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Public health programmes are interlinked and intertwined with communication, advocacy and social mobilisation for their success. The unprecedented situation created by COVID-19 brought a medical emergency all over the world, the like of which was probably not seen after the Spanish Flu outbreak, a century ago. First there seemed no solution in sight when tens of thousands of people lost their lives to the coronavirus in various countries, but when the vaccine arrived, there were, in general, doubts about its efficacy and safety. Indian scenario was not any different. When the government launched the vaccine in a campaign mode in January 2021, it was also battling with misperceptions and vaccine hesitancy. Prime Minister Narendra Modi took it upon himself to address the issue through his various addresses to the nation and his signature programme Mann ki Baat (MKB) on the radio. This review paper examines the empirical research on MKB coverage of the COVID-19 pandemic, the media multiplier impact of the MKB, people's voices through their engagement with various social media platforms, and what is the impact on vaccine uptake. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of "Written Formative assessments with Peer-Assisted Learning Program" was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016–2019 and 2017–2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination. [ABSTRACT FROM AUTHOR]

Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) is a leading cause of mortality worldwide and, in recent years, has become an urgent public health concern in low- and middle-income countries (LMICs). Data from LMICs, however, remains limited. As such, the aim of this article is to systematically review the current literature on the incidence of SCD in LMICs to inform policymakers and identify potential research gaps. A search of PubMed and Embase was utilized to capture the targeted condition, outcome, and setting. Only peer-reviewed cohort studies in LMICs reporting SCD incidence estimates in the general population of individuals aged ≥1 year were eligible for selection. Papers providing incidence data for specific types of SCD, including sudden coronary death or death from sudden cardiac arrest, were also included. After deduplication, 1941 citations were identified and screened. Seven studies representing four countries--Cameroon, China, India, and Iran--met the criteria for inclusion and were considered in our analysis. The crude incidence rate for SCD ranged from 19.9 to 190 cases per 100,000 person-years, while ageadjusted rates ranged from 33.6 to 230 cases per 100,000 person-years. There was notable variability in methods utilized to ascertain SCD cases. These findings suggest that the incidence of all-cause SCD in LMICs and may exceed that of high-income countries; however, observed disparities may be partly attributable to differences in case ascertainment methods. Additional research is needed to better understand the true incidence of SCD in developing countries. It is crucial that future studies across regions utilize standard diagnostic criteria and methodology for identifying SCD, which would provide a framework by which to compare outcomes between settings. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250--500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state. [ABSTRACT FROM AUTHOR]

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Context: With the increasing trend of adopting e-Health technologies, the need for evidence for assessing e-Health technologies has become crucial. The appraisal of the e-Health program is important as this could provide guidance on further e-Health investment and adoption. Aims: The aim of the study was to provide an articulated body of literature on the current state of knowledge about the assessment of e-Health interventions. Settings and Design: Scoping review was conducted based on the framework provided by Arksey and O'Malley (2005) and considering enhancements proposed by Peters et al. (2015). Subjects and Methods: We searched the electronic databases and available gray literature from inception until the last week of October 2019. PRISMA flowchart for the study selection process was used to guide reporting. Data extraction included information on study design, authors, year of study, country, and key findings in terms of approaches used for assessment of e-Health programs. Data were compiled and summarized narratively. Results: Searches were performed between October and December 2019. Seventy-one relevant papers published between the years until the last week of October 2019 were reviewed and analyzed. After considering all the eligibility criteria, 15 papers were included. We identified 15 approaches for assessing e-Health programs, which were summarized and tabulated. Conclusions: This review showed that available literature on the assessment of e-Health programs is heterogeneous in terms of the methodology used. e-Health interventions are highly contextual; therefore; the phase of maturity and objective of the assessment should be considered while carrying out the assessment of e-Health programs [ABSTRACT FROM AUTHOR]

Background: In the climate change discourse, a body of scholarship focusing on how people perceive climate change and its impact is increasing. However, in the Indian context, such scholarship is limited. Objective: This paper aims to describe the perceptions of people on climate change and its health impacts, which were captured as part of a larger study. Methodology: A cross-sectional study was conducted in randomly selected 983 households in four districts spread across Madhya Pradesh and Jammu and Kashmir. A semi-structured questionnaire was used to collect the data. Results: For 72% of respondents, the perception was not related to climate change per se. Their perceptions were contextual and were based on the anomalies which are observed in the immediate weather conditions. The health impacts of climate change were also not understood at the first place, but with probing 64% of respondents were able to report seasonal diseases. Conclusion: Perceptions of the people regarding climate change are more linked to their own experiences with their local weather conditions rather than the overall concept. This also explains their lack of comprehension about the health impact of climate change, but a sound understanding of seasonal diseases. [ABSTRACT FROM AUTHOR]

