Indian Journal of Community Health
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Designing and Validating a Multimorbidity Assessment Questionnaire for a Rural Indian Community
Get PDFIntroduction: Multimorbidity, has received its undue attention in the recent years, because of its hidden impact on the patients and their families, especially in environments with little resources. There is no data available on the prevalence of multimorbidity (for both oral and systemic) in Uttarakhand to the best of our knowledge. The aim of this study is to develop a multimorbidity questionnaire in a rural Indian community. Methods: The pilot study was conducted in Kurkawala, Dehradun, Uttarakhand, India in February 2023. Results: Our sample had mean age of 46 years, with 54.2% females. 88.5 % of the participants were found to be with any morbidity, whereas 31.5% participants were found to be with only oral morbidity. 57.9% participants were found with Oral Morbidities along with One systemic Morbidity followed by 21.1% participants with Oral Morbidities along with Two systemic Morbidities. 25.8% participants were found to have with both Hypertension and Oral Conditions, followed by Acid peptic disease and Any Chronic Bone/Joint Disease; Any Neurological and/or Psychiatric Disorders (19.4% respectively). Discussion: Developing a stronger evidence base of the knowledge of risk factors and their determinants as well as implementing proven effective strategies (both at individual as well as societal level) for multimorbidity risk reduction hold the key to lower multimorbidity burden and improve quality of life globally. Conclusion: Our findings show that this questionnaire is a reliable and trustworthy way to assess multimorbidity in a community setting with a range of chronic illnesses (both systemic and oral)
Prevalence of dental Fluorosis and its epidemiological determinants in a Hilly state of India- A Cross-Sectional Study
Get PDFBackground: From a human health perspective, fluorine acts as a double-edged sword as its deficiency leads to dental caries, while excess fluorine intake is associated with the development of fluorosis (dental and skeletal). Aims and Objectives: This study was conducted with the aim of assessing the prevalence of dental fluorosis associated with different water fluoride concentrations (naturally occurring sources). Additionally, sociodemographic, lifestyle and anthropometric measurements were analyzed to determine their association with the prevalence of dental fluorosis. Methodology: A cross-sectional study was conducted for 12 months in children aged 6-19 years in the Rudraprayag district of Uttarakhand. The fluorosis assessment was done as per Dean’s index. The sample size was 1400. Data was collected using a predesigned, pretested, semi-structured questionnaire by personal interview method. A p-value of < 0.05 was considered statistically significant. Results: Overall prevalence of dental fluorosis was 19.1% (267/1400). Surprisingly, 39% of these cases of fluorosis were drinking water within normal fluoride range (0.5 mg/l- 1.0 mg/l). Only 4 villages out of thirty reported having more than 1 mg/l fluoride content in the drinking water. The children of higher socioeconomic status, class 2 and above, had 1.78 times more chances of being affected by fluorosis than children of lower socioeconomic status (p = 0.015, 1.78 (1.12 - 2.83)). Dental fluorosis was twice more common among stunted children (p = 0.011, 2.08 (1.16 – 3.73)). Conclusion: For the first time, this study reported the occurrence of dental fluorosis in Uttarakhand. Fluorosis was reported even if water fluoride concentration was below 1mg/liter may be due to high altitude of the region
Quality of life and its associated factors of Type-2 Diabetes Mellitus patients attending tertiary care hospital, Yavatmal, Central India: A hospital-based cross-sectional study
Get PDFBackground: Type-2 diabetes mellitus (T2DM) is a long-term, incurable disease affecting negatively on quality of life (QoL). Aim & Objectives: To assess the Quality of life of Type-2 Diabetes Mellitus patients attending tertiary care hospital and its associated factors. Methodology: This cross-sectional study was carried out from Dec 2022 to Feb 2023 among 297 T2DM patients attending tertiary care hospital. The data was collected by first author using a 26-item WHOQoL-BREF questionnaire. The Institutional Ethics Committee approved the study. Statistical analysis was done using JASP version 0.18.3 for mean, standard deviation, t-test, ANOVA test, and multiple linear regression (MLR). Results: Mean age of participants was 55.18±11.09 years. Out of total, 57.9% were males, 85.5% of participants were satisfied with their QoL. The mean score of WHOQoL-BREF domains was highest for social relationships (58.78±15.49), while lowest for physical domain (51.83±12.31). The individual perception of overall QoL and health scored 59.59±19.39 and 55.38±18.73 respectively. ANOVA test showed statistical significance between education & socio-economic status with all domains of QoL (P<0.05). MLR reported that socio-economic class II was independently correlated with all domains of QoL. Conclusion: Overall QoL was above average. Education and socioeconomic status of the participants were significantly associated with QoL
Enhancing Healthcare Service Quality through Awareness and Participation
