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Smokeless tobacco (SLT) use is widespread across many nations and populations, and India shares more than three-quarters of the global burden of SLT consumption. Tobacco use in India has been largely viewed as a male-dominant behaviour. However, evidence from medical, social and behavioural sciences show significant SLT use among women and young girls. This paper highlights key dimensions of SLT use among women in India including prevalence and determinants, the health effects arising from SLT use and cessation behaviours. The paper concludes by providing recommendations with the aim of setting research priorities and policy agenda to achieve a tobacco-free society. The focus on women and girls is essential to achieve the national targets for tobacco control under the National Health Policy, 2017, and Sustainable Development Goals 3 of ensuring healthy lives and promote well-being for all. [ABSTRACT FROM AUTHOR]

Simple Summary: This study examined patterns of dog ownership in three different states in India. The main aim was to understand who owns dogs, their reasons for owning them, and how these patterns vary in different areas. We conducted quantitative surveys to gather information on the number of people who own dogs, their backgrounds, and their attitudes towards their pets. Our findings show that there are significant differences in dog ownership depending on where people live and their economic status. In particular, we found settlements in Gujarat state to possess significantly fewer privately owned dogs that Tamil Nadu and Uttarakhand. These results are important because they help us understand the needs of dog owners and their pets in different parts of India. This information can be used by those making decisions about public health and animal welfare, such as how to manage stray dogs or prevent diseases that can spread from dogs to humans. This study is valuable as it provides a clearer picture of dog ownership in India, which can help improve the lives of both people and animals. This paper presents the demographics, dynamics, and attitudes of dog ownership across three states in India. The background of this research is set against the increasing significance of pet ownership in urban Indian contexts, with a particular focus on understanding the variations in dog-ownership patterns and their implications for public health and animal welfare. We employed a survey-based approach, gathering quantitative survey data from dog owners (n = 563) and non-dog-owners (n = 9282) across different socioeconomic and geographic backgrounds in seven Indian settlements. The results reveal notable differences in dog-ownership patterns, influenced by regional state. In particular, settlements in Gujarat were found to have significantly fewer dog-owning households than those in Tamil Nadu, with no differences found according to settlement size. Dog ownership was found to be more common in households of higher socioeconomic standing, and settlements in Uttarakhand were found more frequently to possess dogs for reasons other than companionship. Data from Ahmedabad and Vadodara, specifically, also indicate rapidly increasing rates of pet ownership. Sterilisation and rabies vaccination proportions were typically low and high, respectively, across all settlements, with few significant differences found among settlements. Confinement of owned dogs at night was significantly lower in Nainital than all other settlements. Differences in attitudes towards roaming dogs between dog owners and non-dog-owners were also examined, with the results indicating both positive and negative trends accordingly. Our results emphasise the need for region-specific strategies in public health and animal welfare policies, acknowledging the diverse nature of pet ownership in India. This research provides valuable insight for policymakers and animal welfare organisations, underlining the importance of tailored approaches to address the unique challenges and opportunities in the Indian context. [ABSTRACT FROM AUTHOR]

The key objective of this paper is to emphasize the importance of acknowledging breastfeeding as an embodied social practice within interventions related to breastfeeding and lactation and illustrate how this recognition holds implications for public health ethics debates. Recent scholarship has shown that breastfeeding and lactation support interventions undermine women's autonomy. However, substantial discourse is required to determine how to align with public health goals while also recognizing the embodied experiences of breastfeeding and lactating individuals. Presently, interventions in this realm predominantly revolve around health-related messaging and the promotion of individual behaviors, often neglecting the systemic and structural factors that influence choices and practices. I closely examine breastfeeding interventions in India, in particular Mothers' Absolute Affection health promotion program, along with breastfeeding narratives. I argue that for such interventions to evolve, they must acknowledge the intrinsic embodied social nature of breastfeeding during their design and implementation. Furthermore, it is important to emphasize that achieving equity and justice objectives necessitates moving beyond the confines of both conventional public health frameworks and frameworks solely centered on private choices. Instead, a more encompassing approach that embraces the concept of embodiment should be adopted. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

A well-structured digital database is essential for any national priority project as it can provide real-time data analysis and facilitate quick decision making. In recent times, particularly after the COVID-19 pandemic, invasive fungal infections (IFIs) have emerged as a significant public health challenge in India, affecting vulnerable population, including immunocompromised individuals. The lack of comprehensive and well-structured data on IFIs has hindered efforts to understand their true burden and optimize patient care. To address this critical knowledge gap, the ICMR has undertaken a Pan-India pioneer initiative to develop a network of Advanced Mycology Diagnostic research centres in different geographical zones of the country (ICMR-MycoNet). Under the aegis of this project, a clinical registry on IFIs in the ICUs is initiated. This process paper presents a detailed account of the steps involved in the establishment of a web-based data entering and monitoring platform to capture data electronically, ensuring robust and secure data collection and management. This system not only allows participating ICMR-MycoNet centres to enter patient information directly into the database using standardized Case Report Form (CRF) but also includes data validation checks to ensure the accuracy and completeness of entered data. It is complemented by a real-time, web-based, and adaptable data visualization platform. This registry aims to provide crucial epidemiological insights, promote evidence-based hospital infection control programs, and ultimately improve patient outcomes in the face of this formidable healthcare challenge. [ABSTRACT FROM AUTHOR]