Research is undertaken to increase scientific knowledge. Knowledge enters the domain of science after it is presented to others. Publishing research, contributes to medical community's knowledge. Research publications earn mileage to the researcher in carrier. Presently, a lot of pressure has built up on medical fraternity to publish in terms of quantity, thereby compromising the quality of papers as official bodies governing the medical professionals have linked the quantity of publications with career growth. These rules are to promote research but they create stress among medical teachers, lowering the quality of research and publications. Hence, It is the responsibility of authors to strictly follow guidelines while doing and publishing research. To promote academic research and deter plagiarism, educational institutions are to establish Academic Misconduct Panel to investigate the allegations, and report to Plagiarism Disciplinary authority which can impose penalties as conduct and publishing of research is a serious issue. [ABSTRACT FROM AUTHOR]

High burden of acute malnutrition among children less than 5 years is a major public health problem in India. A "Two-days National Consultation on Addressing Acute Malnutrition" was organized to gather experiences and evidence from 13 states of India on prevention and management of acute malnutrition among children and documenting viewpoints from experts and government counterparts on the same. The consultation centered around five key themes of addressing acute malnutrition: 1) capacity building, 2) strengthening screening, 3) nutritional care of wasting, 4) tracking progress, and 5) scale-up. The paper highlights the experiences and key recommendations around the above key themes. It emerged that there is a need to further accelerate the efforts toward strengthening existing platforms and services to address acute malnutrition among children. Regular trainings of the frontline workers, increased convergence, regular monitoring, and continued service delivery during the pandemic should be undertaken for better outcomes. [ABSTRACT FROM AUTHOR]

Background: The socio-environmental aspects of southern Assam reflect a general pattern of backwardness. Moreover, child healthcare resources in the region are inadequately used, leading to low vaccination coverage. Given this background, this paper attempted to comprehend wealth-based inequality in full vaccination in rural areas of southern Assam. Methodology: Based on a multistage cluster sampling approach, 360 children of 12–23 months were selected from the study area. To identify the predictors of a child, a non-linear model was estimated by using the generalized linear model (GLM) approach followed by Erreygers decomposition technique to quantify the wealth inequality in the obtained predictors in explaining the disparity in full vaccination. Result: The Bacillus Calmette–Guérin (BCG) vaccination recorded the highest vaccination coverage, at nearly 90% and the lowest was observed for the measles vaccine, around 61 percent. Slightly more than half of the eligible children (54 percent) were vaccinated against all the Universal Immunization Programme (UIP)-recommended vaccines. The decomposition analysis revealed that the occupation of the child's father, maternal age, birth order of the child, and health-seeking behavior such as antenatal care (ANC) were the prime factors related to inequality in full vaccination in the region. Conclusion: Vaccination coverage in the region has improved over time, however, full vaccination is concentrated towards the economically advantaged section of the society in rural southern Assam. Targeted, context-specific, and expanded government initiatives could aid in addressing the overall wealth-related full vaccination inequalities in the valley. [ABSTRACT FROM AUTHOR]

Background: The implementers of the tobacco control policy in the field have been neglected by the policymakers. They are the ones who have first-hand knowledge and their experiences in the field are not being used to bring about changes in the area of tobacco control. Objective: The objective of this paper is to critically examine how Michael Lipsky's concept of street-level bureaucracy can be used to address tobacco control in the health department in district Jalandhar of Punjab. Methods: Semi-structured interview schedules were used to interview Senior Medical Officers/Nodal Officers and Health Supervisors/Sanitary inspectors in four out of ten Community Health Centers and District hospital in Jalandhar. Data so collected were subjected to the process of inductive analysis and themes developed within the framework given by Lipsky. Results: The street-level bureaucrats (SLBs) were not given adequate training, and various organizational resources for tobacco control are missing in the district. There are threats and challenges which are faced by them in the field, and they do not exercise decision-making power to handle these barriers for effective implementation of the tobacco control program. Conclusion: The government needs to be inclusive in the process of policymaking meaning that it can be more accommodative of the suggestions given by the SLBs and provide them with discretionary powers to exercise their role efficiently. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. Materials and Methods: We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. Results: All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Conclusions: Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death. [ABSTRACT FROM AUTHOR]

Background: Properly constructed single best-answer multiple choice questions (MCQs) or items assess higher-order cognitive processing of Bloom's taxonomy and accurately discriminate between high and low achievers. However, guidelines for writing good test items are rarely followed, leading to generation and application of faulty MCQs. Materials and Methods: During lockdown period in 2020, internal assessment was taken through online mode using Google Forms. There were 60 'single response type' MCQs, each consisting of single stem and four options including one correct answer and three distractors. Each item was analyzed for difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE). Results: The mean of achieved marks was 42.92± (standard deviation [SD], 5.07). Dif I, DI, and DE were 47.95± (SD 16.39) in percentage, 0.12± (SD 0.10), and 18.42± (SD 15.35), respectively. 46.67% of the items were easy and 21.66% were of acceptable discrimination. Very weak negative correlation was found between Dif I and DI. Out of total 180 distractors, 51.66% were nonfunctional one. Conclusion: Item analysis and storage of MCQs with their indices provides opportunity for an examiner to select MCQs of appropriate difficulty level as per the need of assessment and decide their placement in the question paper. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India. Objective: To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children. Materials and Methods: A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 µL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard. Results: The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants. Conclusions: Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system. [ABSTRACT FROM AUTHOR]

