Public Health Commons^™

Characterizing Multimorbidity Prevalence And Adverse Outcomes In Ethnically And Culturally Diverse Sub-Populations In India: Gaps, Opportunities, And Future Directions, Preeti Zanwar, Robyn Taylor, Tanisha Hill-Jarrett, Elena Tsoy, Jason Flatt, Zunera Mirza, Carl Hill, Arokiasamy Perianayagam

College of Population Health Faculty Papers

India is a large middle-income country and has surpassed China in overall population, comprising 20% of the global population (over 1.43 billion people). India is experiencing a major demographic shift in its aging population. Chronic diseases are common among older adults and can be persistent over the life course, lead to the onset of disability, and be costly. Among older adults in India, the existence of multiple comorbid chronic conditions (i.e., multimorbidity) is rapidly growing and represents a burgeoning public health burden. Prior research identified greater rates of multimorbidity (e.g., overweight/obesity diabetes, hypertension, cardiovascular disease, stroke, and malignancies) in minority …

Obesity, Overweight Rates, And Related Factors Among Adults In The Rustic Realm Of Western India, Monika Patel, Jimmy Kagathara, Eshwar Kumar Gupta, Nancy Kagathara, Jitesh Mehta, Dipesh Parmar

Makara Journal of Health Research

Background: Obesity and overweight pose significant challenges in developing countries, underscoring the need for evidence-based prevention strategies. This study focuses on assessing the prevalence and associated factors of overweight and obesity in the rural areas of Jamnagar district, Gujarat, India.

Methods: Data collection encompassed six tehsils within Jamnagar district, with primary health center selection via simple random sampling. Individual selection employed the consecutive sampling approach. Statistical analysis was conducted using SPSS software. Regression analysis was employed to identify the independent factors linked to overweight and obesity.

Results: The analysis included 408 participants, revealing a higher obesity prevalence …

The Predictors Of Multimorbidity (Defined As Diabetes + Hypertension) Amongst Males Aged 15-54 In India: An Analysis Of The Nfhs-5, Vikramjit Brar

Electronic Thesis and Dissertation Repository

Research Question: “What are the predictors of multimorbidity (defined as having diabetes + hypertension) amongst males aged 15-54 in India?”

Methods: Using mixed-effect multi-level binary logistic regression models, data from the 2019-2021 India NFHS-5 were analyzed. Separate multivariable analyses were conducted for males from urban and rural areas so the association between common predictors of interest (sociodemographic & lifestyle), and multimorbidity could be determined.

Results: Various predictors (listed below) were found to have a statistically significant association to multimorbidity with some variation across urban and rural areas:

Urban areas: Age, region of residence, wealth, religion, occupation, and …

Depression By Gender And Associated Factors Among Older Adults In India: Implications For Age-Friendly Policies, Ronak Paul, T. Muhammad, Rashmi Rashmi, Palak Sharma, Shobhit Srivastava, Preeti Zanwar

College of Population Health Faculty Papers

Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017-2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to …

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …

Chronic Lower Back Pain Among Women In India: Evidence-Based Approach To Risk Factors And Interventions, Aelita Matosova

Master's Projects and Capstones

Chronic lower back pain (CLBP) is a prevalent issue worldwide, affecting about 1.71 billion people, with a significant proportion being women. CLBP is a major health concern in India, particularly among women, which were 80% reported experiencing this condition. Several factors, such as personal beliefs, sociocultural norms, restricted healthcare access, repetitive movements, and psychological aspects, contribute to this high prevalence leading to severe health and economic implications, including reduced work productivity and income. Although there have been several reports on prevalence and risk factors of CLBP, to our knowledge, there has not been enough work focusing on evidence-based interventions to …

Identifying Patient Perceptions Of Inequality In Public Health Care Services: Evidence From A Single Indian Administrative District, Barnali Biswas, Piyal Basu Roy

Journal of Patient-Centered Research and Reviews

Purpose: Assessment of patient experiences is an essential step to revamp patient-centered care and identify systemic effectiveness as part of universal health coverage. This paper analyzes the variation of health care at different levels of the public health care system in India by measuring patients’ experience with the care they have received in the Alipurduar district of India.

