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Reforms in undergraduate engineering curriculum to produce engineers with entrepreneurial skills should address real-world problems relevant to industry and society with active industry support. Technology-assisted, hands-on projects involving experimentation, design simulation and prototyping will transform graduates into professionals with necessary skills to create and advance knowledge that meets global standards. To achieve this goal, this paper proposes establishing a central facility, "Centre for Engineering Experimentation and Design Simulation" (CEEDS) in autonomous engineering colleges in India. The centre will be equipped with the most recent technology resources and computational facilities where students execute novel interdisciplinary product-oriented projects benefiting both industry and society. Students undertake two projects: a short-term project aimed at an engineering solution to a problem in energy, health and environment and the other a major industry-supported project devoted to a product that enhances innovation and creativity. The paper presents the current status, the theoretical and pedagogical foundation for the centre's relevance, an activity plan and its implementation in the centre for product-based learning with illustrative examples.

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]

Background: The total number of people with HIV (Human Immunodeficiency Virus) infection in India is estimated to be 10% of all global cases. People living with HIV in India often experience discrimination while receiving health care due to inadequate knowledge and fear among health care professionals. Data presented in this paper represents the first phase of a six-year study being conducted at a Medical College in Mumbai, India. Information from this phase of the study will be used to demonstrate the need for an HIV-specific training module for the first year medical students. Methods: A cross-sectional study was conducted among 200 first-year medical students in Mumbai, India to assess knowledge and attitudes as they relate to HIV infection. A self-administered survey was distributed among the medical students at a medical college in Mumbai. The survey sought student responses pertaining to knowledge of HIV risk and transmission, and attitudes towards HIV-infected people. Results: A response rate of 87% was obtained (174 out of 200). Overall, females showed less knowledge pertaining to issues related to human sexuality and HIV transmission when compared to their male peers. Anal intercourse was reported as a risk for HIV transmission by 3% of females as compared to 20% of males (p less than 0.05). Furthermore, 28% of females reported no relationship between the risk of contracting HIV and the type of sexual intercourse compared to 3% of males (p less than 0.05). In general, there were considerable misconceptions regarding the spread and risk of HIV transmission among all medical students. Sixty six percent (66%) of females were comfortable having HIV infected doctors and nurses (co-workers) in clinics and hospitals compared to 36% of males. Forty-four percent (44%) of the medical students preferred not being friends with HIV infected individuals. Sixty-two (62%) percent of the students favored abstinence only messages for prevention of HIV among teenagers. Discussion: Knowledge regarding risk and routes of HIV transmission was lacking among the medical students. Attitudes of the students toward HIV-infected individuals could be best described as ambivalent. However, female students showed more positive attitude towards HIV infected people than their male peers. Conclusions: Based on our findings we recommend the development and integration of a HIV training module in the first year medical curricula in order to address gaps in knowledge and provide training for the development of positive altitudes and tolerance toward HIV infected people. (Contains 2 tables.)

Multinational corporations bring both economic opportunities and technological hazards to developing countries. Discusses the trade-offs between the profit and development objectives and the environmental, health, and safety objectives as seen in three case studies involving Occidental Chemical and Du Pont corporations in Thailand, and Xerox Corporation in India. (MDH)

Although it is well known that vaccines against many infectious diseases confer positive economic externalities via indirect protection, analysts have typically ignored possible herd protection effects in policy analyses of vaccination programs. Despite a growing literature on the economic theory of vaccine externalities and several innovative mathematical modeling approaches, there have been almost no empirical applications. The first objective of the paper is to develop a transparent, accessible economic framework for assessing the private and social economic benefits of vaccination. We also describe how stated preference studies (for example, contingent valuation and choice modeling) can be useful sources of economic data for this analytic framework. We demonstrate socially optimal policies using a graphical approach, starting with a standard textbook depiction of Pigouvian subsidies applied to herd protection from vaccination programs. We also describe nonstandard depictions that highlight some counterintuitive implications of herd protection that we feel are not commonly understood in the applied policy literature. We illustrate the approach using economic and epidemiological data from two neighborhoods in Kolkata, India. We use recently published epidemiological data on the indirect effects of cholera vaccination in Matlab, Bangladesh (Ali et al., 2005) for fitting a simple mathematical model of how protection changes with vaccine coverage. We use new data on costs and private demand for cholera vaccines in Kolkata, India, and approximate the optimal Pigouvian subsidy. We find that if the optimal subsidy is unknown, selling vaccines at full marginal cost may, under some circumstances, be a preferable second-best option to providing them for free. (Contains 14 footnotes, 2 tables, and 8 figures.)

