Background: Hygiene is a part of WASH Strategy which is associated with better health outcomes across the globe. Personal Hygiene practices are essential for prevention of communicable diseases like Pneumonia, Diarrhea, Influenza, COVID etc. Personal Hygiene includes Hand Hygiene, Menstrual Hygiene& Daily routine activities. Objective: To assess the knowledge and practices of population in Shimla city in relation to Personal Hygiene promotion practices. Methodology: Population based house to house survey in randomly selected households of all 34 wards using a semi structured questionnaire. Results: A total of 640 households were surveyed.Majority were (71.7%) females, Hindus (97%)& literate.Around 38% of the study participants had perception that cleaning house & household items, while 50% mopping, dusting & 41.7% daily bathing, brushing teeth, trimming nailswere the practicesto maintain good Hygiene. Almost every participant washes his hands after coming from market, 99.8% before eating, 99.8% before preparation of food. Around 71% clean the seat of public toilet before use, 17% wear trouserswhereas 15% shirt, 6% inner wear for 2 days or more in a row.13.6% of the study participants were not washing their hands at workplace. Around 10% of the study participants were still not using soap for Handwashing. Around 6% still use disposable clothes, 6% reusable cloth & 2% use cotton during menstruation. Conclusions:Most PersonalHygiene practices were found to be satisfactory in our study group. Handwashing at Workplace was still not being followed especially during COVID times also. Women were still using materials other than sanitary pads during menstruation. There are plenty who were not using both soap and water for handwashing which needs intensive IEC for benefits of handwashing. Each and every woman need to be aware of usage and also access to economical disposable sanitary pads.

Background: Menstruation or menses is the natural bodily process of releasing blood and associated matter from the uterus through the vagina as part of the menstrual cycle. Menstrual practices are influenced by taboos and socio-cultural restrictions for women. Material & method: population based Cross-sectional study involving 32 wards of Shimla city. Sampling unit was household in MC Shimla. Sample size estimated 640 stratified random sampling was done for selection of sampling unit.  Results: Perception regarding menstrual hygiene was considered by 71.4% of the respondents and 24.1% as important & only 4.5 % regarded it as slightly Regarding practices of menstrual hygiene 88.4% respondents use disposable pad for menstrual hygiene and 48.59 dispose off them in household waste. Conclusion: Menstrual hygiene perception was regarded as very important by majority of respondent as well as good practices were followed by majority.

Background: Waste poses a threat to public health and environment if it is not stored,collected and disposed of properly.The perception of waste as an unwanted with no intrinsic value has dominated attitudes towards disposal. Material and methodology: This survey was done by the from July to October 2020  to establish a baseline of the current knowledge, attitudes and behavior of population in Shimla city in relation to solid and liquid waste management and other health-related practices, to Identify specific areas where intervention is necessary to increase knowledge or lead to specific behavioural changes for better health. Results: A total of 640 households were selected for the survey. 74.7% respondents were considered solid waste management as very important. 63.59%respondents were comfortable with sanitation situation of Shimla city. 61.1 %respondents were satisfied with the waste disposal facility of Shimla city. 63.3 %respondents were satisfied with the door to door collection of waste facility of Shimla city. 96.6% had drainage system for liquid waste disposal and 95.5% had connection to waste water network.52.8% always separate their garbage, 88.3% separate dry and wet waste, 98.3% always covered their dustbin, 96.1% using door to door collection of waste service, 24.5% had abnormal presence of vectors in their households, among them 45.22 were mosquitoes.63% respondents ever seen a sanitation message, 8.6% had community health worker visit in their household informing them about sanitation and hygiene, 6.1% had ever had community meetings n sanitation and 50.5 % had ever seen message on solid waste management issues.88.4% respondents use disposable pad for menstrual hygiene and 48.59 dispose off them in household waste. Conclusion: To achieve the goal in waste management practices awareness,education and importance of safe refuse disposal program should be initiated for the public. IEC activities must be planned on waste disposal.

Hand washing is the single most effective and inexpensive way to prevent diarrhoea and acute respiratory infections, as automatic behaviour performed in homes, schools, and communities worldwide. Thus this study was carried out to see the perception and practices of hand washing in a hilly city of Shimla. Objectives of the study- To assess the perception and practices of hand washing in Shimla city. Material and methods- it is a population based cross sectional study involving all 34 wards of Shimla city. Sampling unit was households in the Municipal corporation area of Shimla city. Sample size is estimated to be 640 expecting 50% of households having adequate knowledge of WASH and solid waste management with 95% level of confidence, design effect 1.5 and 5% confidence interval and non-response rate of 5%.Stratified random Sampling was done for the selection of Households. The data collectors obtained consent from the head of Family and Pretested Standardized Questionnaire administered in every selected household. Results- Perception of hand washing was regarded as very important by 76% of the respondents and 21% regarded it as important and only 3% regarded it as slightly important. Regarding practices of hand washing 97.8% respondents wash their hands 5 or more times in a day, 79.22% respondents used water and soap for hand washing, 75.6% used clean towel after handwashing,74.7% spent 15-20 second for hand wash, 70.9% own a sanitizer, 18.8% respondent sometimes running out of water for hand wash. Conclusion- we found that hand washing was practiced by all respondents with good practices in terms of duration followed by majority of the city’s residents.