Methods: From May 2021 to April 2022, stratified sampling technique was applied to collect primary data from 450 patients having different health problems from different levels of the public health care system. In addition, Consumer Assessment of Healthcare Providers and Systems (CAHPS) …

Comparative Analysis Of The Water Crisis In Guam And New Delhi: Evaluating Causes And Potential Solutions, Jordina Marshall

Global Honors Theses

The core topic of this paper will be an examination of a comparative study of the water issue in India, with a particular emphasis on New Delhi, and the water crisis on the island of Guam, with a large amount of focus being placed on an assessment of the possible causes as well as potential remedies. Due to the impact the water problem has on the ecosystem, the welfare of the populace, and the security of their food supply, a solution must be found. There are rising concerns that endangers the health of both of these nations as well as …

Vaccination Inequities Among Children 12-23 Months In India: An Analysis Of Inter-State Differences, Octavia K. Goodman, Abram L. Wagner, Dakota Riopelle, Joseph L. Mathew, Matthew L. Boulton

Community & Environmental Health Faculty Publications

Background

Previous research has shown that socioeconomic and demographic risk factors in children are additive and lead to increasingly negative impacts on vaccination coverage. The goal of this study is to examine if different combinations of four risk factors (infant sex, birth order, maternal education level, and family wealth status) vary by state among children 12-23 months in India and to determine the impact of ≥ 1 risk factor on differences in state vaccination rates.

Methods

Using data from the National Family Health Survey (NFHS) conducted in India between 2005 and 2006 (NFHS-3) and 2015-2016 (NFHS-4), full vaccination of children …

Commentary: Examining Contextual Factors Contributing To Differentials In Covid-19 Mortality In U.S. Vs. India., Preeti Zanwar, Katrine L Wallace, Christopher Soria, Arokiasamy Perianayagam

College of Population Health Faculty Papers

No abstract provided.

The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza

Community Health Sciences

Background: Preterm birth remains the major cause of neonatal death worldwide. South Asia contributes disproportionately to deaths among preterm births worldwide, yet few population-based studies have assessed the underlying causes of deaths. Novel evaluations, including histological and bacteriological assessments of placental and fetal tissues, facilitate more precise determination of the underlying causes of preterm deaths. We sought to assess underlying and contributing causes of preterm neonatal deaths in India and Pakistan.
Methods: The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) was a prospective cohort study done in three hospitals in Davangere, India, and …

Specificity Matters: Unpacking Impact Pathways Of Individual Interventions Within Bundled Packages Helps Interpret The Limited Impacts Of A Maternal Nutrition Intervention In India, Shivani Kachwaha, Phuong H. Nguyen, Lan Mai Tran, Rasmi Avula, Melissa F. Young, Sebanti Ghosh, Thomas Forissier, Jessica Escobar-Alegria, Praveen Kumar Sharma, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

BACKGROUND: To address gaps in coverage and quality of nutrition services, Alive & Thrive (A&T) strengthened the delivery of maternal nutrition interventions through government antenatal care (ANC) services in Uttar Pradesh, India. The impact evaluation of the A&T interventions compared intensive ANC (I-ANC) with standard ANC (S-ANC) areas and found modest impacts on micronutrient supplementation, dietary diversity, and weight-gain monitoring. OBJECTIVES: This study examined intervention-specific program impact pathways (PIPs) and identified reasons for limited impacts of the A&T maternal nutrition intervention package. METHODS: We used mixed methods: frontline worker (FLW) surveys (n = ∼500), counseling observations (n = 407), and …

A Comparative Analysis Of Covid-19 Vaccine Distribution Efforts In India And Mongolia Through Data Visualization, Paridhi Latawa, Sadhana Kumar, Udeshna Srimal, Rachana Tanksali, Edward Ning '23, Ajay Macherla, Haily Nguyen, Kristina Lian, Joy Jiang, Julia Ding, Daniel Stewart

External Student Research Opportunities

COVID-19 vaccine allocation efforts have posed challenges and offered opportunities to alleviate the ongoing pandemic. Nations have employed varying approaches for COVID-19 vaccine distribution; in particular, Mongolia and India have differed in approaches to vaccine allocation efforts. As of June 2021, Mongolia has vaccinated more than 60% of its population, whereas India has only vaccinated about 7.5%. This disparity highlights the need for the present study, which utilizes a mixed-method approach to examine the two countries' vaccine distribution strategies and COVID-19 containment policies from January to July 2021. The study has three major components: 1) policy analysis to highlight core …

Sleep Duration, Sleep Quality, Excessive Daytime Sleepiness, And Chronotype In University Students In India: A Systematic Review, Christen Dunn, Octavia Goodman, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Introduction: Optimal sleep is an important aspect of academic performance and mental health. However, poor sleep health is often present among university students due to their lifestyle and academic requirements. University students in India have been shown to have poor sleep health. Though self-reported sleep issues have been evaluated among university students in India, these results have not been synthesized to date. We aimed to identify factors that may be associated with poor sleep health among university students in India from January 2010 to April 2021, inclusive. As a secondary aim, we sought to evaluate factors associated with sleep among …

Nutritional Status Of Children Living Within Institution-Based Care: A Retrospective Analysis With Funnel Plots And Control Charts For Programme Monitoring, Emily Delacey, Evan Hilberg, Elizabeth Allen, Michael Quiring, Cally J. Tann, Nora Ellen Groce, James Vilus, Ethan A. Bergman, Merzel Demasu-Ay, Hang T. Dam, Marko Kerac

All Faculty Scholarship for the College of Education and Professional Studies

Objectives The aim of this study is to fill a key information gap on the nutrition-related epidemiology of orphaned and vulnerable children living within institution-based care (IBC) across six countries.