CoWIN (Covid Vaccine Intelligence Network) is a web-based platform owned and operated by the Government of India for facilitating COVID-19 vaccination of the citizens. This project is considered a tremendous success, apparent from the sheer number of hassle-free and successful COVID-19 vaccinations. We believe that the CoWIN system is an ideal platform for capturing all the vaccine-related data in the Universal Immunization program (UIP) as well as providing an all-inclusive vaccine certificate in digital format. Advantages and challenges of upscaling the CoWIN system to include UIP and a vision statement of how this can be achieved are discussed in this article. We also enlist the state-level solutions currently in use for digital immunization records, which can serve as case studies for upscaling the CoWIN system. [ABSTRACT FROM AUTHOR]

Introduction: Prosocial behaviour is one of the key features of the development of school-going adolescents. Therefore, the current paper focuses on the prosocial behaviour of school-going adolescents in Kollam District, Kerala. Methodology: A cross-sectional descriptive study where 600 school-going adolescents, their parents and 60 class teachers were selected through cluster sampling method. English and Malayalam version of the Strength and Difficulties Questionnaire (SDQ) was administered among respondents. Chi-square and multiple linear regression models were used for analysing the data. Results: Self-report of prosocial behaviour predictors were significantly associated with gender (P < 0.01), urban-rural settings (P < 0.001) and government-private schools (P < 0.001). Parents' report shows highly significant relationship with gender (P < 0.001) whereas teachers' report is significantly related to urban-rural settings (P < 0.01). Conclusion: The current study found that one-fifth of school-going adolescents had borderline to abnormal (self – 17.4%; parents' – 16.9%; teachers' report – 20.8%) prosocial behaviour. School-going adolescents should involve in volunteer activities and campaigns for better development in society. [ABSTRACT FROM AUTHOR]

Introduction: Till 2016, India was the second largest consumer of tobacco in the world, second only to China. However, in June 2017, the factsheet release of Global Adult Tobacco Survey-2 showed a 6% point decline in the prevalence of tobacco use among adults (>15 years) in the country. Materials and Methods: This is a form of ecological study where trends in aggregate prevalence of tobacco use at country level (using secondary data) were studied in relation to corresponding policy actions over a period of two decades. Results: The results have shown that initial policy actions since the cigarettes act of 1975 till prevention of food adulteration Amendment act of 1995 were largely targeting cigarettes, and so smoking prevalence among men was constantly declining. On the other hand, smokeless tobacco use was increasing among both men and women and reached a peak in 2009--2010. After that, the government took strict policy actions including Food Safety and Standards Authority of India Gutka ban in 2011. There were other persistent efforts, which are discussed in this paper. As a result, a transition has occurred in relation to tobacco epidemic in India. Conclusion: The paper has been concluded with a note that there is no room for complacence and we have a noncommunicable disease action goal to further decline the prevalence of tobacco use in the country to <24.22% by the year 2025. [ABSTRACT FROM AUTHOR]

Background: Several competing priorities with health and development sector currently deter research, and as a result of which evidence does not drive policy- or decision-making. There is limited operational research (OR) within the India's National Tobacco Control Programme, as it is in other middle- and low-income countries, primarily due to limited capacity and skills in undertaking OR and lack of dedicated funding. Few models of OR have been developed to meet the needs of different settings; however, they were found to be costly and time-consuming. Objective: To elucidate a cost-effective and less resource arduous training model for building capacity in OR focused on tobacco control. Materials and Methods: This 5½-day partly funded course enrolled 15 participants across the country and nine facilitators. The facilitator-participants interactions were initiated 2 weeks before the course, which enabled them to develop possible research questions and a plan for data analysis. Results: This article presents the new OR model along with experiences of the participants which will provide useful insights on lessons learned for planning similar courses in the future. While we faced several challenges in the process and the outputs were modest, several lessons were learned which will be instrumental in the future courses that we are planning to conduct. Conclusion: This low cost and less time intensive model can be applied in similar settings across range of public health issues. [ABSTRACT FROM AUTHOR]

Background: In India, Nutrition Rehabilitation Centers (NRCs) established at public health facilities provide residential medical nutrition therapy for severe acute malnutrition (SAM) children with complications. A large proportion of their mothers are also malnourished. NRCs do not provide services to such mothers as part of routine practice. However, technical algorithm for delivering Maternal Nutrition (MN) services in facility settings is available. Objectives: To test the practical feasibility of layering the MN services in NRC as a routine service. Methods: The MN services were delivered by a nutrition counselor using a triage approach (assess, classify, supplement/counsel/treat). All mothers received diet, micronutrients, and group counseling, those at nutritional risk received individual counseling and SAM mothers also received catch-up diet during their stay. Program data were collected from mothers during January 1 to August 31, 2019 at the NRC in Kalawati Saran Children Hospital. To gain operational insights, a structured interview with nutrition counselor was conducted. Results: Out of 168 mothers, 8% were found to be pregnant and 89% were at nutrition or medical risk. The prevalence of short stature was 18%, severe/ thin 21%, overweight/obese 34%, and anemic 72%. Feedback from the nutrition counselor indicated no operational challenges, however, further efforts to ensure that mothers keep coming back for follow-up visits is needed. Conclusion: The findings indicated that existing staffs were able to deliver the MN services within the time, cost, and regime of the routine NRC. This paper provides four recommendations for layering the MN services in NRCs. [ABSTRACT FROM AUTHOR]

