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This paper analyzes patient-provider interaction (PPI). More precisely, it deals with the form-function relationship in questions used in counselor-patient interaction. The study is based on naturally occurring primary data collected at the Department of Pediatrics and the Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), located in Aligarh Muslim University, India. The data are composed of audio-visual recordings of Hindi-Urdu interaction between 8 counselors and 27 patients. We identified compliance and condescension as the two unique functions the counselors seeks to accomplish and/or fulfill through the use of questions in their interaction with the patients. We also found four other functions – information seeking, recall, greeting, and diagnosis, which are sought by the counselors through their use of questions. The findings also suggest that these functions maintain and promote what can be termed as a counselor-centered interaction, and thus reflect asymmetrical power relationship between counselors and their patients. [ABSTRACT FROM AUTHOR]

Colonial medical education and public health policies emerged from an intriguing discourse of negotiation between the government and the people. These 'structured conflicts', rooted in the politics and the debates of the colonial institutions not only provided opportunities for creative thinking about public health but also for imposing constraints. The colonial and post-colonial India medical legislative debates revealing a new language of protest, assumed greater significance with the growing nationalist movement and the general (though variegated) intellectual polarisation – western and indigenous systems of medicine. Problematising the historiographic assertion of medical modernisation in colonial India to be a part of 'civilising mission', this paper argues that legislature emerged as a platform of activism and protest against the colonial and post-colonial State's appropriation of modernity. While some members appealed for extending the benefit of 'modern' western medicine to the general Indian population, some debated in favour of introducing the indigenous medical systems to the terms of modern professionalisation. The post-colonial policies reveal the true significance of the legislative debates in reviving the position of indigenous systems of medicine in the context of professional modernity. [ABSTRACT FROM AUTHOR]

Introduction: Addressing social determinants of health (SDH) from a global health security perspective is important especially in low and middle income countries. Socioeconomic status, cultural, political and behavioural factors influence health and disease of the people. This paper seeks to describe how government programmes and other initiatives are expected to play an important role in addressing SDH and thereby improving health of the people. The analysis addresses both health and social policy issues. Context and Aim: The study assumes importance in view of India moving towards strengthening health and social security of its people through several policy-driven initiatives. Methods: This analysis classifies the 100 plus programmes launched by the Government of India into health, education, nutrition, social security, etc., and compares available indicators (2000–2018) Findings: The initiatives of the Government of India are expected to improve health and social security of its people, with focus on addressing health as well as social inequity. One of the programmes (Swachh Bharat Mission – clean India mission) has helped in avoiding 300,000 child deaths. Official survey results are not available for all indicators. Innovative contribution to policy, practice and/or research: Analysis of Government of India's policy-driven programmes and other initiatives with focus on livelihood improvement indicate that they are contributing to ensure health and social security; and are worth replicating in similar settings. [ABSTRACT FROM AUTHOR]

Women in low-and-middle income countries (LMICs) are disproportionately exposed to secondhand smoke (SHS), particularly in the home environment. Girls married before the age of 18 are more likely to remain at home and may be at higher risk of SHS exposure. This paper investigates whether women who were married as child brides had a higher risk of SHS exposure than their peers who were married as adults in India, where both burden of smoking and child marriage are critical public health concerns. Data were obtained from the 2015–2016 wave of the nationally representative India National Family Health Survey and included 306,788 married women ages 18 to 35 years. We estimated bivariate and multivariate logistic regressions to obtain odds ratios in favor of SHS exposure. The prevalence of SHS exposure for those who were married as adults was 50.3% while that was 55.2% for those who were married before age 18. After controlling for sociodemographic characteristics, the adjusted odds of SHS exposure for those who were married as child were 1.06 (95% CI: 1.03, 1.09) times that of those who were married as adults. Findings of this study inform policies for coordinated efforts to eliminate child marriage and strengthen tobacco control. [ABSTRACT FROM AUTHOR]

