in the rural and urban districts of Debark, Northwest Ethiopia: A community-based comparative cross-sectional study

Introduction Adolescence is the time of puberty in which a substantial changes in physical, mental, and emotional are observed; Nutritional requirements significantly rise as a result. Even though improving adolescent girls’ nutritional status helps to break the intergenerational cycle of malnutrition, many studies in Ethiopia focus on determining the nutritional status of under-five and pregnant women and even they don’t show disparities between urban and rural adolescent girls. Thus, this study was aimed at comparing the rural and urban prevalence’s of stunting and thinness and their associated factors among adolescent girls attending school in Debark district, Northwest Ethiopia, 2020. Method A community-based comparative cross-sectional study was conducted among 792 adolescent girls from February 25th to March 21st 2020. A multi-stage sampling followed by simple random sampling technique was used. Data were collected through a face-to-face interviewer-based questionnaire. Different anthropometric measurements were taken. The collected data were entered to Epi-data and exported into SPSS for analyses. Variables with p-values < 0.25 in the bivariable analysis were exported to multivariable logistic regression model to control confounders and identify the factor. The strength of association and statistical significance was declared using the adjusted odds ratios with its corresponding 95% CI, and p-value ≤ 0.05 respectively. Results A total of 757 adolescent girls with a response rate of 95.6% were participated in the study. The overall prevalence of stunting and thinness were 20.1% and 10.3%, respectively. Stunting among rural adolescent girls was 24.2%; whereas it was 16% among urban residents. Likewise, thinness among rural adolescent girls was 8.5%; whereas it was 12.1% among urban dwellers. No latrine [AOR: 1.95 (95% CI: 1.11, 3.43)], lowest media exposure [AOR: 5.14 (95% CI: 1.16, 22.74)], lower wealth class [AOR:2.58 (95% CI: 1.310, 5.091)], and middle wealth class[AOR: 2.37 (95% CI: 1.230, 4.554)] have risen the likelihood of stunting in rural setting while early adolescent age [AOR:3.17 (95% CI:1.445,6.95)] significantly associated with stunting in urban setting. Food insecurity [AOR: 1.95 (95% CI: 1.01, 3.78)] was associated with stunting in overall adolescent girls. Middle adolescent age groups in rural area have more than three times to experience thinness [AOR: 3.67 (95% CI: 1. 21, 11.149)]. Whereas urban resident girls fall in early adolescent age group developed thinness were eight times [AOR: 8.39 (95% CI: 2.48–28.30)]. Conclusion Stunting was higher among rural adolescent girls as compared to urban. However, thinness was higher among urban dwellers. Lower wealth class, food insecurity, lowest media exposure, and age were significantly associated with stunting and thinness. Hence, increasing latrine coverage, boosting the economic status of the community, and increasing media exposure for adolescent girls should get due attention.

Biochemical and Dietary Indicators of Bone Health in Rural Adolescent Girls from Konkan Region of Maharashtra, India (DERVAN-5)

Adolescent period is marked by bone modeling and remodeling and leads to accrual of peak bone mass. Ideal peak bone mass depends on diet, hormones, genetic influence and environment and has consequences on bone health in adulthood. We measured biochemical indicators of bone health in rural adolescent girls. Methods: Five hundred fifty adolescent girls from longitudinal DERVAN cohort study from Indian state of Maharashtra underwent anthropometry. Biochemical parameters (intact parathyroid hormone, vitamin D, calcium, phosphorus and alkaline phosphatase) were measured. Results: Prevalence of underweight & stunting was 28.8%, 30.7% respectively. More than 56% were thin & only 5% were obese. Median body fat% & bone mass measured by bio-impedance were 23.3 and 1.6 Kg respectively. More than 80% were vitamin D deficient and 12.0% were calcium deficient. Median dietary calcium intake was 158.5mg/day which was far below recommended 850 mg/day. Median parathyroid hormone concentration was 8.49pmol/L and 66.7% had elevated concentrations (> 6.89pmol/L). Elevated phosphorus and alkaline phosphatase were observed in 23.3% and 23.0%. Parathyroid hormone was inversely associated with age (p<0.001) and vitamin D (p<0.001) and directly with phosphorus and alkaline phosphatase (p<0.05) for both. On multivariate analysis elevated parathyroid hormone was associated with low vitamin D (p<0.001). Conclusion: The adolescent girls of KONKAN are undernourished and vitamin D deficient. Despite poor dietary calcium intake the serum calcium levels were maintained at the cost of elevated parathyroid hormone. Thus parathyroid hormone may be used as a marker of bone health. This could be useful in planning early interventions to improve bone health.