A resilient health system necessitates strong governance, political commitment, effective administrative entities and inter-organisational collaboration. This paper examines India's current health policy landscape and explores the analytical and operational capacities required to establish a robust post-pandemic health system using the policy capacity framework described by Wu et al. (2015). We emphasised the need for a coordinated policy response to strengthen health information systems, health service management, human resource management and healthcare financing. The role that the planned implementation of Indian public health management cadres would play in the coming era, the importance of a comprehensive health information management system and the need for operational coordination between government and non-governmental organisations has also been emphasised. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Materials and Methods: Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. Results: In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. Conclusion: This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country. [ABSTRACT FROM AUTHOR]

Background: Micronutrient deficiencies such as iron, Vitamin A, and iodine are important public health problems in India. Objective: The objective of the study was to assess subclinical Vitamin A deficiency (VAD) and anemia among women and preschool children from Northeast India. Methodology: A community-based cross-sectional study was carried out by adopting systematic sampling in Phek district of Nagaland. Data were collected from women on sociodemographic particulars, and finger prick blood was collected for hemoglobin and free-flowing drop for Vitamin A estimation on Whatman no. 1 filter paper. Results: The overall prevalence of anemia was 27%, 40%, 44%, and 52% among preschool children, nonpregnant nonlactating women, lactating mothers, and pregnant women, respectively, whereas VAD was 37% among preschool children and 24%-32% among adult women. The prevalence of VAD was observed high among those living in kutcha house, illiteracy of head of households, big family size, and low per capita income. Conclusions: Anemia and VAD are important public health problems among tribal population in spite of the rich biodiversity. [ABSTRACT FROM AUTHOR]

Introduction: Mid-upper arm circumference (MUAC) measures the arm muscle and fat area. The use of MUAC as a screening measure for assessing undernutrition has the following advantages; it makes use of a simple equipment, is easy to carry at the field sites, and requires minimal training. In India, "mid-upper arm circumference" is widely used and accepted in many nutritional programs. Objectives: This study was conducted with the primary objective to compare different anthropometric parameters of children and to validate the usefulness and limitations of MUAC to screen out undernourished children. Subject and Methods: Anthropometric measurements were recorded for all the anganwadi centers of the selected sub-center that comes under the field practice area of our department. The measurements like weight, height, MUAC were done according to the standard guidelines as per WHO, and further, calculations were done with the help of "Anthro software 3.2.2." Comparisons were done between categorization of MUAC tape and Weight-for-Height Z-scores (WHZ), and hence, the sensitivity and specificity of the MUAC tape to screen the malnourished child were found out. Results: Sensitivity of MUAC to categorize a child in red/yellow was only 9.03%, negative predictive value (NPV) was 40.75%, specificity came 95.10%, and positive predictive value was 73.68% on taking WHZ as the gold standard. Conclusion: MUAC has a limited role in screening out an undernourished child (red/yellow category), whereas it has a good role in screening healthy children (green category). [ABSTRACT FROM AUTHOR]

Background: Emergency Contraception Pill (ECP) is an essential intervention to prevent unwanted pregnancies. However, its use has remained low due to various barriers including reservations among medical fraternity. Materials and Methods: This paper presents findings on barriers to ECP’s easy access for potential users from (i) a cross-sectional survey of providers’ attitudes, beliefs, and practices and interviews with key opinion leaders, (ii) three consultations organized by Population Council with policymakers and public health experts, and (iii) evidence from scientific literature. Results: The major barriers to easy access of ECP include misconceptions and reservations of providers (disapproval of ECP provision by CHWs, opposition to its being an OTC product, and myths, misconceptions, and moral judgments about its users) including influential gynecologists. Conclusion: For mainstreaming ECP, the paper recommends educational campaign focusing on gynecologists and CHWs, relaxing restrictive policy on advertisement of ECP, involving press media and strengthening supply chain to ensure its regular supply to ASHA (CHW). [ABSTRACT FROM AUTHOR]