In 2020 editor-in-chief (Andrew Malekoff) issued a special call for papers for group work stories on pandemic 2020. Among the 28 stories accepted for the series there were 16 from India, 9 from the United States, 2 from Canada and 1 from Israel. General submissions from the U.S., Canada and Israel were typical for the journal. Atypical are submissions from India. Rather than publish the stories in one special issue of the Journal, he decided to spread them out over several issues through 2022. In the course of organizing the special series (with a December 2021 deadline) he continued communication with a few of the authors from India, with particular interest and concern in the deteriorating situation as 2021 unfolded. Although the present commentary is not about group work per se, it is an update by Ajay Saini, Nancy and Andrew Malekoff on the current state of affairs in India, with some contrast to the situation in the U.S., that offers continuing context for the stories in the series. [ABSTRACT FROM AUTHOR]

This article examines how Dr. Robert McCarrison's goitre research in British India in the early twentieth century established his credentials as a medical researcher. It argues that the recognition that McCarrison achieved in this field had more to do with the fact that his research was conducted in a colonial non-Western locale. McCarrison resisted the Iodine Deficiency Disease explanation for goitre and critiqued successful public health initiatives conducted in the USA and Switzerland that involved distributing iodised salt or iodine supplements to populations to prevent goitre outbreaks. Thus, he created a path dependency in British India for himself and other British researchers, as well as his junior and affiliated Indian researchers, which impeded effective public health initiatives to prevent goitre outbreaks in India. [ABSTRACT FROM AUTHOR]

An emerging body of literature examines multiple connections between water insecurity and mental health, with particular focus on women's vulnerabilities. Women can display greatly elevated emotional distress with increased household water insecurity, because it's them who are primarily responsible for managing household water and uniquely interact with wider water environments. Here we test an extension of this proposition, identifying how notions of dignity and other gendered norms related to managing menstruation might complicate and amplify this vulnerability. Our analysis is based on systematic coding for themes in detailed semi-structured interviews conducted with twenty reproductive-age women living in two water insecure communities in New Delhi, India in 2021. The following themes, emerging from our analysis, unfold the pathways through which women's dignity and mental health is implicated by inadequate water: ideals of womanhood and cleanliness; personal dignity during menstruation; hierarchy of needs and menstruation management amidst water scarcity; loss of dignity and the humiliation; expressed stress, frustration and anger. These pathways are amplified by women's expected roles as household water managers. This creates a confluence of gendered negative emotions – frustration and anger – which in turn helps to explain the connection of living with water insecurity to women's relatively worse mental health. [ABSTRACT FROM AUTHOR]

India has the highest global burden of tuberculosis (TB), accounting for a quarter of the worldwide TB disease incidence. Given the magnitude of India's epidemic, TB has enormous economic implications. Indeed, the majority of individuals with TB disease are in their prime years of economic productivity. Absenteeism and employee turnover due to TB have economic ramifications for employers. Furthermore, TB can easily spread in the workplace and compound the economic impact. Employers who fund workplace, community, or national TB initiatives stand to gain directly and also enjoy reputational benefits, which are important in the era of socially conscious investing. Corporate social responsibility laws in India and tax incentives can be leveraged to bring the logistical networks, reach, and innovative spirit of the private sector to bear on India's formidable TB epidemic. In this perspective piece, we explore the economic impacts of TB; opportunities for and benefits from businesses contributing to TB elimination efforts; and strategies to enlist India's corporate sector in the fight against TB. [ABSTRACT FROM AUTHOR]

Health challenges of communities are often assessed using biomedical or individual risk-based frameworks which are often inadequate for understanding their full extent. We use observations from the global South to demonstrate the usefulness of structural assessment to evaluate a public health problem and spur action. Following newspaper reports of excessive deaths in the marginalised indigenous or Adivasi community of the Pando people in Northern Chhattisgarh in central India, we were asked by the state government's public health authorities to identify root causes of these deaths. In this rapidly evolving situation, we used a combination of public health, social medicine, and structural vulnerability frameworks to conduct biomedical investigation, social inquiry, and structural assessment. After biomedical investigations, we identified scrub typhus, a neglected tropical disease, as the most likely cause for some of the deaths which was unrecognised by the treating physicians. In the social inquiry, the community members identified the lack of Adivasi status certificates, education, and jobs as the three major social factors leading to these deaths. During the structural assessment of these deaths, we inductively identified the following ten structures– political, administrative, legal, economic, social, cultural, material, technical, biological, and environmental. We recommended improving the diagnosis and treatment of scrub typhus, making the hospitals more friendly for Adivasi people, and tracking the health status of the Adivasi communities as some of the measures. We suggest that a combination of biomedical, social,and structural assessments can be used to comprehensively evaluate a complex public health problem to spur action.. [ABSTRACT FROM AUTHOR]