Background: Safe and Safe and readily available water is one of the important felt needs in public health. Better management of water resources and improved supply helps to boost economic growth. Depleting ground water table, deteriorating ground water, increasing population quality are threatening the sustainability of both urban and rural water supply, so this study was done to analyze water supply and consumption pattern. Material and Methods: Cross- sectional study done from July 2020 to October 2020 by residents and medical social workers of department of Community Medicine. Stratified random sampling used for selection of households. Results: 93.1% had pipe line water connection to their households, 49.2% of respondent had more than 35 liters of water per capita per day in their households, about 93.8% respondents were satisfied with the quality of water supply and 65.2% limit water usage to ensure they have sufficient water Conclusion: Majority of people are satisfied with the quality and quantity of water provided from municipal corporation Shimla.

Background: Water sanitation & Hygiene facilities are basic requirement of each individual to live socially & economically productive life as per WHO approximately 8,27000 people in low- and Middle-income countries die as a result of inadequate water, sanitation, & hygiene each year. Universal access to a basic drinking water source appears within reach, but universal access to basic sanitation will require additional efforts. This study was done to assess prevailing situation and to identify the areas of intervention. Material and Methods: Cross-sectional KAP study done by Residents & Medical Social Workers After proper training during July 2020-september 2020. Results: 97.2 % of respondents had toilet facility , 2.5% use community toilets while 0.8% went for open defecation,95.94 had all toilets functional, 4.7% had toilet related problems like flooding of toilets,17.19% share toilets with other households, and 99.2% had never went for open defecation, 92.8% had bathing facility at their homes, among them 98.4% had drainage system in the bathroom.96.3% had separate kitchen in their household,  among them 94.8 % had smoke outlet in their kitchen. 94.1% respondent used cooking gas as fuel. Conclusion: Situation of kitchen, toilet& bathroom has improved over the years compared to NFHS 4 data, Continuous efforts to sustain existing facilities and to widen the area of coverage to 100% population.

BackgroundNatural water resources in terms of bowris and handpumps are of great importance for habitants living in and around the nearby area. It can serve as a source of water borne infectious diseases like outbreaks of Hepatitia A and E. So, there is an utmost need to know the physiochemical and biological parameters of it. Material & Methods:It was a cross sectional survey to assess the quality of water consumption from natural sources done by  department of Community Medicine from July 2020 to October 2020.Results:Means of parameters for bowris and handpumps are parameter for ph = 6.69±1.59, Turbidity = 3.21NTU±4.91, Chloride = 85.38±70.69ppm, Nitrates = .488mg±2.15/L, Fluoride = .548±.14mg/L, Iron = 0.08±.12mg/L, Hardness = 177±55.63mg/L, Residual Chlorine = 0.07±.04ppm. Means of parameter for handpump areph = 7.4±.78, Turbidity = 8.53±6.02NTU, Chloride = 78.13±87.94ppm, Nitrates = 4.34±11.77mg/L, Fluoride = .540±.15mg/L, Iron = 0.160.14mg/L, Hardness = 178±47.48mg/L, Residual Chlorine = 0.00ppm.39 bowris out of 42 and 11 handpumps out of 15 turned out to be bacteriologically positive.Conclusion:Continuous  survelliance need to be done on these natural water as Shimla being a hepatitis prone area it’s a must for the situation.

Background: Physical inactivity is one of the leading risk factors for non-communicable diseases mortality. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active. This study was done to evaluate the pattern of Yoga, Walking, Sleep & Screen hours among adult population of District Shimla. Methods: A descriptive cross-sectional survey was conducted amongst the participants in the age group of 18 to 60 years, using google forms. The questionnaire was circulated among residents of district Shimla for responses. Results: A total of 400 respondents including 194(48.5%) females and 206(51.5%) males from district Shimla were participated in the study. Among the participants of the majority 189(47.3%) were in age group of 31-40 years, 159(39.8%) were in Govt Job,338(84.5%) were graduate & above, 235(58.8%) were from urban area and 387(96.8%) were belong to Hindu Religion. Majority 213(53.3%) were doing exercise/yoga for one hour a day while 161(40.3%) were not doing exercise/yoga at all in a day. Majority 165 (41.3%) were walk for at least 30 minutes in a day while 101(25.6%) were walk for ≥at least 150 minutes in a day. Majority 332 (83.1%) were sleeping 6-8 hours in a day while 37 (9.5%) were sleeping <6 hours & 31(7.8%) were sleeping > 8 hours in a day. Among the total 400 study participants, majority 82 (20.5%) were using mobile, Laptop, TV for 3 hours and 370 (92.7%) were using mobile, Laptop, TV for ≥2 hours. Conclusion: Majority of study participants do not meet the physical activity, screen hour and sleeping pattern recommended by the World Health Organization. This puts a large Indian population at risk of developing various NCDs