Background: Condom is an integral part of all interventions for female sex workers (FSWs). However, certain situations hinder them from practicing consistent condom use. This paper aims at identifying the situations that predict inconsistent condom use by FSWs of Sonagachi red-light area, Kolkata. Subjects and Methods: The cross-sectional community-based observational study was conducted among 296 brothel-based FSWs of Sonagachi. Outcome variable, that is, inconsistent condom use was said to be present if any sex act with any type of partner was not protected by condom. Association with sociodemographic, occupational, and behavioral characteristics of FSWs was examined. Results: Inconsistent condom use was present among 37.5% of the study participants, and this was predicted by the presence of a nonpaying partner (NPP) (adjusted odds ratio [AOR] [95% confidence interval (CI)]: 15.04 [7.52-30.08]), violence (AOR [95% CI]: 2.08 [1.07-4.03]) and sexual intercourse under the influence of alcohol (AOR [95% CI]: 1.86 [1.02-3.39]). The major cause behind nonuse of condom as reported by the participants was trust on partner. Conclusion: NPPs need to be given emphasis in program strategies for FSWs. The FSWs should constantly be motivated for safe sex emphasizing the fact that trust on partner may be detrimental for their health. [ABSTRACT FROM AUTHOR]

Background: Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. Objectives: This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. Materials and Methods: The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Results: Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Conclusion: Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective. [ABSTRACT FROM AUTHOR]

Emerging zoonoses are the product of socio economic and anthropogenic environmental changes. As human societies continue to develop, pathogens from animal hosts have continued to spill over into our population However, Peri-urban ecosystems remain neglected in the country. With a subsequent increase in demand for food, there has been an expansion of formal and informal livestock-based food production sectors in these areas. The increasing close contact between animals and humans in both work and living environments creates hot spots in peri-urban areas, thereby increasing vulnerability to zoonotic disease transmission and other health hazards associated with food safety, water, and sanitation-related diseases. This paper explores the efforts made by different research bodies to reduce the prevalence of zoonotic diseases in peri-urban areas. [ABSTRACT FROM AUTHOR]

Background: The immunization coverage in India is far away from satisfactory with full immunization coverage being only 62% at national level. Targeting the intensive efforts to poor performing areas and addressing the determinants of nonimmunization and dropouts offers a quick solution. In this paper, we assess the inter-district variations in Haryana state, and the association of social determinants with partial and no immunization. Methodology: This analysis is based on data collected as part of a large household survey undertaken in the state of Haryana to measure the extent of Universal Health Coverage. A multistage stratified random sampling design was used to select primary sampling units (i.e., subcenters), villages, and households. A total of 11,594 mothers with a child between 12 and 23 months were interviewed on receipt of immunization services. Determinants of nonimmunization and partial immunization were assessed using multiple logistic regression. Results: About 21% of children aged 12-23 months were partially immunized, while 4.3% children aged 12-23 months had received "no immunization." While the coverage of full immunization was 74.7% at the state level, it varied from 95% in best performing district to 38% in poorest performing district. Odds of a partially immunized child were significantly higher in urban area (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.1-1.38), among Muslim household (OR = 3.52; 95% CI = 3.03-4.11), children of illiterate parents (OR = 1.58; 95% CI = 1.22-2.05), and poorest quintile (OR = 1.61; 95% CI = 1.36-1.89). Conclusions: Wide interdistrict variations call for a need to consider changes in resource allocation and strengthening of the government initiatives to improve routine immunization in these districts. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the leading causes of death globally (nearly 17.5 million deaths/year). Hypertension and coronary heart disease (CHD) are two of the most important CVDs. There is a dearth of studies at a large scale in India to ascertain the factors as well as social differentials in the prevalence of heart disease associated with hypertension. This paper attempts to bridge the gap in the relevant area. Methodology: Secondary analysis of the data obtained from India Human Development Survey (IHDS), conducted in two rounds in 2004-2005 and 2011-2012, was done (n = 147,201). Bivariate and logistic regression analyses have been used. Results: In India, the prevalence for CHD is 1.1% for 2011-2012. Findings showed that persons with hypertension are 11 times (odds ratio [OR] = 11.58, P < 0.01) more likely to be affected by CHD among adults (15 and above years) as compared to nonhypertensive adults. When the odds are adjusted for socioeconomic and demographic variables, hypertensives are found to be 5 times more likely (OR = 5.096, P < 0.01) to be having CHD as compared to nonhypertensives. Conclusions: The unadjusted odds of suffering from CHD when hypertension is a predictor are much higher than when the odds are adjusted for socioeconomic and demographic variables. Along with hypertension, age, education, and place of residence have also been found to be important determinants of CHD. [ABSTRACT FROM AUTHOR]

