Indian Journal of Community Health
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Enablers and Barriers of Antenatal Health Utilization among Pregnant Women in India: A Comparative Scrutiny from NFHS-4 & 5
Get PDFBackground: The use of effective antenatal care (ANC) plays a important role for minimizing maternal and child mortality and morbidity. Antenatal care (ANC) is the use of suitable and successful screening, preventive, or treatment interventions to minimize the risk of unfavorable health outcomes for mother and child during pregnancy and childbirth. Aims & Objectives: This study assesses the dynamic nature of various predictors associated with optimal ANC utilization in India. Methodology: A secondary data analysis was done based on NFHS-4 & NFHS-5. A uniform sample design, which is representative at the national, state/union territory and district level, is adopted in each round of the survey. Each district is stratified into urban and rural areas. Effect size with a p-value <0.05 were declared as significant factors associated with ANC utilization in both NFHS-4 & 5. This study is based on secondary data so not required IEC approval. Results: ?4 ANC visits by women during pregnancy increases from around 51% to 58% from NFHS-4 to NFHS-5. However, higher household wealth status, women with higher education and exposure to the media were coming out to be enablers while women with higher birth order, women belonging rural setup, distance to health facility coming out to be significant barriers in both the rounds of NFHS for the recommended ANC (?4) visit through with varying effect sizes. Conclusion: According to our research, sociodemographic and health policy interventions, such as enhancements to social services and education, as well as community health education, particularly for women living in rural areas, can reduce obstacles to the advised use of ANC services in India
Teenage Pregnancy in India: Addressing Ethical Dilemmas
Get PDFTeenage pregnancy remains a significant public health and social concern in India. This article examines the prevalence, contributing factors, and consequences of teenage pregnancy in India and explores the important ethical dilemma associated in context of pregnancy care in public health program and teenage pregnancy. Key factors for the teenage pregnancy include early marriage, lack of education, poverty, limited contraceptive use, and cultural norms. Teenage pregnancies are associated with higher maternal and infant mortality, pregnancy complications, and poor socioeconomic outcomes. While national programs address maternal health broadly, there is a lack of targeted interventions for teenage pregnancies, creating an ethical dilemma where this vulnerable group is left exposed to adverse events and outcomes. Additionally, teenagers under 18 are often excluded from key support programs, like conditional cash transfers, leaving them without essential resources. This article highlights the need for comprehensive strategies, including improved adolescent sexual education, behavior change communication, and specific support programs for pregnant teenagers. Addressing teenage pregnancy requires a multifaceted approach targeting social determinants, healthcare access, and cultural attitudes
Perceptions of Medical Students on Research Curriculum: A Cross-sectional Study
Get PDFIntroduction: Medical colleges promote research by incorporating it into the curriculum, which enables students to acknowledge it as a career prospect. The aim of the study was to assess the perceptions of medical students on research curriculum. Methods: This cross-sectional study was conducted among 544 medical students (interns and post-graduates) at AIIMS Rishikesh in 2020. Data was collected thorough online self-administered questionnaire. A comparison between groups was made using the Mann-Whitney test or chi-square test p < 0.05 was considered statistically significant. Results: Out of 544 participants, 218 (40.1%) responded with complete data. The total median score for the self-perceived ability of study participants regarding performing the research tasks differed significantly between interns and post-graduates [29.5 (24.0–34.2) vs 33 (25.2–39.7), p = 0.03]. They suggested that mandatory research projects, workshops, and training should be included in the curriculum. Conclusion: Feedback from medical students regarding the need for guided research projects, hands-on training, and inclusion of research methodology as a course in UG curriculum and provision of support in the form of incentives, academic credits, and motivation are well noted and guide the resource faculties to modify their teaching and student support programs
Impact of COVID-19 pandemic on the utilization of ART Centre Services of a teaching hospital
Get PDFBackground- COVID-19 pandemic has had a huge impact on the collateral health system. It made access to essential health services difficult. Such an essential service is a service provided to HIV patients. This study was planned to assess the effect of the current COVID-19 pandemic on Anti-Retroviral therapy (ART) center services. Methods -Pre-recorded epidemiological data from an ART center of a teaching hospital was used to answer the research question. Data was collected for retrieving 4 parameters i.e. number of registrations, number of HIV-positive patients kept on ART, number of deaths, and loss to follow up of the COVID-19 year and non-COVID-19 year then comparison was made between both. Data analysis was done with the help of SPSS. Independent t-test, one-way ANOVA test, and multiple comparison Tuckey’s test were applied. Results- Statistically significant difference was noted in the total number of registrations, the number of patients kept on ART, death, and loss to follow-up in non- COVID-19 & COVID-19 years. After appling above mentioned statistical test the p-value came out to be <0.05. Conclusion-COVID-19 pandemic has adversely affected the auxiliary non-COVID-19 health services and health programs. The current study gives evidence that ART functioning is negatively affected by the COVID-19 pandemic
Effect of community based intervention on childhood pneumonia and its risk factors in slums of Dibrugarh, Assam
Get PDFBackground: Pneumonia, one leading cause of mortality in children. Preventing pneumonia related deaths is an urgent priority to meet sustainable development goals. Settings and Design: Community based cross sectional study in two registered slums Chandmarighat and Graham bazar in Dibrugarh, Assam. Methods and Material: 2 out of 10 registered slums were chosen and a baseline cross sectional study was done to list out the risk factors. Based on the risk factors, community based intervention was done by capacity building of frontline workers and monitoring and suportive supervision in one while only monitoring was done in non intervention slum. Taking 95% confidence interval for two tail distribution, the sample size in each of the slums was 300. Statistical analysis: done by using SPSS 20, rates, ratios, proportions, univariate and multivariate analysis. Results: Prevalence of pneumonia was significantly low (9.33% vs 16.33%) in intervention and non-intervention area (p<0.001). Univariate analysis reported that initiation of complementary feeding before 6 months and indoor air pollution were associated with pneumonia in intervened area(p<0.001). Multivariate analysis was done and type of family, complementary feeding before 6 months and indoor air pollution were associated with pneumonia in intervened area. Conclusions: Community based interventions targeting the established risk factors found effective in reducing the childhood pneumonia