The critical importance of the early childhood years and the rights perspective to human development has made policy and programming for early childhood development an imperative for every nation. In India, poverty, changing economic and social structures resulting in the breakdown of traditional coping mechanisms and family care systems, and the disparity between the rich and the poor place a large number of children "at risk". Early childhood interventions become a pre-requisite in such contexts to mitigate the effects of deprivation and disadvantage and improve life chances, particularly of children from underprivileged and marginalized environments. The present paper uses documentary analysis and literature review to trace the evolution of early childhood development policy and programming in India, describes changing perspectives in planning and, after a critical analyses of the situation of children and programming for children in the country, discusses paradigm shifts that need to be made as the way forward to ensure the well-being of the young child in India. In keeping with international developments, the approach towards planning strategies related to Early Childhood Development (ECD) in India has, over the years, evolved from "Welfare" to "Development" to "Rights". The Constitution of India and the UN Convention on the Rights of the Child (UNCRC) have been the guideposts for planning but achieving synergy across varied sectors catering to different facets of the child's development has remained elusive. This is reflected in the poor mortality, morbidity and education indicators with respect to the young child. A major reason for this stems from the ambivalent status of ECD in India--while national documents recognize it as the foundation for all other initiatives, these are not backed by resource allocation and political will to provide quality ECD for all. The country's planning processes need to make paradigm shifts in child development strategies and policies to lead to re-designing of interventions. (Contains 3 footnotes.)

The Integrated Child Development Services (ICDS) program was designed to promote the fundamental rights of young children in India. This paper assesses its effects on the survival, development, and education of young children in India by considering the results of two national level evaluation studies. Their findings indicate that the ICDS has played a significant role in improving the survival rate, health and nutritional status, and educational outcomes of children. The ICDS population had a lower infant mortality rate and a better nutrition status than the general child population, which provides further evidence of the efficacy of the program. However, the preschool education component has been faulted and reasons for this are discussed.

Purpose: To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC) 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously.Methods: A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to "match" the AIOC free-paper with the published paper. In addition, the "purpose," "methods," and "outcome measures" between the two were studied to determine the "match."Results: A total of 58 out of 394 free-papers (14.7%) from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90%) were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50%) followed by glaucoma (24.4%) and cornea (23.8%). Fifteen out of 272 posters (5.5%) were published; orbit/oculoplastics had the highest poster publications (13%). Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%.Conclusion: The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country. [ABSTRACT FROM AUTHOR]

Indian cities are growing rapidly due to natural increase and migration from rural areas. This has caused huge pollution problems and has resulted in overcrowded schools and hospitals. Conflict between religious groups has increased; so has crime. India is modernizing, but not fast enough. (CS)

Discusses job training and safety training in the nuclear power and chemical manufacturing industries. Examines the toxic gas leak at Bhopal (India), the Three Mile Island incident, training requirements, government regulation versus self-regulation, and the concern for the public's safety and health. (CT)

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]

