Understanding the factors leading to high prevalence of teenage pregnancies in the four aspirational Districts of Assam, Namely Goalpara, Barpeta, Dhubri, and darrang.

Background: The prevalence of teenage pregnancy in Assam is higher than the national average as per both NHFS-4 and NHFS-5. Four districts in Assam, falling under the NITI-Aayog Aspiration Districts Transformation program of 2018, namely, Goalpara, Barpeta, Darrang, and Dhubri, have a prevalence of teenage pregnancy at levels higher than the state's average (12% as per NHFS-5). Teenage pregnancy affects several health and nutritional indicators. Objectives: The objective of the study was to identify the factors associated with teenage pregnancies in the Aspirational Districts of Assam in both social and public health contexts. Methods: A comparative cross-sectional study was carried out across these four districts, with sample size of teenage pregnant women as 388 and an equal number of controls. Results: The study presents several factors to be statistically significant, viz., lower level of education of the teenage mothers or their spouses and lesser access to adequate health-related information by teenage mothers. Furthermore, less number of teenage mothers are aware of contraceptive availability and face objection from spouses to use contraception. A unique factor presented by the study is the higher elopement rate among teenage mothers. Conclusion: Many of the factors upheld by the study are rooted in social and cultural fabric of the communities and could be addressed by mobilizing local institutions like panchayat and religious bodies to act as deterrence to teenage marriages in the communities. Men should also be brought into the fold of discussions on this sensitive subject through information and awareness generation.

Cancer Awareness and Stigma in Rural Assam India: Baseline Survey of the Detect Early and Save Her/Him (DESH) Program.

BACKGROUND: India has an estimated incidence of more than one million cancers annually. Breast, oral, and cervical cancers account for over one-third of newly diagnosed cases. With the introduction of pilot cancer screening programs in India, little is known about current sociocultural barriers that may hinder acceptance of screening and treatment. We sought to identify knowledge gaps, misconceptions, and stigmas surrounding cancer diagnosis. PATIENTS AND METHODS: A baseline survey was conducted in Assam, India, as part of the Detect Early and Save Her/Him program, a mobile screening program for breast, oral, and cervical cancer. Data were collected on participants' cancer knowledge, and attitudes towards screening, diagnosis, and treatment. RESULTS: Of the 923 residents who participated, a large majority (92.9%; n = 858) were neither aware of cancer screening availability nor had prior screening. Low-medium awareness was demonstrated regarding the carcinogenic effects of betel nuts (n = 433, 47%). Only one-third of participants recognized oral ulcers and dysphagia as cancer symptoms. Approximately 10% of respondents had misconceptions about cancer etiologies, and 42-57% endorsed statements reflecting a negative stigma towards cancer, including its long-term detrimental effects on personal, occupational, and familial life. However, the majority (68-96%) agreed with statements endorsing positive community support and medical care for cancer patients. CONCLUSIONS: This study identifies actionable targets for intervention in cancer education and awareness within a large rural Indian population. Education to address preventable causes of cancer and to correct misconceptions and stigma is a critical component in ensuring the successful implementation of cancer screening programs.