Introduction: The healthcare delivery system of Assam faces several challenges to provide affordable, accessible and quality care services. GNRC (Guwahati Neurological Research Center) is the first super-speciality hospital to address many of these gaps by delivering integrated affordable healthcare services to the populations of Assam and other parts of North-eastern India. Description & Discussion: This paper describes the implementation of a care delivery model which provides integrated care delivery services through linking hospitals to primary healthcare services, including preventive, promotive, and curative care, along with delivering easily accessible and affordable care to the people of Assam and other parts of North-eastern India. Conclusion: The proposed model is the first innovative approach from Northeastern India, Assam, to deliver affordable, accessible and patient-centric hospital led community-based preventive, promotive, and primary, secondary, and tertiary hospital-based care. It is anticipated that GNRC's "Affordable Health Mission" will help redesign and integrate the way primary, secondary and tertiary healthcare is delivered to the population of Assam in helping patients manage their own health and reduce the numbers that needs to be admitted to secondary care and tertiary care by improving patients' independence and well-being as well as dramatically reducing the cost to the overall health system. [ABSTRACT FROM AUTHOR]

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]

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]

The World Economic Forum has called dementia one of the biggest global health crises of the 21st century. In this paper, I make the case that unpaid caregiving by family or close others of persons living with dementia should be a matter of public health. Shaji and Reddy proposed this in 2012 in the context of dementia care in India. They explicitly acknowledge the influence of Talley and Crews' 2007 article on caregiving as an emerging public health concern. However, they narrow their proposal to caregiving for persons living with Alzheimer's disease and related dementias (ADRD), which I take to be an important first step in building an argument for putting caregiving more firmly on a public health agenda. In order to support my claim, first, I establish that caregiving is a social determinant of health. Second, I counter objections to the addition of caregiving for persons living with ADRD to a public health agenda, as it would lead to public health mission creep. I then argue that a broad understanding of public health can be inclusive of this type caregiving and is preferable as it highlights an issue of health equity, the gendered nature of caregiving. Finally, I make the case that a definition of public health inclusive of the social determinants of health and caregiving is more adequately suited to address the health consequences of the current changing demographic patterns. My argument adds support to writings on migration calling for broadening the scope of public health. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) against women is a global phenomenon. IPV is a public health, social policy and human rights concern across the globe. It remains a serious issue in Indian context as well. This paper aims to identify the factors associated with IPV using India's nationally representative National Family Health Survey (NFHS) data. Design/methodology/approach: To identify the factors associated with IPV in India, the authors have used binary logistic regression to estimate two models. The outcome variables are women facing physical violence in the first model and sexual violence in the second. The explanatory variables are broadly socio-economic indicators related to the women and a few other indicators related to the characteristics of the household. Findings: The authors found that urban and working women face higher odds of violence. Alcohol consumption by the husband increases the risks of IPV, whereas risk decreases with women's autonomy. Even though the prevalence of physical and sexual violence has decreased by 6.8% and 3.9% from 2005–2006 to 2019–2021, the data shows that women across social, economic and regions still face violence from their partners. However, the physical violence increased from 2015–2016 to 2019–2021. Originality/value: To the best of the authors' knowledge, this study is a distinct attempt to use pooled data of the nationally representative sets NFHS-3 (2005–2006), NFHS-4 (2015–2016) and NFHS-5 (2019–2021) to study the factors associated with IPV in India. [ABSTRACT FROM AUTHOR]

In this paper, I have described the healthcare problem (maldistribution of doctors) in India. Later, I have introduced the concept of artificial intelligence (AI) and I have described AI technology with various examples, how it is rapidly changing the healthcare scenario across the world. I have also described the various advantages of artificial intelligence technology. At the end of the paper, I have raised some serious concerns regarding complete replacement of human based healthcare technology with artificial intelligence technology. I concluded that there is not the slightest question that AI will influence the future. People must be innovative, insightful, and context-aware for AI to work. This is because humans will continue to contribute value that cannot be reproduced by robots. [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]

Presents several research papers and studies on medicine presented at the 10th Annual Conference of the Indian Society of Critical Care Medicine in India. Background of the research; Objectives; Study design.

Background: Building on a distinguished history of community medicine training, public health programs have been expanding in India in recent years. The COVID-19 pandemic has brought additional attention to the importance of public health programs and the need for a strong workforce. This paper aims to assess the current capacity for public health education and training in India and provide recommendations for improved approaches to meet current and future public health needs. Methods: We conducted a desk review of public health training programs via extensive internet searches, literature reviews, and expert faculty consultations. Among those programs, we purposively selected faculty members to participate in in-depth interviews. We developed summary statistics based on the desk review. For qualitative analysis, we utilized a combination of deductive and inductive coding to identify key themes and systematically reviewed the strengths and weaknesses of each theme. Results: The desk review captured 59 institutions offering public health training across India. The majority of training programs were graduate level degrees including Master of Public Health and Master of Science degrees. Key factors impacting these programs included collaborations, mentorship, curriculum standardization, tuition and funding, and student demand for public health education and careers. Collaborations and mentorship were highly valued but varied in quality across institutions. Curricula lacked standardization but also contained substantial flexibility and innovation as a result. Public sector programs were perceived to be affordable though fees and stipends varied across institutions. Further development of career opportunities in public health is needed. Conclusion: Public health education and training in India have a strong foothold. There are numerous opportunities for continued expansion and strengthening of this field, to support a robust multi-disciplinary public health workforce that will contribute towards achieving the sustainable development goals. [ABSTRACT FROM AUTHOR]