Design A retrospective analysis with Shewhart control charts and funnel plots to explore intersite and over time variations in nutritional status.

Setting We conducted a retrospective analysis of records from Holt International’s Child Nutrition Programme from 35 sites in six countries; Mongolia, India, Ethiopia, Vietnam, China and the Philippines.

Participants Deidentified health records from Holt International’s online nutrition screening database included records from 2926 children, 0–18 years old. Data were …

Is Living In A Region With High Groundwater Arsenic Contamination Associated With Adverse Reproductive Health Outcomes? An Analysis Using Nationally Representative Data From India, Jessie Pinchoff, Brent Monseur, Sapna Desai, Katelyn Koons, Ruben Alvero, Michelle J Hindin

Department of Medicine Faculty Papers

Background: Exposure to groundwater arsenic via drinking water is common in certain geographies, such as parts of India, and causes a range of negative health effects, potentially including adverse reproductive health outcomes.

Methods: We conducted an ecological analysis of self-reported rates of stillbirth, recurrent pregnancy loss, and infertility in relation to groundwater arsenic levels in India. We used a gridded, modeled dataset of the probability of groundwater arsenic exceeding 10 μg/L (World Health Organization drinking water limit) to calculate mean probabilities at the district level (n = 599 districts). A spatial integration approach was used to merge these estimates with …

Advancing Use Of Nutrition Knowledge To Improve Practice By Policy And Program Communities In India During A Political Transition, Edward A. Frongillo Jr., Jessica L. Escobar-Alegria

Faculty Publications

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the …

Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula

Faculty Publications

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children < 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (< 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.

Indian Healthcare System: Reflections Of Swedish Nursing Students, Elisabeth Mangrio

Manipal Journal of Nursing and Health Sciences

Internationalization within nursing programs is essential to provide nurses with cultural competence and for nursing students to gain an international perspective. It has also been shown to be effective to gain a cultural understanding. This paper aims to illuminate and explain the experiences that Swedish nursing students had while they engaged in clinical training during an exchange program in India and to provide a comparison between the health service in both countries. Nursing students from Sweden did a four-week clinical placement within the primary healthcare in India in 2020. During the clinical placement, which consisted of a variety of healthcare …

A Comparative Analysis Of Covid-19 Vaccine Distribution Efforts In India And Mongolia Through Data Visualization, Paridh Latawa, Sadhana Kumar, Udeshna Srimal, Rachana Tanksali, Edward Ning '23, Ajay Macherla, Haily Nguyen, Kristina Lian, Joy Jiang, Daniel Stewart

External Student Research Opportunities

COVID-19 vaccine allocation efforts have posed challenges and offered opportunities to alleviate the ongoing pandemic. Nations have employed varying approaches for COVID-19 vaccine distribution; in particular, Mongolia and India have differed in approaches to vaccine allocation efforts. As of June 2021, Mongolia has vaccinated more than 60% of its population, whereas India has only vaccinated about 7.5%. This disparity highlights the need for the present study, which utilizes a mixed-method approach to examine the two countries' vaccine distribution strategies and COVID-19 containment policies from January to July 2021. The study has three major components: 1) policy analysis to highlight core …

More Than Brides Alliance—Marriage: No Child’S Play, Endline Evaluation Brief, Population Council

Poverty, Gender, and Youth

This brief summarizes key results from the endline evaluation of the More than Brides Alliance (MTBA) project “Marriage: No Child’s Play” (MNCP) in India, Malawi, Mali, and Niger. The MTBA consists of partners Save the Children Netherlands, Simavi, Oxfam Novib, and the Population Council, along with 25 local implementing partners. The MNCP project—which took place from 2016 to 2020—aimed at being holistic and targeting pathways to child marriage on multiple levels simultaneously, treating communities as either having the full MNCP package or no intervention. The Population Council’s MNCP evaluation was designed to estimate program impact and trends among girls at …

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …

Breastfeeding Education Support Tool For Baby (Best4baby): Feasibility, Acceptability, And Preliminary Impact Of An Mhealth Supported Breastfeeding Peer Counselor Intervention In Rural India, Parth D. Lalakia, Vanessa L. Short, Roopa M. Bellad, Patricia J. Kelly, Yukiko Washio, Tony Ma, Katie Chang, Niranjana Majantashetti, Umesh S. Charantimath, Frances J. Jaeger, Shivaprasad S. Goudar, Richard J. Derman

Rowan-Virtua Research Day

Objective: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF).