Background: Women's empowerment, a precondition of sustainable development, is a multidimensional and complex concept, often described with three interrelated components: resources, agency, and achievement. There is no universal construct for women's empowerment; rather, it has been assessed based on the context. It had been hardly explored in rural West Bengal. Objectives: This study was formulated to construct a women's empowerment index (WEI), in rural West Bengal, and assess the reliability of the index. Methods: A community-based cross-sectional study focusing on Women's Empowerment, Child Health and Nutrition (WE-CHANT) was conducted in a community development block in West Bengal. Mother (of reproductive age)--child (6--59 months) pairs were recruited from 20 villages by two-stage sampling (n = 268). Mothers were interviewed. Exploratory factor analysis (EFA) with oblique rotation was conducted with 25 measurement variables to construct the WEI. The internal consistency was assessed with Cronbach's alpha, item-rest, average inter-item, inter-domain, and domain-to-index correlation. Results: A 12-item (factor loading ≥0.40) WEI comprising three domains--decision-making power, attitude toward gender-based violence (GBV), and social independence--was constructed with acceptable internal consistency (Cronbach's alpha = 0.747). The multidimensionality of the index was also observed. Conclusion: A concise agency-based WEI was constructed, where decision-making power was explored as the major domain. This index in the context of rural West Bengal could be further utilized to assess women's empowerment and elicit its association with resources and achievements. [ABSTRACT FROM AUTHOR]

Background: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. Objective: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. Methods: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Results: Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Conclusion: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life. [ABSTRACT FROM AUTHOR]

Evidence for reducing cardiovascular and renal events with sotagliflozin is uncertain among type 2 diabetes mellitus (T2DM) patients. To gather more evidence, this meta-analysis assesses the beneficial effects of sotagliflozin, a dual sodium--glucose cotransporter 1 and 2 inhibitor, in reducing the cardiovascular and renal events in diabetic patients with or without chronic kidney disease (CKD). Scopus, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed were the databases used to search. The studies published from January 1, 2018, to January 30, 2022, were considered. The eligibility of studies was assessed independently. The data were collected in a modified Cochrane data extraction form. The included studies' quality was assessed with the Cochrane risk-of-bias tool. The quality of evidence for renal and cardiovascular outcomes was evaluated using GRADEpro software. The number of events of urgent visits to the hospital and requiring hospitalization was reduced (RR: 0.73; 95% CI: 0.69, 0.78; P value <0.00001). The mortality rate because of cardiovascular events was decreased with sotagliflozin (RR: 0.73; 95% CI: 0.67, 0.80; P value <0.00001). Patients taking sotagliflozin had a drastic decline in the number of deaths due to stroke and non-fatal myocardial infarction. Yet, there is no difference between the groups in terms of changes in mortality due to other causes or the glomerular filtration rate (GFR). Sotagliflozin demonstrated effectiveness in reducing the mortality rate related to heart failure and cardiovascular events when the dose was increased from 200 mg to 400 mg. Despite this, evidence is still needed to prove the renal protective action. [ABSTRACT FROM AUTHOR]

Intellectual disability (ID) is a public health challenge affecting communities worldwide. ID is characterized by impaired physical and cognitive functioning and less engaged in physical activities. The objective of this study was to assess the impact of adaptive yoga practices on cognitive and motor abilities in the subjects with ID. Sixty-six subjects with mild and moderate IDs were purposively selected and randomly divided into experimental and control groups, with 33 subjects in each group. One month of adaptive yoga module was provided to the experimental group. To assess the impact of the yoga intervention, Functional Reach Test (FRT), Wall Toss Test (WTT), Finger Tapping Test (FTT), Sit-- Reach Test (SRT), and Six Letter Cancellation Test (SLCT) were administered. The experimental group showed a statistically significant improvement with P < 0.05 across all the parameters, whereas the control group could not observe a significant improvement. Based on the results, this study concludes that "one month of adaptive yoga module" delivered impact and helped to improve the dynamic balance, eye--hand coordination, neuro-motor function, spinal flexibility, and selective attention in ID-afflicted subjects. [ABSTRACT FROM AUTHOR]

Background: Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans. Material and Methods: Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families. Results: Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population. Conclusions: The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation. [ABSTRACT FROM AUTHOR]

Background: Injuries have become a major public health concern. Recent data show that globally over 5 million people lose their life due to injury every year. Especially in low- and middle-income countries, people living below the poverty line are drastically scathed due to injuries. Objective: The objective of this paper is to find the magnitude and risk factors of fall among the elderly in India. Materials and Methods: A systematic search was done by using Google Scholar and PubMed. Results: The selected studies revealed that the prevalence of fall ranges from 26% to 37% across various regions, fall injuries are associated with poor vision, vertigo, imbalance, fear of falling, history of fall, presence of osteoarthritis, visual impairment, hearing impairment, and depression. This study has shown the risk of fall was higher among female elderly population. Conclusion: The major contributing factors for fall injuries are aging, visual impairment, previous history of fall, depression, and gait problem. Females have a higher risk of fall comparatively to males. [ABSTRACT FROM AUTHOR]

