All India Institute of Hygiene and Public Health

This study investigates the cascading impacts of recurrent cyclones on the physical and mental health, livelihoods, infrastructure, well-being, and long-term development of communities in the Indian Sundarbans, one of the world’s most climate-vulnerable regions. Semi-structured interviews were conducted with community members, frontline public health workers government officials, NGO leaders, mental health counselors, and non-licensed village doctors. We aimed to identify the ecological, geographic, and socioeconomic conditions exacerbating the region’s vulnerability to cyclones; examine the intersecting short-term and long-term health, economic, and social impacts; characterize existing response systems; identify structural barriers impeding long-term recovery and development; and propose stakeholder-informed recommendations to strengthen disaster preparedness and promote lasting resilience and recovery. Findings reveal that these communities remain entrapped in a recurring cycle of disaster and inadequate recovery marked by saline water intrusion, collapsed infrastructure, displacement to overcrowded shelters, loss of agricultural land, infectious outbreaks, disruptions to healthcare delivery and child education, life-threatening health emergencies, damage to livelihoods, food insecurity, and rising gender inequity, trauma, and depression. These vulnerabilities and impacts are perpetuated by chronic underinvestment and a lack of responsive policy. Participants called for solutions such as the following: (1) pre-positioning food, water, and medicines to strengthen disaster preparedness; (2) digitizing educational certificates to mitigate school dropout; (3) expanding insurance coverage, compensation schemes, vocational training, and employment opportunities to mitigate income losses; (4) establishing mangrove reforestation programs for livelihood diversification and bolstering natural ecological defense; and (5) increasing investment in resilient infrastructure, especially hospitals, roads, and homes. Policy reforms and tax incentives could mobilize private sector investment. The lived experiences captured in this study illuminate the daily struggle for basic security, income, health, education, and survival in the Indian Sundarbans and the urgent need for policies that uphold health equity and dignity in the face of accelerating climate threats.

Background: Poor menstrual hygiene management among adolescent girls in rural India is influenced by socio-cultural taboos, limited knowledge, and inadequate water, sanitation, and hygiene facilities. Behavior changes interventions guided by the health belief model (HBM) may improve knowledge, perceptions, and practices related to menstrual hygiene. Aims and Objectives: To assess the effectiveness of HBM-based health education on menstrual hygiene perceptions and practices among adolescent girls in rural West Bengal. Materials and Methods: A school-based quasi-experimental study was conducted among 307 girls (classes VII–IX) from two government schools, one intervention and one control, in the Hooghly district of West Bengal. Baseline data on socio-demographic profile, perceptions (susceptibility, severity, benefits, barriers), and menstrual hygiene practices were collected using a pretested questionnaire. The intervention group received HBM-based health education sessions with culturally appropriate teaching aids, while the control group received no structured intervention during the study period. Follow-up assessments were conducted at 3 months (post-test 1) and 6 months (post-test 2). Results: At baseline, perceptions and practices were comparable between the two schools. Post-intervention, the intervention school showed significant improvements in perceptions of susceptibility (median 11→14), severity (8→10), and benefits (6→9) while perceived barrier score decreased (10→8, P<0.001). Menstrual hygiene practices improved markedly in the intervention school, with frequent absorbent changes (39.7%→86.3%), genital cleaning ≥4 times (52.1%→89.7%), reduced cloth reuse, safer washing, and improved disposal practices. The control group showed minimal or inconsistent change. Conclusion: HBM-based menstrual health education effectively improved perceptions and promoted sustainable menstrual hygiene practices among rural adolescent girls. Periodic reinforcement is recommended to sustain behavioral change and to address deeply rooted cultural practices.

Background:Assessing physical workload is the most important step in deciding whether the workload is high and adopting appropriate control strategies to reduce physical workload. Objective:To assess physical workload, maximum working capacity (MWC), and relative load (RL) of study participants engaged in manual material handling. Methods and Materials:A cross-sectional observational descriptive study was conducted in two aluminum processing metallurgy factories in the Howrah district of the Indian state of West Bengal. The sample size for the proposed research work was 424 workers. Data was collected on a predesigned and pretested questionnaire and was subsequently analyzed by using a suitable statistical package. Results:Mean age of the workers was 45.46 ± 10.25 years. Most of the (28.54%) respondents had completed the Primary level of education. The majority of respondents were from the upper middle class (34.67%). Most of the workers (63.44%) were engaged in "workers doing other types of job," whereas 12.03% workers were operating machines, and 7.31% workers were doing manual material handling. The majority of the workers (48.39%) were manual material handlers who had moderate physical workload, and 32.26% and 19.35% manual material handlers had heavy and light physical workload, respectively. Conclusion:About one-third of the manual handlers of the present study were subjected to RL beyond the acceptable limit because of disproportionate physical workload and MWC.

Women of reproductive age (15–49 years) form a significant yet vulnerable group in India due to distinct health needs affected by inequitable social norms and systemic injustice. Those living in slums face compounded deprivation across social, occupational, and family settings. Resilience, the ability to adapt to stressful life experiences, is central to their mental health and overall life outcomes. A community-based observational study using a mixed-methods explanatory sequential design (QUAN→qual) was conducted among 144 women in a densely populated slum in southern Kolkata, a metropolis in Eastern India, from September 2024 to March 2025. Multistage cluster sampling was used for the quantitative strand and intensity sampling for the qualitative strand. Data were collected using a predesigned, pretested interview schedule incorporating the Connor–Davidson Resilience Scale (CD-RISC-25). Quantitative data were analysed using SPSS v16 and Jamovi v2.6.13, and qualitative data from in-depth interviews were analysed thematically using an inductive approach. Ungar’s social-ecological model guided qualitative data collection and integration. The median (IQR) resilience score was 71.0 (63.0, 80.3). Higher resilience was associated with personal decision-making capacity, social support, and engagement in paid work, while depression was associated with lower resilience. Qualitative findings described economic insecurity, limited skill-building opportunities, gaps in social support, and unmet mental health needs as reasons for low resilience. Integrated findings indicate that decision-making capacity and social support are central to resilience, supporting a socio-ecological approach for locally relevant interventions. Ethical approval was obtained from the Institutional Ethics Committee, All India Institute of Hygiene and Public Health, Kolkata (IEC/2024(3)/102).

Background: Early marriage among girls under 19 years remains a significant public health and social concern in the Sundarbans of West Bengal, India. Despite legal restrictions, the practice continues due to socio-cultural norms, economic constraints, and gender inequality. Objectives: To assess the sociodemographic characteristics of girls married before the age of 19 years and to explore their opinions regarding early marriage. Methods: A mixed-methods study employing a convergent parallel design was conducted among 20 girls married before the age of 19 years. Quantitative sociodemographic data were analyzed descriptively, while qualitative insights were generated through two Focus Group Discussions (FGDs) and analyzed using thematic analysis. The findings were integrated using a joint analysis approach to examine convergence, divergence, and complementarity across data strands. Results: Quantitative findings: Most participants were aged 16–18 years (80%), with 90% living with their husbands. A majority were housewives (60%), while others were engaged in daily work or farming. Half had secondary education (50%), while 15% had no formal education. Most participants had no children (65%). Qualitative findings: Early marriage was socially accepted and influenced by family pressure and limited autonomy. Although participants preferred marriage after valued education, early marriage often resulted in school discontinuation. Girls reported a lack of readiness for marital responsibilities and economic dependency. However, many expressed a desire to delay marriage and continue education. Conclusion: Early marriage persists due to entrenched socio-cultural and economic factors despite awareness of its adverse effects. Strengthening education, empowerment, and community awareness is essential to delay the age of marriage.