A novel Corona virus disease 2019 (COVID-19) outbreak is declared as the international public health emergency concern by the World Health Organization in the month of March 2020. This viral disease invented from China in the month of December 2019 has previously caused havoc around the world, including India. In this paper, efficient mathematical models using Gustafson–Kessel fuzzy clustering approach for the transmission of the COVID-19 are developed by considering the actual reported cases in the state of Tamil Nadu, India. The results proved a good concord between the reported data and the estimated data given by the proposed models. Moreover, the developed models are also capable to predict the requirements of beds in hospitals on the month of August 2020 in Tamil Nadu, India. Also, this work suggests strictly implementing/extending the complete lockdown for at least 21 days in the month of August 2020 and immediate separation of infected cases are the positive steps to reduce the spread of novel corona virus in Tamil Nadu state, India. [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]

Anemia is one of the most pressing public health issues in the world with iron deficiency a major public health issue worldwide. The highest prevalence of anemia is in developing countries. The complete blood count is a blood test used to diagnose the prevalence of anemia. While earlier studies have framed the problem of diagnosis as a binary classification problem, this paper frames it as a multi class (three classes) classification problem with mild, moderate and severe classes. The three classes for the anemia classification (mild, moderate, severe) are so chosen as the world health organization (WHO) guidelines formalize this categorization based on the Haemoglobin (HGB) values of the chosen sample of patients in the Complete Blood Count (CBC) patient data set. Complete blood count test data was collected in an outpatient clinical setting in India. We used Feature selection with Majority voting to identify the key attributes in the input patient data set. In addition, since the original data set was imbalanced we used Synthetic Minority Oversampling Technique (SMOTE) to balance the data set. Four data sets including the original data set were used to perform the data experiments. Six standard machine learning algorithms were utilised to test our four data sets, performing multi class classification. Benchmarking these algorithms was performed and tabulated using both10 fold cross validation and hold out methods. The experimental results indicated that multilayer perceptron network was predominantly giving good recall values across mild and moderate class which are early and middle stages of the disease. With a good prediction model at early stages, medical intervention can provide preventive measure from further deterioration into severe stage or recommend the use of supplements to overcome this problem. [ABSTRACT FROM AUTHOR]

Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats—including heatwaves, drought, and floods—negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers. • Climate change is exacerbating many risks to informal workers' health and livelihoods. • WASH access may foster gender equality and decent work, while tackling heat stress. • Policymakers can partner with informal workers to create inclusive, multi-pronged interventions. [ABSTRACT FROM AUTHOR]

Kerala is one of India's most vulnerable states in India when it comes to climate‐induced disasters. Kerala's public health department grappled with a flood of unprecedented magnitude in August 2018. Situating the flood in the context of Kerala's state and society, this paper addresses three questions: What was the level of flood‐prevention preparedness? What were the public health effects and how were they managed? Finally, what policy lessons were learned? Drawing from reports of relevant national and state agencies responsible for disaster management as well as first‐hand accounts of nongovernmental organizations and media coverage, this paper argues that while Kerala's flood‐prevention preparedness was far from ideal, its postflood response in mounting a rapid and effective rescue and relief operation as well as in preventing a public health crisis was commendable. The paper also shows that impressive achievements in climate‐disaster health management can be achieved through a decentralized and participatory public health system in which coordinated public action is managed by a capacious state with the active collaboration of civil society. [ABSTRACT FROM AUTHOR]

Background: In the last two decades, cesarean section (CS) deliveries in India have increased by six-fold and created economic hardship for families and households. Although several schemes and policies under the National Health Mission (NHM) have reduced the inequality in the use of maternal care services in India, the distributive effect of public health subsidies on CS deliveries remains unclear. In this context, this paper examines the usage patterns of CS delivery and estimates the share of public health subsidies on CS deliveries among mothers by different background characteristics in India.Data: Data from the fourth round of the National Family Health Survey (NFHS-4) was used for the study. Out-of-pocket (OOP) payment for CS delivery was used as a dependent variable and was analyzed by level of care that is, primary (PHC, UHC, other) and secondary (government/municipal, rural hospital). Descriptive statistics, binary logistic regression, benefit incidence analysis, concentration curve and concentration index were used for the analysis.Results: A strong economic gradient was observed in the utilization of CS delivery from public health facilities. Among mothers using any public health facility, 23% from the richest quintile did not pay for CS delivery compared to 13% from the poorest quintile. The use of the public subsidy among mothers using any type of public health facility for CS delivery was pro-rich in nature; 9% in the poorest quintile, 16.1% in the poorer, 24.5% in the middle, 27.5% among richer and 23% in the richest quintile. The pattern of utilization and distribution of public subsidy was similar across the primary and secondary health facilities but the magnitude varied. The findings from the benefit-incidence analysis are supported by those obtained from the inequality analysis. The concentration index of CS was 0.124 for public health centers and 0.291 for private health centers. The extent of inequality in the use of CS delivery in public health centers was highest in the state of Mizoram (0.436), followed by Assam (0.336), and the lowest in Tamil Nadu (0.060), followed by Kerala (0.066).Conclusion: The utilization of CS services from public health centers in India is pro-rich. Periodically monitoring and evaluating of the cash incentive schemes for CS delivery and generating awareness among the poor would increase the use of CS delivery services in public health centers and reduce the inequality in CS delivery in India. [ABSTRACT FROM AUTHOR]

