Despite growing evidence for the effectiveness of community interventions to address violence against women (VAW), the evidence on factors that motivate community participation in them is insufficient. We did a grounded theory study of a large-scale non-government (NGO) program in informal settlements in Mumbai, India, aiming to analyses motivations for community participation in program activities. We systematically collected data using a grounded theory framework, guided by theories of collective action. We conducted 27 focus group discussions and 31 semi-structured interviews with 77 women and 36 men, as well as with 9 NGO staff. We also undertook over 170 h of field observation. All data was coded using open and selective coding. We constantly compared codes for community participation in primary prevention with codes for response. We found meaningful differences between motivations for participation in prevention activities and motivations for response to incidents of VAW. A desire to practice community citizenship, expected or desired material incentives from the NGO, and opportunities to learn to navigate government services motivated participation in prevention activities, whilst concerns about time use demotivated participation. These concerns played a lesser role in motivating community responses to incidents of VAW, which depended on factors such as belief in individual efficacy, perceived privacy norms, and confidence in action in the face of risks of retaliation. Support from family, neighbors, and the implementing organization facilitated participation in both prevention and response activities. We argue that differences in motivational factors can be accounted for by differences in the focus, costs, and benefits of prevention versus response activities. Researchers, policymakers, and practitioners should account for the full range of motivations to participate in community action when designing intervention programs and evaluating their impact on the effectiveness of VAW prevention. This likely involves collaborating with implementers and field staff to address differences in prevention and response activities in program implementation.
Suicide remains a leading cause of preventable mortality in Southeast Asia (SEA), a region that bears a disproportionate share of the global suicide burden yet remains underrepresented in research, funding, and policy attention. In this article, we articulate ten priority research areas for suicide prevention across SEA, informed by surveys, workshops, and roundtable discussions convened around a regional forum, to guide key stakeholders including shaping funding calls, journal editorial focus, and interagency action. These priorities include strengthening suicide surveillance and data integration; embedding social determinants such as poverty, debt, gender inequity, and interpersonal violence into prevention frameworks; advancing family- and community-based approaches; integrating cultural, spiritual, and historical contexts; addressing alcohol and substance use; responding to youth suicide and online environments; addressing mental health needs; strengthening implementation science to adapt and evaluate interventions with fidelity; and improving translation of evidence into policy. Advancing this coordinated priority research agenda is essential to progress toward regional global reduction targets, by ensuring the research and funding ecosystem focuses the unique context of the SEA region.
INTRODUCTION:The problem of poor adherence to medical advice in the case of non-communicable diseases, the reasons thereof, and how these are exacerbated in low- and middle-income countries (LMICs) is well-recognized. However, there is less conceptual clarity on what 'poor' adherence encompasses in these settings. Conventional classifications treat poor adherence as a singular category, often disregarding its multifaceted nature. This study aimed to explore the nuances of what constitutes 'poor' adherence to medical advice for chronic diseases in vulnerable LMIC settings. This was done by examining the different ways in which hypertension and diabetes patients living in urban informal settlements in the Mumbai Metropolitan Region attempted to adhere to medical advice. METHODS:This is a qualitative study using a grounded analysis approach. The study was part of larger research conducted to understand care-seeking for hypertension and diabetes in urban informal settlements. Purposive sampling was used to identify participants. Data was collected from September to November 2022 through in-depth interviews with 26 hypertension and diabetes patients. Emerging patterns of adherence were inductively coded and categorized using grounded analysis. FINDINGS:The study highlights multiple ways in which patients attempted to adhere to medical advice. By tracing patient journeys and experiences in adherence, the study categorizes 'poor' adherence to medical advice as adherence to medication, lifestyle changes and follow-ups with various sub-categories within each. Most patients reported more than one way in which they tried to adhere to medical advice. Patients adhered well to some aspects of their medical advice and not to others, highlighting the complexities in understanding this concept. CONCLUSIONS:By understanding the nuances and complexities of 'poor' adherence in urban informal settlements, the study builds an empirically grounded typology on adherence. Such a typology is useful for research and practice on improving adherence to medical advice in vulnerable LMIC settings.
Minimum dietary diversity (MDD) is associated with malnutrition, influencing children’s growth and development. Understanding the relationship between maternal and child MDD is crucial as mothers play a central role in food preparation and child feeding. This study examines the alignment between maternal and child MDD and the factors influencing each, to inform nutrition interventions in resource-limited settings. We analyzed cross-sectional data from 398 mother-child dyads (children aged 6–23 months) residing in urban informal settlements in Mumbai. Bivariate and multivariable logistic regression analyses were conducted to examine the association between maternal and child MDD and to identify factors associated with each. Only 31.4
Background India records the highest number of suicide deaths globally, but suicide prevention efforts are hindered by a lack of trained personnel within the public health system. Given that an index suicide attempt is a strong predictor of future suicide, intervening with individuals who have recently attempted suicide is a targeted prevention approach that can be delivered within the public health system and has potential to be scaled up across low-resource settings. Aim To test the implementation and preliminary effectiveness of Contact and Safety Planning (CASP) in reducing suicidal behaviour and symptoms of depression among adults with a recent suicide attempt in Chhattisgarh. Methods We will carry out a non-randomized, controlled pilot study to evaluate the feasibility, acceptability, adoption, reach, implementation (including cost) and preliminary effectiveness of CASP when delivered by health workers – emergency nurses and Community Health Officers – in two districts of Chhattisgarh (n=250). The control group will receive Enhanced Usual Care, consisting of telephonic counselling by trained District Mental Health (n=250) program staff. Data will be collected at baseline and at 6- and 12-month follow- up. Conclusion This study will shed light on the feasibility of CASP and inform its further refinement to address suicide at scale in India. Trial Registration Clinical Trials Registry India (CTRI/2022/12/048087) dated 1 October 2022. Link here.