Get PDFThis study investigates the awareness and participation of medical service seekers in Kanpur concerning local health care service centers and health awareness programs. The research highlights a significant shift in the knowledge and voluntary engagement of medical service seekers, driven by advancements in technology and health care products. The analysis reveals that the variables related to medical service seekers are sufficient to represent the concept of facilities-oriented strategies. Additionally, the study examines the variances in perceptions of medical service seekers regarding these strategies. The findings provide valuable insights into the characteristic features of medical service seekers and their interaction with health care facilities in Kanpur. This research underscores the importance of understanding the evolving needs and behaviors of medical service seekers to enhance the effectiveness of health care services and programs. By identifying key factors that influence awareness and participation, the study offers practical implications for health care providers and policymakers aiming to improve health care delivery and accessibility in Kanpur. The insights gained from this research can inform the development of targeted strategies to increase engagement and satisfaction among medical service seekers. Overall, this study contributes to the broader understanding of health care service utilization and the role of technology and awareness programs in shaping health care behaviors. The findings emphasize the need for continuous assessment and adaptation of health care strategies to meet the dynamic needs of the population, ensuring that health care services are both accessible and effective for all medical service seekers in Kanpur
Poster Presentation as an Education tool: Use, Views and Reviews from Undergraduate Medical students
Get PDFBackground: Medical education has entered its modern era in our country with the new NMC devised Competency Based Curriculum de-emphasizing autocratic teaching techniques and in turn replacing them with continuous stress upon critical thinking, parallel reading, creative expression and information evaluation. Aims & Objectives: 1. To assess the use of Poster Presentations as an Educational Tool for Under Graduate (UG) Medical Students. 2. To assess the views of Under Graduate (UG) Medical Students on Poster Presentation as an Educational Tool. 3. To assess the reviews of Under Graduate (UG) Medical Students on Poster Presentation as an Educational Tool. Methodology: After ethical clearance and face validity of the questionnaire students who had participated in poster competition, were asked to fill the form for study and analysis of both open and close ended questions was done. Result: The average response recorded on Likert scale was of 4.21 (± 0.65); Cronbach’s alpha for the set of questions asked was found to be 0.914 depicting excellent internal consistency and showing that the data is very much reliable. Conclusion: Academic poster competition can be an innovative teaching and learning tool for both academic and soft skills
Broadening the avenues of complementary medicine and way forward to integrate it with evidence-based modern medicine research – A need of the hour
No full textThis scoping review explores the evolving role of complementary and traditional medicine (TC&M) in modern healthcare systems, emphasizing the need for evidence-based practices to facilitate their integration into conventional medical research and practice. Complementary medicine refers to health practices which are not main-stream like modern medicine used along with conventional medicine, contributing to holistic health by addressing physical, mental, and social well-being. Despite their widespread use, particularly in underserved and resource-constrained settings, TC&M lacks rigorous scientific validation, hindering its acceptance and integration into mainstream healthcare. The review outlines the historical evolution of TC&M, citing key milestones such as the establishment of dedicated research institutions like the National Center for Complementary and Alternative Medicine (NCCAM) and WHO recommended strategies on Traditional Medicine. It also highlights the challenges of integrating TC&M due to the lack of research data, financial support, and standardized practices. Furthermore, the review identifies the growing need for evidence-based approaches, particularly in countries like India, where traditional systems such as AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) are widely practiced. To achieve Universal Health Coverage (UHC) and address the growing burden of non-communicable diseases, the review advocates for a shift toward integrative medicine, combining modern and complementary approaches. It stresses the importance of collaborative research, standardized training for healthcare professionals, and the development of global frameworks to evaluate TC&M practices. Ultimately, this integration could improve healthcare accessibility, reduce costs, and enhance overall health outcomes
Determinants of Nonadherence to Antihypertensive Medications Among Adults in Bharatpur Metropolitan City, Nepal
No full textBackground: Elevated blood pressure is a critical risk factor for cardiovascular diseases, this can be managed effectively with antihypertensive medications. However, nonadherence to prescribed medications and unhealthy lifestyle choices exacerbate cardiovascular complications and increase mortality. Aim & Objective: To identify the factors associated with nonadherence to antihypertensive medications among the adult population. Methods and Materials: This cross-sectional study was conducted in Bharatpur, Chitwan, among 238 patients who had been taking antihypertensive medicine for at least three months. Data were collected using structured interviews, and BP was measured using standardized equipment. Study sites and participants were randomly selected. Descriptive statistics and bivariate logistic regression methods were used to analyse the collected data. Results: 47.1% of participants had elevated BP despite taking antihypertensive medication, and 32.8% nonadherence. Nonadherence was significantly associated with sociodemographic and behavioral factors. In 95% CI, those who did not consume fruits (p < 0.001) or green vegetables (p = 0.014) were less likely to adhere, avoiding extra salt were more likely to adhere (p < 0.001) and those not engaging in vigorous physical activity had lower odds of adherence ( p = 0.007). Conclusion: Dietary habits and physical activity were key determinants of nonadherence