Weight perception and symptoms of depression in rural Australian adolescents

Objective To investigate associations between measured and perceived weight, and symptoms of depression in rural Australian adolescents. Method: At baseline a prospective rural adolescent cohort study collected demographic data, measured weight and height, weight self-perception, and presence of depression (Short Mood and Feelings Questionnaire). Using World Health Organisation’s (WHO) age and gender body mass index (BMI) standardisations, participants were classified into four perceptual groups: PG1 healthy/perceived healthy; PG2 overweight/perceived overweight; PG3 healthy/perceived overweight; and PG4 overweight/perceived healthy. Logistic regression analyses explored relationships between these groups and symptoms of depression. Results: Data on adolescents ( n = 339) aged 9–14. PG1 contained 63% of participants, PG2 18%, PG3 4% and PG4 14%. Across the cohort, 32% were overweight and 13% had symptoms of depression. PG2 (overweight/perceived overweight) were more likely to experience symptoms of depression than PG1 (healthy/perceived healthy; Adjusted Odds Ratio [AOR] 3.1, 95% CI 1.5–6.7). Females in PG3 (healthy/perceived overweight) were more likely to experience symptoms of depression (38%) than males (14%) and females in PG1 (10%, AOR 5.4, 95% CI 1.1–28.2). Conclusions: Results suggest that perceptions of being overweight may be a greater predictor for symptoms of depression than actual weight. This has public health implications for youth mental health screening and illness prevention.

A study to assess the knowledge and practices of menstruation among rural adolescent girls

Background: Adolescence is phase of maturations where an individual experiences drastic changes in growth and development. Age group 10-19 years is defined as adolescent age by World health organization. In developing countries, this is the period when many children drop-out of school and miss out on education. Among adolescent girls’ menstruation is a major life changing event. We conducted this study among rural adolescent girls to know their knowledge, attitude and practices towards menstruation. We also educated all girls on physiology and hygienic practices during menstruation.Methods: A cross-sectional study was conducted among adolescent girls attending our out-patient clinic in the rural area. All girls were interviewed to assess their knowledge and practices towards menstruation. Informed consent was taken from all girls before stating the study. Data presented in form of frequency, percentages. Chi-square test was applied to analyze for association.Results: 87% were students, 88% adolescent girls belonged to Below Poverty Line (BPL) families. 98% adolescent girls had attained menarche before 15 years of age, 27% adolescent girls had dysmenorrhea presenting as pain in abdomen region. Sanitary pad was being used by only 64% adolescent girls, of whom, 59.4% change sanitary pad twice daily, 75% dispose it by burning. Overall, 36% adolescent girls used cloth, of whom, 41.7% changed cloth twice a day, 69.4% adolescent girls wash and burn the cloth. Among adolescent girls still studying in school 71.2% used sanitary pads which was statistically significant.Conclusions: Education is essential to empower girls to take informed decisions. On receiving adequate information on menstruation, girls were willing to adapt healthy hygienic practices. Hence, health education activities should be started at all schools so as to inculcate good practices early in life.

Hypertension among School going Urban and Rural Adolescents: A Comparative Study

Background: In the modern society, technology has contributed to create physical comfort in the life and simultaneously, there is alteration in dietary habits of youngsters. This has affected adolescent’s health significantly, leading to hypertension in both urban and rural adolescent population. Objectives: Present study aimed to access and compares the prevalence of hypertension among urban and rural adolescent. Methods: A community-based cross-sectional comparative study conducted on 300 healthy age matched adolescents, 10- 19 years of age from each of rural and urban school of Jaipur (Rajasthan). After Institutional Ethical Committee and school administration approval, a predesigned proforma was filled having socio-demographic details, personal and family history. An average blood pressure was calculated by measuring 3 recordings with 5 minutes break through sphygmomanometer. The blood pressure was classified on percentile bases into prehypertension and hypertension. The data inferred by chisquare and ‘p-value’ less than 0.05 considered as significant. Result: The prevalence of hypertension among urban and rural adolescent of Jaipur was 7.6% and 7%, while prehypertension was 32% and 28%, respectively. The prevalence of hypertension was high for systolic than diastolic blood pressure and more in late adolescent than early adolescent age group which was found significant only for systolic hypertension (p=0.003). Conclusion: High prevalence of adolescent’s hypertension is an important risk factor for future consequences of cardiovascular disease suggesting that there should be change in lifestyle. The early detection and management of it can prevent any future disability and mortality.