Background: Low fruit, vegetable and Water consumption as well as increased Tea and Junk Food consumption remains a global health challenge. This study was done to evaluate the pattern of fruit, vegetable, water, tea and junk food consumption among adult population of District Shimla. Methods: A descriptive cross-sectional survey was conducted amongst the participants in the age group of 18 to 60 years, using google forms. The questionnaire was circulated among residents of district Shimla for responses. Results: A total of 400 respondents including 194(48.5%) females and 206(51.5%) males from district Shimla were participated in the study. Among the participants of the majority 189(47.3%) were in age group of 31-40 years, 159(39.8%) were in Govt Job,338(84.5%) were graduate and above, 235(58.8%) were from urban area and 387(96.8%) were belong to Hindu Religion. Among the total 400 study participants, majority 233(58.3%) were taking fruits only one time a day while 206(51.5%) were taking vegetables only one time a day. Majority 130 (32.5%) were taking 2 cups of tea /coffee in a day while 122(30.6%) were taking 3 or more cups of tea /coffee in a day. Majority 69(17.3 %) were taking 5 glasses of water in a day while 291(72.75%) were taking less than 8 glasses of water in a day. Majority 175 (43.8%) were taking junk food /fast food one time in a week and 58(14.5%) were taking junk food /fast food 3 or more times in a week. Conclusion: Health promotion campaigns emphasizing health hazards of lower intake of fruit, vegetable and Water as well as increased Tea and Junk Food consumption needs to be organized by the health care workers in this area to encourage the creation of favorable environment. 

Background: Sufficient sleep is essential in school children as it directly impacts mental and physical development. However, chronic sleep loss continues to increase in our country. This study was done to evaluate the sleep pattern among school going children of New Delhi. Methods: A cross-sectional study was performed in January to March 2022 among 400 students chosen using a simple random sampling procedure in New Delhi. Data was collected through school teachers based on their observation and analyzed using Epi info version 7. To predict the relationship between the Sleep pattern and its associated factors, a univariate analysis was done. At a p-value of 0.05 was taken as statistically significant. Results: Present study included 180 (45%) females and 220 (55%) males school children from New Delhi. Among them 243(60.8%) were ≤ 10 Years while 157(39.2%) were >10 years old. In the present study, 198(49.5%) school children had adequate sleep hours of 6-8 hours, 174(43.5%) had sleep hours of more than 8 hours and 28(7%) had sleep duration of less than 6 hours. 364(91%) school children had onset of sleep with in 30 minutes after going to bed while 36(9%) had after 30 min or more than that. 251(62.7%) school children didn’t have habit of watching Mobile/TV before sleeping while 149(37.3%) had this habit . In the present study there was no significant difference in Average duration of sleep per day on a weekday, Onset of sleep after going to bed and Habit of watching Mobile/TV before sleeping among male and female school children. In the present study the school children who were less than 10 years had significantly more adequate duration of sleep of 6-8 hours and had onset of sleep with in 30 minutes after going to bed and significantly less habit of watching Mobile/TV before sleeping as compared to children who were more than 10 years old. In the present study, 216(54%) school children rate their sleep quality to highest of 5, 135(33.8%) rate to 4, 41(10.3%) rate to