Assessing District Hospital Preparedness During a Public Health Emergency of International Concern (PHEIC): Development of a Comprehensive Checklist in the Indian Context
Get PDFBackground: The COVID-19 pandemic exposed critical weaknesses in healthcare systems, particularly in low- and middle-income countries such as India. In Delhi, district hospitals faced severe challenges during successive waves, including inadequate infrastructure, staffing, and poor emergency coordination. These shortcomings underscore the need for a standardized, context-specific tool to assess and improve hospital preparedness for future Public Health Emergencies. Material & Methods: A preparedness checklist was developed using a mixed-methods approach. The initial draft was developed through a literature review of global and national frameworks, followed by expert consultations with public health specialists, physicians, administrators, and infectious disease experts. Feedback was incorporated through structured consensus-building exercises, ensuring contextual relevance and technical rigor. Results: The resulting checklist encompasses six core domains: (1) Infrastructure, Equipment and Supplies, (2) Health Worker Safety, (3) Patient Care, (4) Biomedical Waste Management and Disinfection, (5) Health Information, Outreach and Communication, and (6) Monitoring and Reporting. Each domain includes actionable items with standardized response formats for scoring and gap identification. Conclusion: This checklist provides a comprehensive, adaptable framework aligned with WHO health emergency standards. It supports institutional learning, staff preparedness, and policy planning. Field validation is needed, but it presents a practical solution for enhancing hospital readiness in future health emergencies
A cross-sectional descriptive study assessing minimum dietary diversity among women desiring pregnancy in tribal and non-tribal blocks in rural area of a north Maharashtra district, India
No full textIntroduction: Minimum Dietary Diversity reflects the consumption of micronutrients and is measured by assessing consumption items from various food groups. The preconception phase is crucial in women’s reproductive cycle. Objectives: to estimate the proportion of women having minimum dietary diversity in desiring to conceive within one year in tribal and non-trial blocks, to compare the proportion in tribal and non-tribal blocks, and to identify associated risk factors. Methods: A cross-sectional descriptive study of two tribal and two non-tribal blocks in the Nashik district of Maharashtra. All women desiring pregnancy in a year were enrolled. The consumed items in 24 hours were grouped into ten. The study gave one score for each consumed group. The study considered accomplished minimum dietary diversity when the woman scored five or more. Results: The study enrolled 7,794 women. The mean age of the women was 23.19 years (SD=3.72). The mean dietary diversity score of the women was 4.73 (SD=0.7), 68.8% had minimum dietary diversity, and there was no difference between tribal and non-tribal blocks. Starchy food consumption was 100%, and fruit and vegetable consumption were minimal. Lower parity had a positive effect (AOR =0.90; CI 95%= 0.81-0.99). Unemployed women (AOR =1.12; CI 95% =1.01-1.24), consumption of tobacco in any form (AOR=1.38; CI 95% =1.11-1.70), and substantially less protein intake (AOR=2.49; CI 95%=1.61-3.84) had a negative effect. Conclusions: About two-thirds of women had minimum dietary diversity. Residence in tribal areas did not affect, but socio-demographic factors, tobacco, and less protein consumption affected minimum dietary diversity
Navigating Risks: Exploring Sexual and Reproductive Health and Contraceptive Awareness among Adolescent Girls in in District Dehradun
Get PDFBackground: Adolescence brings about significant changes in the life, making it crucial to develop lifelong healthy habits. However, societal norms often restrict open discussions on sexual and reproductive health (SRH). In India, access to accurate SRH information and healthcare remains limited for many adolescents. Aim & Objective: To study trend in risk taking behavior related to sexual & reproductive health of adolescent girls and to find out awareness about and use of contraception in the study population. Settings and Design: A cross-sectional study was conducted in two randomly selected intercolleges in district Dehradun. Methods and Material: A total of 400 unmarried school-going adolescent girls (classes 9th–12th) were surveyed with a focus on SRH. Statistical Analysis Used: Percentages and chi-square test. Results: The mean age of respondents was 15.62 (±1.557) years. Teachers were the primary source of SRH information, but only 26.2% respondents had attended sex education classes. While most had heard of HIV/AIDS, knowledge about other sexually transmitted infections was low. Awareness of condoms and oral contraceptive pills was higher than other methods and improved with age. Conclusion: The study highlights inadequate access to accurate SRH information and the need for comprehensive education programs to promote informed decision-making