Background: Developing public health educational programs that provide workers prepared to adequately respond to health system challenges is an historical dilemma. In India, the focus on public health education has been mounting in recent years. The COVID-19 pandemic is a harbinger of the increasing complexities surrounding public health challenges and the overdue need to progress public health education around the world. This paper aims to explore strengths and challenges of public health educational institutions in India, and elucidate unique opportunities to emerge as a global leader in reform.Methods: To capture the landscape of public health training in India, we initiated a web-based desk review of available offerings and categorized by key descriptors and program qualities. We then undertook a series of in-depth interviews with representatives from a purposively sample of institutions and performed a qualitative SWOT analysis.Results: We found that public health education exists in many formats in India. Although Master of Public Health (MPH) and similar programs are still the most common type of public health training outside of community medicine programs, other postgraduate pathways exist including diplomas, PhDs, certificates and executive trainings. The strengths of public health education institutions include research capacities, financial accessibility, and innovation, yet there is a need to improve collaborations and harmonize training with well-defined career pathways. Growing attention to the sector, improved technologies and community engagement all hold exciting potential for public health education, while externally held misconceptions can threaten institutional efficacy and potential.Conclusions: The timely need for and attention to public health education in India present a critical juncture for meaningful reform. India may also be well-situated to contextualize and scale the types of trainings needed to address complex challenges and serve as a model for other countries and the world. [ABSTRACT FROM AUTHOR]

Introduction: In this paper, we introduce geographical information systems (GIS) as a tool to study trends in disease spread in time and space. Based on data gathered by the integrated disease surveillance programme (IDSP), we can see where outbreaks of Chickenpox have occurred. Objective: The aim of this study is to assess the trends in chickenpox diseases in India between January 2015 and April 2021 using GIS maps. Methods: For the collection of secondary data relating to chickenpox, a free app called collect 5 was used for collecting data weekly from the IDSP website and then storing them in an online server. In this project, variables that needed to be processed with QGIS were combined with table attributes of many shapefiles of India and presented as maps. Results: Between Jan 2015 and May 2021, 1269 chickenpox outbreaks (27,257 cases) have been recorded. Thirty-one deaths have been confirmed, with most occurring in Bihar and Uttar Pradesh. Nineteen states did not report any deaths. According to the seasonally adjusted trend, the number of cases was highest during the months of January and March. Conclusion: In summary, geographic information systems have become an invaluable tool for mapping the hotspots of acute epidemics and planning public health interventions to prevent the spread of these diseases. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism is an emerging public health concern, which need to be of due significance. Inspite of iodine supplementation started three decades ago, hypothyroidism is still a problem to be tackled. Apart from iodine deficiency, the contributing factors of hypothyroidism have to explored. Aim: To identify the contributing factors of hypothyroidism in adults. Materials and Methods: A systematic literature search was done using PubMed, MEDLINE, Embase, Google Scholar and the internet search from 2000 to 2018. The key words used were hypothyroidism, thyroid disorders, underactive thyroid, contributing factors, causes and associative factors. All the articles were analysed and the data were extracted using eligibility (inclusion and exclusion criteria) criteria. A total of 14 articles, which are either review articles or systematic reviews, in English language, and are fully retrievable were analysed and a systematic review was performed. Among the reviews, nine were review analysis and five were systematic reviews. The risk of bias assessment was done at the study level and data synthesis was done based on the criteria satisfied by the checklist. Results: The present analysis has included studies related to contributing factors of hypothyroidism. The analysis revealed the following contributing factors of hypothyroidism. Too little or too much iodine (43%), excess fluoride (7%), female gender (14%), presence Thyroid Per Oxidise (TPO) antibodies (36%), smoking status (14%), age above 70 years (21%), unregulated use of pesticides (14%), contaminated drinking water (14%), certain medicines (29%), use of plastic bottles contain Bisphenol A (BPA) and paper cups insulated with plastics (7%) and exposure to goitrogens (7%). Conclusion: Hypothyroidism is a leading emerging health problem in India. The prevalence is 11-15%. Despite the fact iodine fortification since 1983, hypothyroidism is a major public health to be tackled. In the current review five studies from India were included. Most of the studies showed the iodine as the contributing factor either in too much level or too little level. [ABSTRACT FROM AUTHOR]

For decades, decentralisation reforms have been seen as a powerful instrument by health policy advocates to improve health sector performance in developing countries. In India, the 73rd Constitutional Amendment introduced in 1992 called for strengthening the fiscal autonomy and service delivery capacity of rural local governments. This paper explores how decentralised governance influences public health sector resource allocation, equity and efficiency in rural Karnataka. For this, the authors analysed administrative data published by the Karnataka state government to create tailored standardised performance measures that capture the degree of local governments' fiscal discretion in implementing public health programmes from 2011-18 at the district level. The findings highlight sector-specific differences in fiscal autonomy, ranging from high local discretion over funds in the nutrition sector to very limited discretion in the medical and public health sector. They also show that decentralised public health funding is not well-targeted to areas of greatest need in Karnataka. [ABSTRACT FROM AUTHOR]