There have been attempts recently to bring clarity as to the role/functions of the discipline of community medicine. Debates on whether community medicine is a discipline in itself and if so is it a clinical discipline has been there for decades across the world. As the departments of community medicine do not exclusively teach any clinical skill to undergraduate or postgraduates, it is difficult to argue that our discipline is a clinical discipline. Our stalwarts are also known for their work at community and government level and not as clinicians. Our current undergraduate course does not prepare the students adequately for their role in society, profession and health system. Our mandate is to prepare the would-be-doctors as a "finished product" to the country. Our training should address the current crisis that afflicts our profession. A list of learning objectives to be achieved in the three domains of profession, health system, and society and suggestions to improve the teaching of this discipline are provided in this paper. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a natural, physiological process experienced by all adolescent girls and women. The reproductive age group is the largest and most susceptible to various health and illness-related risk factors. This study aims to find the prevalence of satisfactory menstrual hygiene management (MHM) among women of reproductive age group and we also want to explore the cultural practices and beliefs related to menstruation and barriers to satisfactory MHM. Material and Methods: This study was conducted in rural field practice areas of Department of Community and Family Medicine, AIIMS, Rishikesh including 271 participants; women of reproductive age group using a mixed method study design (sequential quan--qual). Quantitative data were collected by household surveys and government schools using a validated structured questionnaire. Descriptive statistics were used to analyze the data. Focus group discussions (FGD) were conducted to have insights about understanding menstrual hygiene and barriers to satisfactory hygiene practices. Results: It was found that only 70 (29.6%) participants adhered to satisfactory menstrual hygiene practices. The age group of 20--24 years had a higher proportion compared to other groups. Through FGD, the main themes derived were practices related to menstruation (maintenance of personal hygiene), daily activities (physical and mental problems during menses), and barriers faced (cultural, economic, privacy concerns, and shyness). Conclusion: The prevalence of satisfactory menstrual hygiene practices was very low only 29.6%, which is a cause of concern; either Taboos associated with menstruation, socio-cultural, economic barriers, or lack of awareness related to menstrual hygiene in the community can be contributing factors for low prevalence. [ABSTRACT FROM AUTHOR]

Background: Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India. Materials and Method: In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman's correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI. Results: CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R² = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R² = 0.327) were determinants of CHART mobility. Conclusion: Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity. Material and Methods: Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant. Results: Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively). Conclusion: Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. Material and Methods: The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. Results: The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. Conclusion: The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health. [ABSTRACT FROM AUTHOR]

Introduction: Safe disposal of feces is ensured when it is deposited into a toilet, whereas unsafe disposal of child's feces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. Objective: To determine the effect of positive deviance (PD) approach on safe disposal of child's feces among households who owned a toilet. Materials and Methods: A community-based quasi-experimental study was conducted in the four field practice villages of the Urban Health Training Center, Villupuram, for 18 months. Households who owned a toilet and had a child less than 5 years old were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for 6 months to promote safe disposal practices in the study villages. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 24). The Chi-square test was used to determine the significance of difference between baseline and endline data. The effect size was calculated to estimate the magnitude of difference between baseline and endline data. Results: Before intervention, only 3% of households disposed the feces into a toilet, while after intervention, almost 38% of households disposed in the toilet (χ² = 37.39; df = 1; P = 0.001). The effect size (Cramer's V) was found to be 0.43. Conclusion: PD approach demonstrated considerable improvements in safe disposal of child's feces in rural settings. Further, to sustain the behavior change, frequent reinforcement of key messages at frequent intervals needs to be emphasized. [ABSTRACT FROM AUTHOR]

Background: One of the most important aspects of women's well-being and welfare is RSH (reproductive and sexual health). Reproductive health is not an exception to the threat that CCC (climate change and climate crisis) poses to numerous facets of public health. Firstly, the present review seeks to identify the influence of climatic changes, natural disasters, and climate-driven migration on RSH. Secondly, to identify knowledge gaps regarding the same. Material and Methods: Two databases (Scopus and PubMed) were scanned using Boolean operation. The literature search aimed to find records pertaining to topics of RSH and climate change. Using the PRISMA-ScR method, records were screened and shortlisted based on established inclusion criteria. This literature search was carried out in November 2022. In the shortlisted records, preference for the comprehensive review articles was given. Results: The present review is based on 38 records that collectively revealed that climate crisis and natural disasters have many negative impacts on female reproductive health. These effects are observed in different phases of life, ranging from teenage to menopause. The unique strength of the present review is that it draws a relationship between female reproductive health and the direct as well as indirect effects of the CCC. The available literature about LMICs is predominantly confined to drought, flood, and earthquake. Disasters like tsunamis, cyclones, and avalanches remain unexplored. Conclusion: From the available literature, it is quite evident that CCC has an adverse effect on a woman's reproductive life as well as a bearing on future generations' health. Filling these knowledge gaps is pivotal for designing more effective disaster and health policies. Policymakers should take into consideration these detrimental effects while designing health schemes and policies for females. [ABSTRACT FROM AUTHOR]