Background: The Knowledge Network project was launched in 2010 to build evidence on the HIV epidemic by using the data generated by HIV programme implementing organisations in India. This paper describes the implementation of the programme and the strategies adopted to enhance the capacity of individuals to document and publish HIV prevention programme learnings. Further, it discusses the outcomes of the initiative.Methods: A multipronged approach was adopted, where a group of experts were brought together to collaborate with programme implementing organisations, review available data, develop research questions and guide peer-reviewed publications. Further, scientific writing courses were conducted to support individuals from HIV programme implementing organisations as well as educational and government organisations (mentees) to build the documentation capacity of individuals leading programme implementation and current and future researchers. The impact and quality of evidence generated was measured by examining the number of papers published, the number of citations, and the number of papers with at least 10 citations. Additionally, course participants' responses to open-ended questions in the anonymous course evaluation questionnaires are presented as verbatim quotes.Results: Overall, 99 papers on HIV programmatic learnings from India were finalised under the programme, of which 95 have been published. In all, 67 papers were co-authored by mentees. Most papers were published in high-impact factor (1 or more) journals and 72% were cited at least once in the literature. The main themes documented include key populations' HIV risk, HIV risk of general population groups, HIV/STI service delivery models and community mobilisation interventions.Conclusion: The study demonstrates that an integrated approach, involving partnership, capacity-building and mentorship, can maximise the use of available data and build the evidence base on HIV programmatic learnings. The capacity-building model adopted in the programme can be used to build scientific writing and documentation capacity in other public health programmes that are implemented at scale. [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]

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]

Evidence-informed policymaking integrates the best available evidence on programme outcomes to guide decisions at all stages of the policy process and its importance becomes more pronounced in resource-constrained settings. In this paper, we have reviewed the use of systematic review evidence in framing National Health Programme (NHP) guidelines in India. We searched official websites of the different NHPs, linked to the main website of the Ministry of Health and Family Welfare (MoHFW), in December 2020 and January 2021. NHP guideline documents with systematic review evidence were identified and information on the use of this evidence was extracted. We classified the identified systematic review evidence according to its use in the guideline documents and analysed the data to provide information on the different factors and patterns linked to the use of systematic review evidence in these documents. Systematic reviews were mostly visible in guideline documents addressing maternal and newborn health, communicable diseases and immunization. These systematic reviews were cited in the guidelines to justify the need for action, to justify recommendations for action and opportunities for local adaptation, and to highlight implementation challenges and justify implementation strategies. Guideline documents addressing implementation cited systematic reviews about the problems and policy options more often than citing systematic reviews about implementation. Systematic reviews were linked directly to support statements in few guideline documents, and sometimes the reviews were not appropriately cited. Most of the systematic reviews providing information on the nature and scale of the policy problem included Indian data. It was seen that since 2014, India has been increasingly using systematic review evidence for public health policymaking, particularly for some of its high-priority NHPs. This complements the increasing investment in research synthesis centres and procedures to support evidence-informed decision making, demonstrating the continued evolution of India's evidence policy system. [ABSTRACT FROM AUTHOR]

The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacitybuilding measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country. [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]

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]

Trickle-down has been addressed, so far, using income-based measures of inequality and poverty. However concerns over the inequality in access to other dimensions important for quality of life remains. I revisit trickle-down using the Alkire and Foster (J Public Econ 95(7-8), 2011) class of measures to estimate multidimensional poverty in India. Using NSS data estimates are presented for the 16 major states and are compared to income-based measures. Adding dimensions in poverty measurement results in the reversal of several income-based conclusions about poverty across regions. The paper also finds that contrary to income-based findings, Muslims are less poor than Hindus under the multidimensional criteria. [ABSTRACT FROM AUTHOR]

In recent years, community health governance structures have been established in many low and middle-income countries (LMICs) as part of decentralization policies aimed at strengthening primary healthcare systems. So far, most studies on these local structures either focus on measuring their impact on health outcome or on identifying the factors that affect their performance. In this paper we offer an alternative contribution that draws on a sociological interpretation of community health governance to improve understanding of how the government's policy vision and instrumentation translate to interactions that take place within local spaces at field level. We study 13 Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, India, from 2016 to 2018 focusing on sanitation, nutrition and hygiene which remain impediments to improving primary healthcare amongst poor and marginalized communities. Three local governance mechanisms of horizontal coordination, demand for accountability and self-help help to explain improvements that have taken place at village level and contribute to the creation of a new theory of community health governance as evolving phenomenon that requires a constant process of learning from the field to strengthen policymaking. [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]