Purpose: Competency-based education and assessment are globally trending, also embraced by recently announced National education policy 2020, India. Medical programs are rapidly transforming to produce competent health professionals, to satisfy public health requirements. This paper describes Delphi study with a participatory approach, to develop a competency matrix required for training of eye care professionals.Methods: Scoping review of literature formulated the baseline architecture of competency framework identifying two core competencies for management of refractive error, namely, "visual function assessment" and "optical technology management." The Delphi technique was employed for the development of a competency matrix with detailed knowledge, skills, and attitude (KSA) definitions for all competency elements. A heterogeneous group including optometry practitioners, academicians, researchers, association representatives, and industry representatives accomplished the objective in four rounds.Results: Delphi study resulted in defining two competency clusters (CC): "CC1: Refraction" with 10 units and 43 elements and "CC2: Dispensing optics" with 8 units and 54 elements. KSA components of each of competency elements were identified and mapped with applied optics curriculum in the optometry program.Conclusion: Participation of all stakeholders of the educational system is essential and beneficial for nurturing of the competent workforce in healthcare. It helps build a curriculum not only having theoretical knowledge and skills but also the attitude and behavioral component of measurable competencies that satisfies the needs of the local healthcare system. This study has evolved a comprehensive competency matrix highlighting essential competencies required for the effective management of refractive error. [ABSTRACT FROM AUTHOR]

Background: Reduction of multidimensional poverty and tuberculosis are priority development agenda worldwide. The SDGs aims to eradicate poverty in all forms (SDG 1.2) and to end tuberculosis (SDG 3.3.2) by 2030. While poverty is increasingly being measured across multiple domains, reduction of tuberculosis has been an integral part of public health programmes. Though literature suggests a higher prevalence of tuberculosis among the economically poor, no attempt has been made to understand the association between multidimensional poverty and tuberculosis in India. The objective of this paper is to examine the association of multidimensional poverty and tuberculosis in India.Methods: The unit data from the National Family Health Survey-4, conducted in 2015-16 covering 628,900 households and 2,869,043 individuals across 36 states and union territories of India was used in the analysis. The survey collected information on the self-reported tuberculosis infection of each member of a sample household at the time of the survey. Multidimensional poverty was measured in the domains of education, health, and standard of living, with a set of 10 indicators. The prevalence of tuberculosis was estimated among the multidimensional poor and non-poor populations across the states of India. A binary logistic regression model was used to understand the association of tuberculosis and multidimensional poverty.Results: Results suggest that about 29.3% population of India was multidimensional poor and that the multidimensional poverty index was 0.128. The prevalence of tuberculosis among the multidimensional poor was 480 (95% CI: 464-496) per 100,000 population compared to 250 (95% CI: 238-262) among the multidimensional non-poor. The prevalence of tuberculosis among the multidimensional poor was the highest in the state of Kerala (1590) and the lowest in the state of Himachal Pradesh (220). Our findings suggest a significantly higher prevalence of tuberculosis among the multidimensional poor compared to the multidimensional non-poor in most of the states in India. The odds of having tuberculosis among the multidimensional poor were 1.82 times higher (95% CI, 1.73-1.90) compared to the non-poor. Age, sex, smoking, crowded living conditions, caste, religion, and place of residence are significant socio-demographic risk factors of tuberculosis.Conclusion: The prevalence of tuberculosis is significantly higher among the multidimensional poor compared to the multidimensional non-poor in India. [ABSTRACT FROM AUTHOR]

The exponential spread of Covid-19 is not only a serious concern for public health but has also severely affected the global economy. India is not an exception. The banking sector must plan innovatively in a wide range of scenarios focusing upon Covid-19 specific requirements. It becomes essential to examine the impact of Covid-19 on the performance of the Indian banking sector and take focused initiatives at both the tactical and the strategic levels. This paper offers the Covid-19 Impact on Banking Ontology (Covid19-IBO) that provides semantic information about the impact of Covid-19 on the banking sector of India. The developed ontology has been verified and validated and has been made available on the Linked Open Data cloud. It can be utilized to annotate the related data to provide meaningful insights. The Covid-19 ontologies already available have some overlapping information that causes redundancy. Unified integration of these ontologies is required to operate upon them unambiguously. It becomes reasonable to develop a matching approach to link all these ontologies semantically. We, therefore, also provide a schema matching approach with reasonable results to map the Covid-19 ontologies. [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]

The sudden upsurge in the newly emerging COVID-19 variants acted as a catalyst for India to scale up the viral Genomic surveillance in order to understand the nature and trends of the newer variants of concern and strengthen public health interventions across the country. The Government of India has proposed the Indian SARS-CoV-2 Genomics Consortium to expand the whole-genome sequencing (WGS) of this virus. However, in a vast country like India introduction and implementation of any new strategies amidst the already existing barriers due to COVID-19 will be a herculean task. This paper talks about how the primary care physicians can play a vital role in successful implementation of the above strategy in addition to the surveillance systems in India. [ABSTRACT FROM AUTHOR]