Background: The Indian government launched national teleconsultation services (eSanjeevani OPD) to provide safe doctor-to-patient consultations. This study aimed to determine the awareness and willingness to seek services from eSanjeevani OPDs. Material and Methods: This is a cross-sectional descriptive study conducted in Nandigudi village, Karnataka. The total sample size was 273, and participants were recruited using a systematic sampling technique. Results: The prevalence of awareness about teleconsultations was 2.2% (n = 6, 95% CI: 0.8–4.7%). None of the participants utilized eSanjeevani services in the last year. Approximately 56.0% (n = 153, 95% CI: 49.9–62.0%) were willing to use eSanjeevani OPD. "Not being familiar" (n = 99, 82.5%) with eSanjeevani OPD was the major reason for unwillingness to use teleconsultation, and 73.8% (n = 113) preferred video calls as the mode of communication. Conclusion: The majority of the participants were not aware of and were unwilling to use eSanjeevani OPD. Therefore, healthcare professionals should focus more on creating awareness of teleconsultations. [ABSTRACT FROM AUTHOR]

Background: Pregnant women in urban poor societies are vulnerable groups. Due to low financial capacity, there are obstacles to accessing delivery in an institution for poor women in urban areas. The study analyses factors associated with the delivery place among pregnant women in urban poor society in Indonesia. Materials and Methods: The study analyzed secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 1,562 samples were childbearing-age women (15–49 years) who gave birth in an urban poor society in Indonesia in the last 5 years. The study examined some variables, such as delivery place, age, education, employment, marital status, parity, insurance, knowledge of pregnancy danger, antenatal care (ANC), the autonomy of health, and family finance autonomy. The study employed binary logistic regression in the final stage. Results: The results show that age is associated with the place of delivery. The higher the education, the higher the possibility for delivery in an institution. Being employed and having partners are protective factors for women in institution delivery. The likelihood of giving birth in a medical facility decreases as more children are born alive. In addition, having health insurance, thorough ANC visits, knowledge of pregnancy danger symptoms, and health autonomy are protective factors for pregnant women having deliveries in medical facilities. On the contrary, pregnant women who rely solely on family financing have a higher chance of delivering in a medical facility. Conclusion: The study concluded that 10 variables were associated with pregnant women's delivery in Indonesia's urban poor society: age, education, employment, marital, parity, insurance, pregnancy danger knowledge, ANC, health autonomy, and family finance autonomy. [ABSTRACT FROM AUTHOR]

Background: Youth are considered to be most vulnerable to health and lifestyle issues (HLS) in India. The current study aims to investigate the factors that contribute to health and lifestyle issues among youth attending mental health promotion clinics (YMHP) in Karnataka. Method: Three-year first-visit data from beneficiaries (aged 15–35 years) attending YMHP clinics in Karnataka between 2017 and 2020 were analyzed. Multivariable logistic regression analysis included beneficiaries reporting any HLS issue as the outcome and a host of 57 hypothesized variables as exposures. Results: Overall, 2,615 (25%) beneficiaries reported HLS issues. Years of schooling (AOR 5–7 years = 0.89; 95% confidence interval [CI] =0.60–1.31), (AOR 8–10 years = 0.65; 95% CI = 0.46–0.91), (AOR >10 years = 0.67; 95% CI = 0.49–0.93)], unemployed youth (AOR = 0.52; 95% CI = 0.45–0.61) business and salaried workers (AOR = 1.69; 95% CI = 1.33–2.13), and other occupations (AOR = 2.11; 95% CI = 1.73–2.56), junk food consumption (AOR = 0.76;95% CI = 0.68–0.84), having issues related to relationships with parents (AOR = 3.01; 95% CI = 2.47–3.68) and intergenerational issues (AOR = 1.71; 95% CI = 1.19–2.45), self-development issues (AOR low-self-awareness = 1.57; 95% CI = 1.33–1.85), (AOR low-self-esteem = 1.29; 95% CI = 1.062–1.57), (AOR emotional issues = 1.57; 95% CI = 1.31–1.89), education and academics (AOR = 1.23; 95% CI = 1.09–1.39), safety issues (AOR = 4.11; 95% CI = 3.07–5.50), gender sex and sexuality issues (AOR = 2.44; 95% CI = 1.43–4.15), suicidal ideation (AOR = 1.91; 95% CI = 1.44–2.54), substance use (AOR tobacco chewing = 1.45; 95% CI = 1.09–1.93), (AOR tobacco-smoking = 1.66; 95% CI = 1.18–2.32), (AOR smoking = 4.94; 95% CI = 3.52–6.93) and experiencing emotions (AOR feel anxious = 1.63; 95% CI = 1.41–1.88), (AOR forgetfulness = 1.50; 95% CI = 1.41–1.98), (AOR difficulty in concentration = 1.37; 95% CI = 1.035–1.81), (AOR anger = 1.61; 95% CI = 1.25–2.07), (AOR feel worthless = 2.21; 95% CI = 1.71–2.86) were associated with HLS issues among beneficiaries. Conclusion: This analysis addresses an important but neglected component of HLS issues among youth highlighting the importance of early intervention among youth to prevent the development of diseases later in life. The study has important implications for youth health promotion in India and countries such as India. Health and Lifestyle Issues Among Youth: A record analysis of contributing factors among beneficiaries attending Youth Mental Health promotion clinics (Yuva Spandana Kendras) in Karnataka, India. [ABSTRACT FROM AUTHOR]