Prevalence, pattern and predictors of domestic violence against women in Delhi: a community based study

Background: Domestic violence against women has serious health consequences for women. Prior research indicates its pervasive nature, albeit with wide variations in its prevalence across different settings. We examined the prevalence, pattern and predictors of domestic violence against women. Methods: Our community based, cross sectional, mixed methods study included 827 ever married women aged up to 60 years, from Delhi (India), selected through cluster sampling followed by systematic random sampling. Data were collected during 2010 to 2011 using structured questionnaires and in-depth interview guide. Statistical analysis was carried out using Stata 11.0 (College Station, Texas, USA) and thematic analysis for qualitative data obtained on in-depth interviews.Results: The life time prevalence of psychological, physical and sexual violence was 43.4%, 27.2 % and 26.4 % respectively; and when measured over past 12 months it was 37.6%, 19.3% and 20.3% respectively. ‘Any form of violence’ emerged as a sizeable category with a lifetime prevalence of 43.4%, and 37.8% in past one year. In most instances, the acts of violence were continuing and were perpetrated by husband. Violence was significantly higher among women having low neighborhood support (OR: 2.71, 95% CI: (1.39, 5.27), negative dowry effect (OR: 19.93, 95% CI: (10.36, 38.35) and alcoholic husband (OR: 2.12, 95% CI: (1.46, 3.09), whereas family support was protective against violence (OR: 0.31, 95% CI: (0.20, 0.49).Conclusions: The prevalence of domestic violence in Delhi is considerably high. There is need to use multipronged approach including effective and sustainable public health interventions to address the violence.

Predictors of Breastfeeding Problems in The First Postnatal Week and Its Effect on Exclusive Breastfeeding Rate at Six Months: Experience in A Tertiary Care Centre in Northern India.

In spite of the countless benefi ts of breastfeeding, prevalence of exclusive breastfeeding (EBF) has been far from optimal in the developing world. Breastfeeding problems at or after 4 weeks has been reported as one among the constraints to EBF. The study aimed to determine the breastfeeding problems in the 1st postnatal week, their predictors and impact on EBF rate at 6 months. Under a prospective cohort design, 400 mother-newborn dyads were assessed for breastfeeding problems before discharge and at 60 ± 12 h of discharge. Nearly 89% of the mother-newborn dyads had one or more BF problems before discharge. Major concern was diffi culty in positioning and attaching the infant to the breast (88.5%), followed by breast and nipple problems (30.3%). BF problems continued to persist even after discharge in a signifi cant proportion of the mothers (72.5%). The only independent predictor of BF problems in the 1st week was the caesarean section (odds ratio: 1.9, 95% confi dence interval: 1.3-3.2, P < 0.05). There was a marked improvement in the EBF status (69.5%) at 6 months, and BF problems did not predict EBF failure at 6 months.

Quality of life and psychosocial functioning of HIV infected children.

Objective. To assess the quality of life (QOL) and the psychosocial problems of HIV infected children. Methods. The present study was a comparative, cross-sectional survey conducted in the clinic of a tertiary care hospital in north India from July- December 2007. Children suffering from cystic fibrosis (CF) were chosen as a comparison group. Children ≥ 6 yr of age with HIV infection or Cystic Fibrosis, with no acute illness at the time of survey were included in the study. Quality of life of the enrolled children was assessed by using the Pediatric Quality of Life InventoryTM (PedsQLTM). Pediatric Symptom Checklist (PSC) was used for assessing the psychosocial problems in the enrolled children. Results. Forty one HIV infected and 30 children with cystic fibrosis were enrolled. According to child self -report in the PedsQLTM 4.0, the difference of perceived physical health status between the two study groups was statistically significant (p=0.04), with HIV infected children demonstrating a better QOL in this domain. A significantly greater number of children with cystic fibrosis (8/30 or 26.67%) suffered from psychosocial problems as compared to HIV children (3/41 or 7.32%) [p=0.026]. Conclusions. The quality of life and psychosocial functioning is reasonably good in children with HIV infection. Thus, we should strive to maintain and optimize the overall quality of life of these children so that they can have a productive and meaningful future.

Knowledge, attitude and practices among health care professionals regarding pain.

Objective. To assess the knowledge, attitude and practices among health care professionals regarding pain in children. Methods. This was a prospective descriptive survey conducted at a tertiary care hospital in north India. A semi structured questionnaire regarding pain in children was administered to pediatric residents and nurses in a teaching hospital. The questionnaire consisted of 24 items, of which 18 items were rated on a 5-point scale (‘strongly agree’ to ‘strongly disagree’) and 6 items were open-ended questions. Results. The response rate was 89.5%. Of 77 participants, 47 (61.1%) were nurses and 30 (38.9%) were pediatric residents. The knowledge about pain scales among the studied healthcare professionals was not widespread. Majority of respondents believed that the best judge of intensity of pain is the child. Nearly two-thirds of the respondents felt that non-pharmacological measures were better to control pain and also their practices showed that most were willing to allow the parental presence during minor invasive procedures. Conclusion. There is need to improve the knowledge of health care personnel regarding pain assessment and management in children.

Comparison of two pain scales in Indian children.

OBJECTIVE: To compare the faces pain scale and color analogue scale among children aged 6-12 years undergoing selected procedures (venipuncture, intravenous cannulation, intramuscular injection, lumbar puncture, bone marrow aspiration) and to compare the procedural pain in a child as perceived by the child, parents and health care professionals using the above mentioned scales. METHODS: This was a prospective, descriptive correlational study of children aged 6-12 years, who had undergone selected procedures. Children were assessed for their pain severity using Faces Pain Scale and Color Analogue Scale. Parents and health care professionals also independently assessed the child's pain using the same scales. RESULTS: 181 children who fulfilled the eligibility criteria were enrolled in the study. There was a significant positive correlation (R = >0.8) between both the pain scales. There was fair to moderate positive correlation (R = 0.29 to 0.58) of pain perception of child with parents and health care professionals. CONCLUSIONS: Faces Pain Scale and Color Analogue Scales seem to be appropriate instruments for measuring pain intensity among Indian children aged 6-12 years undergoing selected procedures.