Background: The occurrence of workplace hazards, occupational diseases, and deaths contribute significantly to the increase in the global burden of diseases. The Municipal Solid Waste (MSW) workers experience occupational stressors throughout the process of waste management that affects their well-being and results in high rates of occupational health problems. It is vital to understand the workplace practices and occupational morbidities of the MSW workers to ensure their safety and well-being. In this context, the study aimed to explore the occupational health and safety practices at the place of work among the MSW workers in Karimnagar and Hyderabad in Telangana, India. Methodology: A cross-sectional study was conducted in two cities of Telangana. A total of 394 MSW workers were surveyed. The number of MSW workers in Karimnagar and Hyderabad were 152 and 194, respectively. A pre-tested questionnaire was administered to the MSW workers to study the occupational morbidities and workplace safety practices. Focused group discussions were conducted among the MSW workers in both cities. In-depth interviews of sanitary supervisors in Karimnagar were conducted. Semi-structured questionnaires and interview guides were used with questions on sociodemographic characteristics, health status, work environment, protection strategy, and healthcare utilization. MS Excel and NVivo-12 were used for data analysis. Results: Musculoskeletal problem was the major reported morbidity among the MSW workers (76.6%). Injuries were reported more among the MSW workers in Hyderabad (39.7%) along with a fear of being hit by vehicles while working on the main roads. About 88.7% of the MSW workers had less than secondary education. There was a wage difference between the contract and permanent MSW workers. There was a lack of provision of personal protective equipment and poor working conditions, overall. Lack of basic amenities such as the provision of drinking water and toilets apart from inadequate social security and healthcare facilities was reported. Conclusion: This paper highlights the unsatisfactory working environment and high-occupational morbidities among the MSW workers in Telangana. There was a lack of basic amenities at the workplace making it difficult for the MSW workers. A comprehensive approach which focuses on the health and safety with social security for the MSW workers is required. [ABSTRACT FROM AUTHOR]

Domestic violence (DV) is a serious public health concern, affecting women's health and well-being. An international governance framework, through the United Nations' Sustainable Development Goals and national policies in India have committed the country to attempt elimination of violence against women. Even so, efforts remain starkly inadequate for altering conditions under which women experience DV. This review paper aims to develop an evidence-based, integrated life cycle model to alter conditions that perpetuate DV and related vulnerabilities in society. The analyses identify and determine community-based innovative practices and policies. We propose a collaborative 'R5 model' to incorporate a multi-stage response to break the cycle of gendered vulnerability. The model identifies five stages of vulnerability in the lives of victims of violence: rescue, recovery, rehabilitation, resilience, and reform. This approach can result in promoting a proactive state-society engagement to uphold the rights and the welfare of women. We recommend the 'R5 model' to bridge the global SDG targets, national policies, and local practices. [ABSTRACT FROM AUTHOR]

The efficient and effective management of climate risks is dependent on the availability of reliable climate information and services. To make health system resilient towards the impacts of climate variability and change, climate-related data and information need to be routinely integrated into health science, practice and policy making. The present paper studies the policy congruence at international, regional, national and sub-national levels for climate services for public health, with specific focus on India; to identify the gaps in understanding and possibly suggest a roadmap for co-developing climate services for the public health sector in India. [ABSTRACT FROM AUTHOR]

Non-communicable diseases are already acknowledged as a double burden, and now childhood obesity is putting extra strain on our health system. The current paper aimed to analyze the ongoing health and related programmes/policies in India, and we discussed the existing opportunities in the programmes to address the issue of childhood obesity in India. We searched the "MEDLINE," "PsycINFO," "Scopus," "Web of Science," and "Google Scholar" databases using the following keywords: ("overweight") and ("obesity"), ("childhood obesity"), ("nutritional programmes in India"), ("Health policies in India"), ("malnourished children in India") in combination with each other and in truncated form. All the relevant articles and policy documents (MOHFW, INDIA) available in the public domain were included to support the argument for this narrative review. We found that we have programme gaps like guidelines issues by Food Safety Standards Authority of India to tackle childhood obesity and it has not been strictly implemented due to multiple reasons. School health programme has an opportunity to address the issue of childhood obesity, but at the ground level the outcomes are not very promising. The National Nutrition Mission have only focussed on undernutrition and anemia problem, ignoring the overweight/childhood obesity. Primary care physicians are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke is dealing with health promotion and prevention, early diagnosis, and management of all ages, except children. Diet provided in Integrated Child Development Scheme is calculated based on calories, not by the quality which is a concern to us. The breastfeeding promotion programme named Mothers Absolute Affection programme has not been implemented with letter and spirit. Other than health programmes, we assume that Ministry of Urban Planning, Foreign Direct Investment policy, Advertisement Council of India and many more sector/policy/programme are indirectly responsible for the increasing burden of childhood obesity in India. Lack of awareness and wrong perception also responsible for the development of childhood obesity. We have multiple National Health Programmes and Policies to address the childhood malnutrition, but are focussing the undernutrition component only, ignoring overnutrition problem in the children, which is emerging as quadruple burden to our health system. Appropriate actions and inclusion of suggestions provided in this study for the improvement of the programmes at the practical level needs to be considered by the policy makers to halt the ever-rising trend of childhood obesity and primary care physicians should play a leadership role. [ABSTRACT FROM AUTHOR]

Several digital contact tracing smartphone applications have been developed worldwide in the effort to combat COVID-19 that warn users of potential exposure to infectious patients and generate big data that helps in early identification of hotspots, complementing the manual tracing operations. In most democracies, concerns over a breach in data privacy have resulted in severe opposition toward their mandatory adoption. This paper examines India as a noticeable exception, where the compulsory installation of such a government-backed application, the "Aarogya Setu" has been deemed mandatory in certain situations. We argue that the mandatory app requirement constitutes a legitimate public health intervention during a public health emergency. [ABSTRACT FROM AUTHOR]