Background: Screen-based media have become an important part of human lifestyle. In view of their easy availability, increasing use in Indian children & their excessive use is being linked to physical, developmental and emotional problems. Excessive screen hours has been found to be associated with various health problems in children. This study was done to evaluate the pattern of Screen hours among school going children of New Delhi. Methods: A cross-sectional study was performed in January to March 2022 among 400 students chosen using a simple random sampling procedure in New Delhi. Data was collected through school teachers based on their observation and analyzed using Epi info version 7. To predict the relationship between the screen hours and its associated factors, a univariate analysis was done. At a p-value of 0.05 was taken as statistically significant. Results: Present study included 180(45%) females and 220(55%) males school children from New Delhi. Among them 243(60.8%) were ≤10 years while 157(39.2%) were >10 years old. Among the total 317(79.3%) school children had screen hours <2 hours per day while 83(20.7%) had ≥2 hours per day. 355(88.8%) school children watched TV <2 hours per day while 45(11.2%) watched ≥2 hours per day. 349(87.3%) school children using smart phone <2 hours per day while 51(12.7%) using ≥2 hours per day. 344(86.0%) school children had habit of internet surfing <2 hours per day while 56(14.0%) had ≥2 hours per day. 363(90.7%) school children play videogames/games on mobile <2 hours per day while 37(11.2%) play ≥2 hours per day. 251(62.7%) school children didn’t have habit of watching Mobile/TV before sleeping while 149(37.3%) had this habit. In the present study there was no significant difference duration of screen hours, duration of watching TV, Duration of using smart phone, duration internet surfing, duration of videogames/games on screen and habit of watching Mobile/TV before sleeping among male and female school children. Similarly, school children who were more older than 10 years had significantly more duration of screen hours, more duration of watching TV, more duration of using smart phone, more duration internet surfing and more often had habit of watching Mobile/TV before sleeping while there no significant difference between duration of videogames/games on screen according to age groups. Conclusion: The present study findings suggest that many school children were spending more than the recommended duration in front of screen and necessitates actions at family, school, community, government and policy level actions to reduce screen hours associated with smart phone , television, internet surfing and video game use.

Background: Hepatitis B and C virus infection is an issue for public health worldwide. We conducted this study to assess the Knowledge about HBV infection and its association with HBsAg positivity among residents of Kaza sub- division of district Lahaul & Spiti in Himachal Pradesh. Material & Methods: From June 2015 to October 2017, the study was carried out at Kaza, a division of Lahaul & Spiti, by the department of gastroenterology, community medicine, and microbiology of Indira Gandhi Medical College Shimla. By using the cluster sampling technique, the target sample size of 4000 was attained. 40 Clusters were chosen using probability proportionate to size sampling, and 100 research participants were added to each Cluster. For data collection, a pretested interview plan was used. Five millilitres of blood were drawn from each study participant and tested for HBsAg. Results: Around 53% participants had not heard about the disease. Breast feeding as a mode of transmission was known among 18.8% of population. Traditional medicine was thought to be the cure of Hepatitis B in 13.9% population. Around one fourth of the population knew that there is no effective treatment for hepatitis B (25.2%) and there is a vaccine to prevent the same (25.7%). Around one third of the study population (32.6%) who have heard about Hepatitis B infection were tested to be positive for the same as compared to 34.1% among those who have had no knowledge about it. (OR: 0.93; 95%CI:0.80-1.09; p: 0.41). There was 50% less risk of HBsAg positive among vaccinated as compared to those who were not (p<0.001) Receiving information about HBV infection from more than one source (print media, health service providers and entertainment media) had 80% less risk of HBV infection as compared to those who have never heard of the infection (OR: 0.20; 95% CI: 0.07-0.61; p:0.01). Immunization against HBV was a significant independent protective factor against the infection as compared to non immunized (OR: 0.52; 95% CI: 0.40-0.68; p<0.001).  Conclusion: Present study concluded that knowledge of source of infection, and immunization against HBV emerged as independent factors associated with HBsAg positive test after adjusting for confounders.

Background: Breastfeeding is universally acknowledged as essential for infant nutrition and maternal health, with the World Health Organization recommending exclusive breastfeeding for the first six months of life. Despite these guidelines, breastfeeding practices in India, including District Una, Himachal Pradesh, are hindered by cultural, social, and systemic barriers. This study aims to explore the myths, challenges, and potential community-driven solutions to improve breastfeeding practices in Una.Materials and Methods:This qualitative study employed in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare professionals and community health workers to capture diverse perspectives on breastfeeding practices in District Una. A purposive sample of five doctors, five staff nurses, and five community health workers participated in IDIs, while five FGDs were conducted with multidisciplinary groups of healthcare professionals. Data were analyzed thematically, focusing on myths, challenges, and solutions, with measures such as member checking and triangulation ensuring credibility and reliability.Results:The findings reveal that cultural norms and familial beliefs, such as the rejection of colostrum and prelacteal feeding practices, significantly hinder breastfeeding initiation. Knowledge gaps, including misconceptions about breast milk sufficiency and formula milk superiority, reinforce these barriers. Practical challenges, such as pain during breastfeeding, improper latching, and a lack of structural support for working mothers, further discourage optimal practices. Solutions identified include targeted antenatal and postnatal education, training of grassroots healthcare workers, public awareness campaigns, and the establishment of breastfeeding support groups. Community engagement, particularly involving fathers and elder family members, emerged as critical for sustaining improvements.Conclusion:Addressing breastfeeding barriers in Una requires a multi-faceted approach integrating education, community engagement, and structural support. Targeted interventions that dispel myths, bridge knowledge gaps, and address practical challenges can foster an enabling environment for breastfeeding. These findings provide actionable insights for policymakers and healthcare providers to promote breastfeeding as a fundamental health priority.