Aim: The purpose of this study is to highlight the ethical, health, and technical concerns around manual scavenging in urban India. Subject and methods: As a country, India is passing through a transitional phase of urban development, with concepts of Smart Cities and Resilient Cities taking center stage on the urban development discourse. But the country is lagging in managing crucial indicators of social and human progress within a city, especially on issues of proper sewage and sanitation facilities. In view of this light, the horrendous practice of manual scavenging has been declared an illegal profession by Indian laws; however, the profession is still rampant, even in urban areas such as Delhi and Bengaluru. Thus, this paper discusses the ethical and health implications of this practice and simultaneously reviews the technologies being implemented in several countries. Additionally, an analysis is carried out on grave issues; for instance, the number of workers engaged in such practices and their death cases in recent years. Lastly, this study presents new thinking and approaches of technological advancement that could bring an end to this rather unethical practice. Results: The review paper shows that, although the field of manual scavenging has been highly mechanized in many countries, India is yet to find a permanent solution that separates human beings from manually cleaning sewers. Conclusion: This paper brings forth a combination of measures that are legislative and technical in nature, including societal awareness, to eradicate manual scavenging in Indian cities. [ABSTRACT FROM AUTHOR]

Purpose: Fear of crime is an emerging social problem in Indian society that has a significant impact on the quality of life of the elderly. In the view of this fact, the purpose of this paper is to examine the factors such as (prior victimisation, vulnerability and incivility) which contribute their role in bringing fear of crime among the elderly. Design/methodology/approach: Mixed method approach has been applied in this paper. This study has been designed as an exploratory lead-in to a planned wider study into rural–urban context as possible factors in shaping the victimisation experience. The study has been conducted from October 2012 to January 2013 on a sample of 220 elderly living in both rural and urban areas of Lucknow in the state of Uttar Pradesh, India. Findings: The study found that elderly have been victimised by known persons as compared to unknown persons. Further, the study found that immediate neighbourhood was swarming with loiters, unruly teenagers, gangs, beggars and alcoholic people walk in the society which have significantly impact on the elderly and give threat in neighbourhood. Originality/value: This is an original work of researcher. [ABSTRACT FROM AUTHOR]

Over 70 per cent of India's surface water is polluted by human excreta and other waste and less than 35 per cent of urban wastewater is treated. This poses a severe risk to public and environmental health. Urban waterbody rejuvenation in India often focuses on aesthetic improvements rather than addressing its systemic interdependencies with sanitation. This paper establishes these systemic links through a mixed-methods study using water-quality testing and stakeholder interviews in the city of Bengaluru, India. A conceptual system dynamics model of technical, social, institutional and environmental factors is developed. Results show that sewage leaks into lakes via stormwater drains are a major pollution pathway, among others. Three system levers for positive change have been identified: coordination of government entities, adequate faecal sludge management and strong citizen involvement. Citywide inclusive sanitation (CWIS) is proposed as an approach to provide leverage and solve the intertwined issues of public and environmental health. [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: 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]

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]

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 present pilot study was conducted to investigate the effectiveness and efficiency gains in collect outpatient health information from primary health centres and health sub centres through mobile applications for detecting disease outbreaks in near-real-time. The researchers were also interested in evaluating the difficulties in implementing mobile health technology with health workers of lesser technical experience in electronically submitting patient data. "Evaluating a Real Time Biosurveillance Program: A pilot project" was conducted in Thiruppathur block of Sivaganga district in southern rural Tamil Nadu in India from July 2008 to July 2010. During the first year, the researchers and technicians interacted with the health workers to develop the technology. Thereafter, digital data submission using the mHealthSurvey, from the 28 rural health care centres, began in June 2009. The digitized data was analysed for unusual patterns using the TCWI (T-Cube Web Interface). Adverse events detected through TCWI were disseminated via SMS, Email, and Web with the Sahana Alerting Broker web-based software. Averages of 217 health records were collected each day for detection of adverse epidemiological events. A major advantage of the mobile phone patient data collection method was the improved timeliness for real-time detection of any disease outbreak. Besides the delays of digitizing data because of the parallel routine labor intensive paper work, the health workers in Tamil Nadu were able to submit reliable patient health data using mobile phone, which makes it a friendly, efficient, and cost effective tool of data collection. [ABSTRACT FROM AUTHOR]