Existing literature demonstrates agro-chemicals result in physical toxicity and damages human health, flora and fauna. However, little is known about how such ‘toxicity’ relates to mental well-being and social suffering. This paper aims to demonstrate how local, national and international vectors are interlinked to shape social distress among cotton farmers in India. Ethnographic interviews and focus group discussions were conducted in a cotton-growing village of the Warangal district, Telangana state, India. The results advance the concept of counter therapeutic spaces and hypothesise that toxic landscapes emerge through a dynamic interaction between dispersed agencies that interact and reconfigure agricultural spaces into socially toxic places. The paper argues that the disciplines of public health and agriculture suffer from a failure of imagination to forge vital interdisciplinary links that could address farmer suffering. Unpacking local ecologies of farmer suffering offer innovative ways for enhancing mental health policy and interventions in India. [ABSTRACT FROM AUTHOR]

Global health diplomacy has gained significant importance and undoubtedly remained high on the agendas of many nations, regional and global platforms amid the coronavirus disease 2019 (COVID-19) pandemic. Many countries have realized the importance of the health sector and the value of a healthy workforce. However, there is little control on issues related to trade that impact on human health due to the dominance of profit-oriented business lobbies. A balance, however, needs to be struck between economic profits and a healthy global population. This paper aimed to highlight the importance of building capacity in global health diplomacy, especially during the COVID-19 pandemic so that health personnel may effectively negotiate on the multisectoral stage to secure the resources they need. The recent proposal to waive off certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement for the prevention, containment and treatment of COVID-19 by India and South Africa at the World Trade Organization (WTO) presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access at the international level so that both developed and developing nations may enjoy improved health outcomes related to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: In a country with a high demand for contraception such as India, one of the most common methods is surgical sterilization, which is delivered by two approaches namely the camp approach and the fixed day static approach. The quality of services for sterilization in India for both the approaches has remained questionable. Objectives: This paper seeks to determine the quality of sterilization services at fixed day static centers of Madhya Pradesh. Methods: It was a descriptive observational study done between September 2017-December 2017 in 10 districts of Madhya Pradesh. One District Hospital and 2 Community Health Centers were randomly chosen from each district. The study was carried out using a prestructured, pretested, and prevalidated tool which used the Ona Platform. Results: Two of the facilities conducted more than 30 operations on the day of the visit. In only 18.3% of the cases was the patient informed about all contraception options. The duration between the start of surgery and the signing of consent was less than 2 h in 42% of the patients. The surgical protocol for proper surgical wear was not followed in most cases. Conclusion: The quality of care of sterilization services was found to be substandard in the fixed day static centers. The guidelines for the sterilization services were not being followed, and follow up of the patients was also neglected. Better training of the staff with strict and timely supervision is required for the better quality provision at the fixed day static centers. [ABSTRACT FROM AUTHOR]

Female sterilization is the most popular contraceptive method among Indian couples, and the public sector is the major source of sterilization services in the country. However, concerns remain on the quality of services provided, deaths, failures, and complications following sterilization. In this paper, we study the complexities around the quality of care in female sterilization services at public health facilities and identify strategies for improving the measurement of such quality. A better understanding of these issues could inform pragmatic strategies for enhancing quality. This study uses data from the National Family Health Survey (NFHS) 2015–16 and District Level Household and Facility Survey (DLHS) 2012–13. The study is limited to only districts whose data are available in both DLHS 2012–13 and NFHS 2015–16. The methods of analysis include bivariate statistics, Pearson's chi-square test, and two-level mixed-effects logistic regression. We found that the quality of care (QoC) in sterilization service at the public health facilities in India is associated with facility readiness and the socio-economic characteristics of the clients. There is a significant association between household wealth and the QoC received. Our study provides empirical shreds of evidence on the role of structural attributes in delivering quality sterilization services. The spatial analyses revealed the geographies in the country where the QoC and facility readiness are low. Quality should be an overriding priority to establish the credibility of any health care delivery system. It is essential to provide safeguards against adverse events to develop the client's confidence in the services, which is the key to success for any voluntary family planning program like in India. [ABSTRACT FROM AUTHOR]

This paper engages critically with the global assemblage framing sickle cell and thalassaemia disorders as a ‘global health crisis’; and the promise of genomics, largely DNA-based carrier/pre-conceptual screening, prenatal diagnosis with a view to terminations, deployed in framing a solution to these historically racialised spectrum of diseases as essentially preventable. Sickle cell and thalassaemia are recessively inherited, potentially life-threatening haemoglobin disorders with significant variation of severity, often needing life-long treatment. I argue that the re-classification of inherited blood disorders (IBDs) under ‘prevention and management of birth defects’ by the WHO in 2010 can be read as an ethical moment within the ‘globalising turn’ of IBDs and the use of genomics in addressing structural inequalities underpinning health in low- and middle-income countries. Using an Indian case study, the paper aims at first examining the language of risk through which genes and IBDs are mapped onto pre-existing populations (e.g. caste and tribe) as discrete, categories. Second, it discusses the likely social and ethical ramifications of classifying these recessive gene disorders as essentially preventable, despite cheaply available diagnostic tests and treatment options available in most countries in the South. [ABSTRACT FROM AUTHOR]

Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home. [ABSTRACT FROM AUTHOR]