Methods: In this quasi-experimental pilot study, participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received nine in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were aided with an mHealth tool. The control group received routine prenatal and postnatal health education. …

Incidence And Pathophysiology Of Diabetes In South Asian Adults Living In India And Pakistan Compared With Us Blacks And Whites, K M Venkat Naraya, Dimple Kondal, Natalie Daya, Unjali P. Gujral, Deepa Mohan, Shivani A. Patel, Roopa Shivashankar, Ranjit Mohan Anjana, Lisa R. Staimez, Muhammad Masood Kadir

Community Health Sciences

Introduction: We compared diabetes incidence in South Asians aged ≥45 years in urban India (Chennai and Delhi) and Pakistan (Karachi), two low-income and middle-income countries undergoing rapid transition, with blacks and whites in the US, a high-income country.
Research design and methods: We computed age-specific, sex-specific and body mass index (BMI)-specific diabetes incidence from the prospective Center for Cardiometabolic Risk Reduction in South Asia Study (n=3136) and the Atherosclerosis Risk in Communities Study (blacks, n=3059; whites, n=9924). We assessed factors associated with incident diabetes using Cox proportional hazards regression.
Results: South Asians have lower BMI and waist circumference than blacks …

Rates And Risk Factors For Preterm Birth And Low Birthweight In The Global Network Sites In Six Low- And Low Middle-Income Countries, Yamini V. Pusdekar, Archana B. Patel, Kunal G. Kurhe, Savita R. Bhargav, Vanessa Thorsten, Ana Garces, Robert L. Goldenberg, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esamai

Community Health Sciences

Background: Preterm birth continues to be a major public health problem contributing to 75% of the neonatal mortality worldwide. Low birth weight (LBW) is an important but imperfect surrogate for prematurity when accurate assessment of gestational age is not possible. While there is overlap between preterm birth and LBW newborns, those that are both premature and LBW are at the highest risk of adverse neonatal outcomes. Understanding the epidemiology of preterm birth and LBW is important for prevention and improved care for at risk newborns, but in many countries, data are sparse and incomplete.
Methods: We conducted data analyses using …

Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg

Community Health Sciences

Background: While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women.
Methods: For this study, we used data collected from two South Asian countries (Pakistan - …

Lifetime Risk Of Diabetes In Metropolitan Cities In India, Shammi Luhar, Dimple Kondal, Rebecca Jones, Ranjit M. Anjana, Shivani A. Patel, Sanjay Kinra, Lynda Clarke, Mohammed K. Ali, Dorairaj Prabhakaran, Muhammad Masood Kadir

Community Health Sciences

Aims/hypothesis: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI.
Methods: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by …

Effects Of Covid-19 On Nutrition In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

An extended nationwide lockdown and stoppage of economic activities resulting from COVID-19 caused substantial loss of income for many families in Bihar, India. One of the significant implications is a food shortage in households and a reduction in food intake. This nutrition shock may hit females harder than males due to the deep-rooted gendered culture prevalent in India. This study's key objectives are to understand the extent of food shortage in households, any changes in food intake, and coverage of government nutrition schemes. Half of the households in Bihar reported food shortages in the past month, causing most to reduce …

Are More People Adopting Covid-19 Prevention Measures?, Unicef, Population Council Institute

Poverty, Gender, and Youth

Drawing on data from two rounds of COVID-19 knowledge, attitudes, and practices (KAP) telephone surveys conducted in Bihar, India, this research brief sheds light on the socioeconomic differentials and changes over time in the adoption of COVID-19 preventive measures. Though the adoption of preventive measures has increased, around two-fifths of males and one-quarter of females reported that they were currently practicing all four standard preventive measures. The better educated, wealthier, and those belonging to privileged castes were more likely than others to practice these measures, as were those who perceived moderate or high risk of COVID-19 in their neighborhood. Social …

Awareness Of And Receiving Social Protection Measures During Covid-19 Lockdown In Bihar, India, Unicef, Population Council Institute

Poverty, Gender, and Youth

Economic hardships caused by the nationwide lockdown to prevent the spread of COVID-19 have been reported across India. Social protection measures have been announced by the state and central governments to ease these hardships. The key objectives of this research brief are to examine the awareness and the social protection measures received during the COVID-19 lockdown in Bihar, and the socioeconomic differentials in receiving these measures. The majority of respondents (64%) reported a family member losing their job/income-earning opportunity and lacking resources to survive for long. Awareness of social protection schemes was high (88%). Among households, 68% reported having ration …