Purpose Recently, the Indian government launched health insurance schemes for the poor both to protect them from high health spending and to improve access to high-quality health services. This article aims to review the potentials of health insurance interventions in order to improve access to quality care in India based on experiences of community health insurance schemes. Data sources PubMed, Ovid MEDLINE (R), All EBM Reviews, CSA Sociological Abstracts, CSA Social Service Abstracts, EconLit, Science Direct, the ISI Web of Knowledge, Social Science Research Network and databases of research centers were searched up to September 2010. An Internet search was executed. Study selection One thousand hundred and thirty-three papers were assessed for inclusion and exclusion criteria. Twenty-five papers were selected providing information on eight schemes. Data extraction A realist review was performed using Hirschman's exit-voice theory: mechanisms to improve exit strategies (financial assets and infrastructure) and strengthen patient's long voice route (quality management) and short voice route (patient pressure). Results of data synthesis All schemes use a mix of measures to improve exit strategies and the long voice route. Most mechanisms are not effective in reality. Schemes that focus on the patients’ bargaining position at the patient-provider interface seem to improve access to quality care. Conclusion Top-down health insurance interventions with focus on exit strategies will not work out fully in the Indian context. Government must actively facilitate the potential of CHI schemes to emancipate the target group so that they may transform from mere passive beneficiaries into active participants in their health. [ABSTRACT FROM PUBLISHER]

Since the 1990s, community-based health insurance (CBHI) schemes have been proposed to reduce the financial consequences of illness and enhance access to healthcare in developing countries. Convincing evidence on the ability of such schemes to meet their objectives is scarce. This paper uses randomized control trials conducted in rural Uttar Pradesh and Bihar (India) to evaluate the effects of three CBHI schemes on healthcare utilization and expenditure. We find that the schemes have no effect on these outcomes. The results suggest that CBHI schemes of the type examined in this paper are unlikely to have a substantial impact on access and financial protection in developing countries. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Urban sanitation in India faces many challenges. Nearly 60 million people in urban areas lack access to improved sanitation arrangements, and more than two-thirds of wastewater is let out untreated into the environment, polluting land and water bodies. To respond to these environmental and public health challenges, urban India will need to address the full cycle of sanitation, i.e. universal access to toilets, with safe collection, conveyance and treatment of human excreta. This paper outlines these concerns, and highlights the need for focusing on access to water and the full cycle of sanitation for the urban poor, as fundamental to addressing the sanitation challenge. Priorities for policy and financing for urban sanitation in India are discussed, and the paper concludes with an examination of key policy initiatives in the last decade, assessing the extent to which these priorities are gaining attention. [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]

Objective: Despite several government initiatives aimed at improving public healthcare services, private-sector has been a dominant player in most of the Indian states. Limited evidence is available on the factors that influence the choice of using public or private health services, which assume significance in the present context, when the government is willing to purchase care from the private providers. This subject is further explored in the paper by using the 71st round of National Sample Survey, 'Key Indicators of Social consumption in India Health', 2014. Data sources/study setting: The analysis included 15 major states of India, dividing them into three groups: low-, middle- and high-income, using average GSDP per capita. We further used multi-variate regression to examine the factors explaining the utilization of either public or private facility. Findings and conclusion: The utilization of public facilities for outpatient and inpatient services was found to be very low, except Assam and Odisha, which attributed to the poor quality of care and long waiting hours. Caste, education and wealth quintiles were the main factors explaining the choice of either public or private facility and strength of association between socio-economic variables and their utilization that varied across 3-categories of states. [ABSTRACT FROM AUTHOR]