Imposter Phenomenon Among the Final Year (Part 1 and 2) Medical Students of a Private Medical College in the Union Territory of Puducherry: A Cross Sectional Study
Get PDFIntroduction: “Imposter syndrome” or “Imposter Phenomenon” is not a mental disorder but is considered as a psychological pattern in which people doubt their accomplishments and is associated with certain poor psychological functioning like low self-esteem can be detrimental to medical students. Objective: To find out the prevalence of Imposter phenomenon as well as it association with self-esteem among the final year medical students. Methods: A cross sectional study was carried-out among 249 medical students of a private medical college in the U.T of Puducherry using Clance Imposter Phenomenon scale. Results: 58.2% and 41.8% of the participants were in Part-1 and part-2 of final year respectively. It was observed that every participant had some degree of Imposter phenomenon. Low self –esteem, was found among 12.85% of the study participants. In this study there was no association between the low self-esteem and Imposter Syndrome. Conclusion: It is very clear that the burden of Imposter syndrome is quite high among the medical students as the reasons are varied. Extensive research to elaborate these is the need of the hour, as this information helps in designing the preventive measures for the students who are the future of the nation and the foundation stones of progress
Airborne Infection Control measures among Government and Private Health Facilities in a hilly district of North India
Get PDFIntroduction: Guidelines for Airborne Infection Control in Health Care Settings were published in the 2010 to reduce Airborne Infections in health service providers and visitors to health facilities. Objectives: To evaluate healthcare facilities regarding implementation of Guidelines for Airborne Infection Control in Health Care Settings. Methods: An analytic, cross- sectional, health care facility-based study in the district Solan of Himachal Pradesh. A total 53 health care facilities from both public and private sectors were assessed and compared. Results: The implementation of these guidelines was unsatisfactory. Government health care facilities were better implementing the guidelines, compared to the private sector. Conclusion: The guidelines are over a decade old and implementation is not optimal. Efforts and emphasis are required to be put into implementation of these guidelines in health care facilities. An update of policy with stringent penalties are advocated for better compliance in the private sector
Assessing Household Catastrophic Healthcare Expenditure and its Associated Factors: A Study in a North-Eastern State of India
Get PDFBackground: Out-of-pocket expenses (OOPE) are the primary means of funding healthcare costs in developing nations, and when the cost is too high, it leads to catastrophic healthcare expenditures (CHE). Aim & Objective: This study aimed to assess the proportion of households that faced CHE and also examined the associated factors that determine CHE at the household level. Methods and Material: Between September 2020 and February 2021, a cross-sectional study covering a sample of 771 households was conducted in four districts of Assam. A multistage sampling design was employed to select the sample households. Statistical analysis used: Binary logistic regression analysis has been performed to ascertain the factors that could determine household CHE. Results: 23% households had experienced CHE, high dependence on the private healthcare system. Monthly household income, duration of illness, presence of children under five years of age and elderly members, education of household head, and health insurance were the significant factors influencing CHE. Conclusions: The study identified the growing use of private healthcare services as a major concern that contributes to the prevalence of CHE. To make all healthcare services accessible and affordable and to lower OOP on healthcare, it is also crucial to improve the infrastructure and quality of the public healthcare system in rural and remote locations
Using data mining methods for risk assessment and intervention planning in diabetic patients-An exploratory study
No full textEvaluation of quality certification programs for public health facilities in tribal villages of Dahod district, Gujarat
Get PDFBackground: Rural and tribal India poses significant challenges in addressing healthcare quality. Along with healthcare staff, beneficiaries’ perspectives nowadays play a crucial role. The Government Health system has started to implement various quality certification programs (QCPs) like National Quality Assurance Standards, Kayakalp etc. on a wider scale. So, it’s very crucial to measure the results and evaluate the impact of these QCPs on the health system. Aims & Objective: To investigate the impact of quality certification programs for public health facilities in tribal villages. Material and methods: A qualitative study was undertaken in 18 PHCs of one of the tribal blocks of Dahod district. The participants were selected using purposive sampling. The participants included staff working at healthcare facilities and patients who have availed services at those facilities. Qualitative data was collected using in-person in-depth interviews (IDI). A total of 19 health staff and 23 patient IDIs were conducted. The audio recording was done for the interviews. Later on, process of transcribed verbatim and manual thematic analysis was done. Result: The transcripts’ manual thematic analysis part produced 12 different categories, 6 different sub-themes and 3 major themes, while the staff part, yielded 16 different categories, 6 different sub-themes and 3 major themes. Beneficiaries were satisfied with a noticeable improvement in healthcare services. Staff found these programs helpful but predominantly raised concerns about the implementation of QCPs. Conclusion: QCPs have demonstrated a significant positive impact on healthcare services; it\u27s very promising specifically in the context of rural and tribal health facilities. These programs hold great promise as they enable and empower these facilities to achieve quality and higher standards with the availability of better care