The present paper reviewed studies on cancer patients in India, with the aim of identifying a) the nature and content of illness representations among Indian cancer patients and b) Coping approaches in the same population c) the role of distress in the relationship of illness representation and coping. 14 papers were included in the present review. The inclusion criteria were, studies must examine illness perceptions, stress/distress and coping among adult cancer patients and it should be empirical based on sample from India. Studies dealing with drugs or biological measures, reviews, meta-analysis, cancer in children and adolescents, and primary care giver were excluded from this review. Except time line, all dimensions of illness cognitions were dealt with. Identity of the illness overlapped with its causality. Most of the patients were found to be unaware of their diagnosis as well as prognosis. Avoidance and denial coping was prominent among Indian cancer patients. Role of distress could not be determined on the basis of the present group of researches, yet it can be suggested that, distress acts as a moderator between illness cognitions and coping because perception of distress will determine the coping strategies to be selected. Number of studies in the area under review is very less in India. The genesis of the CSM lies in the fact that patient should be aware of diagnosis, i.e. the identity. How will the stages interpretation, coping and appraisal of CSM commence unless and until there is any label attached to the disease? [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]

Abortion service provision has changed noticeably in the recent past and medication abortion currently accounts for four-fifths of all induced abortions taking place in India. How these changes have modified abortion experiences among young women - a group known to be more disadvantaged than adult women - remains unanswered. This paper fills this gap and examines the experiences of married young abortion seekers, including pre-abortion decision-making, abortion seeking and experiences of the procedure, and post-abortion complications. Data were drawn from a community-based survey of 4952 married young women aged 15-24 years conducted in Uttar Pradesh and Rajasthan in 2015. The study focused on 166 young women who had an induced abortion in the two years before the survey, and used descriptive statistics to describe their abortion experiences. Seventy-four per cent of abortion seekers had relied on medication abortion and 47% had obtained it over the counter without a physician's prescription. Moreover, 90% accessed abortion services from private facilities, including drug sellers. A small proportion (4%) had undergone abortion in the second trimester of pregnancy. At the same time, 13% reported multiple abortion attempts; 17% underwent dilation and curettage; and 52% experienced self-reported complications, including 5% who experienced moderate to severe complications. The findings call for greater attention to providing contraceptive counselling and services to married young women, ensuring abortion services in public health facilities and exploring mechanisms to improve drug sellers' knowledge and practices in providing medication abortion. [ABSTRACT FROM AUTHOR]

Civil society engagement around health care and population health improvement is an important driver towards Health for All. Research can improve the effectiveness of health activism by examining the resources, structures and strategies of civil society engagement. However, research to support such engagement faces epistemological and methodological challenges which call for specific research strategies. A four year multi-country study was undertaken by the People's Health Movement, a global network working for health for all. The research took place in six countries (Brazil, Colombia, DR Congo, India, Italy, South Africa) and globally, and was directed to understanding five domains of civil society engagement: movement building; campaigning and advocacy; capacity building; knowledge generation, access and use; and engaging with governance. The research plan and methods of data collection and analysis were tailored to address the objective of improving activist practice, while negotiating research challenges identified during the design phase. Results include insights into the practice of civil society engagement in relation to the five domains of activist practice, as well as experience gained in managing six methodological challenges which we describe as: making meaning, aligning research and action, managing power relations, valuing experiential knowledges, chaos and contingency, challenging preconceptions. Researching activism can produce useful insights into practice as well as support continuous improvement in the effectiveness of such activism. However, there are significant methodological challenges that can be addressed through appropriate strategies. More research, building on the approach described in this paper, can contribute to more effective civil society activism for health. [ABSTRACT FROM AUTHOR]

The public health laws are passing through a process churning in the COVID-19 pandemic in India. The effectiveness of quarantine law under 160 years old Indian Penal Code, 1860, and 123 years old Epidemic Diseases Act, 1897 proved short-lived euphoria in controlling horrendous COVID-19 pandemic. The nation-wide Lockdowns on the ground of Sections 6, 10, 38, and 72 of the Disaster Management Act, 2005, provided significant assistance in dealing with formidable challenges of COVID-19. The execution of these laws revealed the safety and security of public health professionals and the delivery system to high vulnerability. Therefore, the President of India promulgated the Epidemic Diseases (Amendment) Ordinance, 2020 declaring 'act of violence' cognizable and non-bailable with high deterrent value. The paper explores the range of normative choices in refurbishing the public health laws beyond the command and control approach evidenced in Epidemic Diseases (Amendment) Ordinance, 2020, to therapeutic perception public health and equity in India. [ABSTRACT FROM AUTHOR]

The concept of 'one health' recognizes that there is an inextricable link between the health of people, animals, and the shared environment. With the rapid growth in population and the destruction of natural habitats, humans are coming into closer contact with wild and domesticated animals. This, in turn, creates ripe conditions for the movement of viruses and diseases between animals and people. The world is seeing frequent occurrences of epidemics caused by new pathogens, to which humans have little immunity, owing to this phenomenon. 'One Health' assumes global significance today when the world is in the grip of the COVID-19 pandemic. The response of the state of Kerala to the COVID-19 crisis is guided by its prior experience with curbing the Nipah virus epidemic in 2018. The same core philosophy of 'one health' that was at the heart of the campaign to rein in the Nipah outbreak has spearheaded the state response to the COVID-19 pandemic. A review of available literature in Pubmed/Medline & Google scholar databases was carried out to study the impact of 'one health' on the epidemic response of Kerala state to the Nipah virus, and how it has been extrapolated in managing the current COVID-19 pandemic. The articles obtained were screened by title, abstract and full text to obtain the most relevant papers. Recommendations have also been proposed regarding the incorporation of 'one health' in public health strategy. [ABSTRACT FROM AUTHOR]