The outbreak of novel and recent coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has made an emergency throughout the world. In India, the outspread of the pandemic was observed on 3 March 2020, and after that exponential growth in the cases was observed in the country. Owing to the widespread transmission, high population density, high testing capacity and ineffective treatment, a continuous rise in cases was observed due to the pandemic in India. In this paper, we have discussed the trend and spread of COVID-19 spread in India with time, history of initial confirmed cases, the impact of phased manner lockdown, age- and gender-wise trend of cases and comparison of cases with the other most affected countries. The study uses exploratory data analysis to describe the current situation of COVID-19 cases in India till 16 August 2020, with the help of data from the Ministry of Health and Family Welfare, Government of India (GOI) and the World Health Organization (WHO). As of August 16, the total number of confirmed cases in India crossed 2.5 million marks with over 50,000 causalities. With more patients recovering and being discharged from hospitals and home isolation (in case of mild and moderate cases), the total recoveries have crossed the 1.8 million mark with a recovery rate of more than 70% and case fatality rate of 1.94% which is maintained below the global average and is on a continuous positive slide. The study also enlightens the preventive and stringent measures taken by India to combat the COVID-19 situation along with the future prospects. The GOI is following its proactive and preemptive approach for management, prevention and containment of COVID-19 in collaboration with the WHO. [ABSTRACT FROM AUTHOR]

Introduction: Road traffic accident (RTA) is one of the major preventable public health problems and is on the rise which can be attributed to increase in the number of vehicles and lifestyle changes and risky attitudes. This paper is intended to search for available published information which in turn might help the policy makers as well as practitioners to make use of it. Methods: The information has been gathered from papers related to RTAs from various databases such as PubMed, Google scholar, government websites to get an overview in India for the last 15 years. Result and Conclusion: The burden of RTA was found to be considerably high globally as well as in India. RTA causes a number of effects which can be: economical, physical, psychological and social. The burden of RTA is on the rise which makes it necessary to take a multi-sectoral approach in its prevention and control [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]

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]

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: The Theory of Change (ToC) is a management and evaluation tool supporting critical thinking in the design, implementation and evaluation of development programmes. We document the experience of Future Health Systems (FHS) Consortium research teams in Bangladesh, India and Uganda with using ToC. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening.Methods: This paper combines literature on ToC, with a summary of reflections by FHS research members on the motivation, development, revision and use of the ToC, as well as on the benefits and challenges of the process. We describe three FHS teams' experiences along four potential uses of ToCs, namely planning, communication, learning and accountability.Results: The three teams developed ToCs for planning and evaluation purposes as required for their initial plans for FHS in 2011 and revised them half-way through the project, based on assumptions informed by and adjusted through the teams' experiences during the previous 2 years of implementation. All teams found that the revised ToCs and their accompanying narratives recognised greater feedback among intervention components and among key stakeholders. The ToC development and revision fostered channels for both internal and external communication, among research team members and with key stakeholders, respectively. The process of revising the ToCs challenged the teams' initial assumptions based on new evidence and experience. In contrast, the ToCs were only minimally used for accountability purposes.Conclusions: The ToC development and revision process helped FHS research teams, and occasionally key local stakeholders, to reflect on and make their assumptions and mental models about their respective interventions explicit. Other projects using the ToC should allow time for revising and reflecting upon the ToCs, to recognise and document the adaptive nature of health systems, and to foster the time, space and flexibility that health systems strengthening programmes must have to learn from implementation and stakeholder engagement. [ABSTRACT FROM AUTHOR]

Malnutrition and related health complexities are creating a plethora of challenges to human development. The context of India is not an exception for the multifaceted impacts of malnutrition. The policy frameworks and program based interventions in India had given enough attention to address the issues of nutrition in a pragmatic manner. The question that arises here is whether these policies and programs budgeted appropriately or not? The policies itself won't be materialized as action unless enough resources are allocated. In this context, the present paper focuses on analyzing the efforts of the Union governments to address health and nutritional problems of children. The paper further look into the nutrition-specific as well as nutrition-sensitive interventions by examining the budget outlays and implementation of interventions for improving nutrition. The available secondary database was significantly utilized as the source of information for this study. The reflections from the analysis indicate some of the unpromising trends. Although the allocation of National Health Mission (NHM), which is the core scheme for health-related interventions, has increased by 9.5 percent it constitutes only one percent of total union budget. The budget allocation for ICDS has not increased significantly in accordance with the time and needs. The budget for the important components of NHM, the Reproductive and child health (RCH), is also declining. Therefore ministries need to come together and try to focus nutrition specific and sensitive schemes for the nutrition of children. [ABSTRACT FROM AUTHOR]