The non-governmental but not-for-profit sector seems to bridge the gap apparent in a shortage of government resources and unaffordable for-profit services in the healthcare market of India. Based on a background study about the non-governmental organisation for official health accounts, it was found to be imperative, especially in providing preventive and promotive healthcare services. To the current health expenditure of the country, this sector contributes around 2.1%, with funds generated largely as grants from governments and foreign sources. Indeed, financial contribution is not as imperative as the ability to reach grassroots for providing healthcare, which should be considered as an opportunity to augment the capacity of the health system, especially during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The present study addressed the gender differential of socioeconomic disparity in the age-adjusted daily consumption of smoked tobacco, smokeless tobacco and both among the adults in North-East India, and the risk factors associated with it. Methods:We analysed data from the second round of the Indian Global Adult Tobacco Survey (2016-17).Prevalence ratio and disparity index were used to capture the socioeconomic disparity in the regular consumption of tobacco. Binary logistic regression modelswere used to estimate the risk factors associated with tobacco use. The study found about three out of every ten adults aged 15 years and above consume smokeless tobacco daily, whereas the prevalence of smoked tobacco consumption was less than that. This study also captured the existence of socioeconomic inequalityin the age-adjusted prevalence of daily consumption of smoked and smokeless tobacco among the study subjects, regardless of the measurement by educational level, employment and wealth status. However, the poorest and the unemployed were more prone to consume any form of tobacco as compared to less poor and employed. Proper execution of policies that includes health education about the daily consumption of tobacco and its direct association with severe health diseases needs to be devised in the Northeastern region. [ABSTRACT FROM AUTHOR]

The article discusses research which examined how hotel industry leaders responded to the business, economic, and public health impact of the coronavirus disease 2019 (COVID-19) pandemic in India and Jamaica. Topics explored include the global economic disruption which may be attributed to the pandemic, the crisis management model adopted in the study, and brief details regarding crisis leadership, public relations initiatives during the crisis, and the prevention mechanisms implemented.

India has recently implemented several major health care reforms at national and state levels, yet the nation continues to face significant challenges in achieving better health system performance. These challenges are particularly daunting in India's poorer states, like Odisha. The first step toward overcoming these challenges is to understand their root causes. Toward this end, the Harvard T.H. Chan School of Public Health conducted a comprehensive study in Odisha based on ten new field surveys of the system's performance to provide a multi-perspective analysis. This article reports on the assessment of the performance of Odisha's health system and the preliminary diagnosis of underlying causes of the strengths and challenges. This comprehensive health system assessment is aimed toward the overarching goals of informing and supporting efforts to improve the performance of health systems in Odisha and other similar contexts. [ABSTRACT FROM AUTHOR]

Common mental health disorders are studied extensively among adult women globally. However, they remain under-researched among young women. This study aims to determine whether gender disadvantage factors are associated with psychological distress among young women in rural India, where the child sex ratio is lower than the national average. A cross-sectional survey was conducted in rural Pune, India. A total of 229 young married women who had a live birth in the last 12 months were screened for psychological distress. The predictors of psychological distress were estimated using multivariable logistic regression analyses. Psychological distress was found among 50 respondents (21.9%). Young women who were married before 18 years had 2.19 times higher odds of distress than women who were married after 18 years. Young women who gave birth to a female infant had 2.43 times higher odds of distress than those who gave birth to a male infant. Lack of partner support and experience of postnatal health complications were other predictors. Study findings ascertain the role of gender disadvantage factors in causing psychological distress. From a public health perspective, early identification and treatment of psychological distress, is imperative, along with addressing gender inequitable practices. [ABSTRACT FROM AUTHOR]