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Aim: The coronavirus disease 2019 (COVID‐19) pandemic affected cancer service delivery and the feasibility of following the standard treatment guidelines. The present paper describes the use of clinical care guidelines for cancer management in routine practice and the approach adopted towards cancer care during the COVID‐19 pandemic in India. Methods: A web‐based survey was done in 107 hospitals (including public and private health facilities) that hosted Hospital‐Based Cancer Registries under the National Cancer Registry Programme. The participants comprised Principal Investigators of these registries, who were also medical, surgical, and radiation oncology clinicians. The survey was done between May 1, 2021, and July 31, 2021. Participants were provided with a web link for the survey questionnaire, confidential login, and password. Results: The study found high utilization of Clinical Practice Guidelines (CPGs) during practice, with eight out of ten physicians constantly to referring them. The study reported lack of knowledge, skills, and training to administer the treatment based on the guidelines followed by organizational infrastructure and affordability of treatment by the patients as the factors hampering utilization. International clinical guidelines were preferred when compared to national guidelines. The COVID‐19 pandemic decreased the use of CPGs, wherein six out of ten clinicians reported their use. Conclusion: Stakeholders who formulate clinical guidelines must consider the practical aspects and feasibility of implementing such guidelines during a pandemic and similar situations. This should be coupled with adequate changes in care practice to ensure optimal care delivery and a continuum of cancer care in routine and pandemic‐imposed situations. [ABSTRACT FROM AUTHOR]

Essential medicines or drugs are recognized as highly cost-effective components within contemporary healthcare, demonstrating significant potential for improving health outcomes. The provision of essential medicines directly impacts the functioning of healthcare facilities, resulting in financial hardship. This review aims to fill knowledge gaps by examining obstacles hindering access and utilization of essential medicines in India. This study conducted a comprehensive evidence synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to analyse articles on the availability and utilization of essential medicines in India. The search strategy included various databases and keywords. Published, peer-reviewed articles focusing on the National/State List of Essential Medicines and meeting specific criteria were considered. Data items included essential medicines, drug availability, utilization, and challenges. Data was extracted, synthesized, and analysed using thematic framework analysis. Out of 1,129 articles, 11 were selected for review. Studies consistently highlighted the inadequate availability of essential medicines in different Indian states. Availability of essential medicines varies in the range of 17-51 percent across major states of India. Stock-outs of medicines vary from 4 to 14 weeks. Governance issues including differential procurement mechanisms across states of India, hinder seamless availability of essential medicines. Other challenges included distribution and purchasing system inefficiencies, governance-related issues, and facility/user-level challenges impacting drug utilization. Disruptions in utilization were observed due to improper prescription practices and non-availability of affordable options. Accessibility and affordability also affected drug utilization. Issues with supply chain management and conflicting guidelines further contributed to the obstacles faced in ensuring availability and utilization of essential medicines in India. Ensuring the availability, accessibility, and affordability of essential medicines is of utmost importance. The public health system needs to strengthen its procurement and distribution management. Strengthening the logistics support for an efficient supply of essential medicines will reduce the time lag in receipt of drugs. Guidelines on essential drugs prepared by the National Health System Resource Centre need to be strictly adhered to and monitored in inventory management system. There is an urgent need to develop a sustainable model for achieving uniformity in the availability and utilization of essential medicines in India. [ABSTRACT FROM AUTHOR]

Background: Indigenous tribal people experience lower coverage of maternal, newborn and child healthcare (MNCH) services worldwide, including in India. Meanwhile, Indian tribal people comprise a special sub-population who are even more isolated, marginalized and underserved, designated as particularly vulnerable tribal groups (PVTGs). However, there is an extreme paucity of evidence on how this most vulnerable sub-population utilizes health services. Therefore, we aimed to estimate MNCH service utilization by all the 13 PVTGs of the eastern Indian state of Odisha and compare that with state and national rates. Methods: A total of 1186 eligible mothers who gave birth to a live child in last 5 years, were interviewed using a validated questionnaire. The weighted MNCH service utilization rates were estimated for antenatal care (ANC), intranatal care (INC), postnatal care (PNC) and immunization (for 12–23-month-old children). The same rates were estimated for state (n = 7144) and nationally representative samples (n = 176 843) from National Family Health Survey-5. Results: The ANC service utilization among PVTGs were considerably higher than national average except for early pregnancy registration (PVTGs 67% versus national 79.9%), and 5 ANC components (80.8% versus 82.3%). However, their institutional delivery rates (77.9%) were lower than averages for Odisha (93.1%) and India (90.1%). The PNC and immunization rates were substantially higher than the national averages. Furthermore, the main reasons behind greater home delivery in the PVTGs were accessibility issues (29.9%) and cultural barriers (23.1%). Conclusion: Ours was the first study of MNCH service utilization by PVTGs of an Indian state. It is very pleasantly surprising to note that the most vulnerable subpopulation of India, the PVTGs, have achieved comparable or often greater utilization rates than the national average, which may be attributable to overall significantly better performance by the Odisha state. However, PVTGs have underperformed in terms of timely pregnancy registration and institutional delivery, which should be urgently addressed. [ABSTRACT FROM AUTHOR]

Objective: Sociodemographic factors play a crucial role in shaping the health-seeking behaviors of individuals residing in slum areas, particularly in their choice of healthcare facilities. Recognizing the importance of strengthening the existing healthcare systems, this research project was undertaken with the primary objective of comprehending the health-seeking behaviors among residents of Mumbai's slum dwellings in India. To achieve this goal, a comprehensive cross-sectional community needs assessment was conducted spanning from October 2018 to January 2019. Results: 432 respondents reported utilizing at least one health facility in the past year. They reported using private hospitals (172), public hospitals (208), Community Health clinics [23], or other healthcare services (29). To gain further insights into the factors influencing these choices, logistic regression analysis was conducted. The analysis revealed that being female was found to be negatively associated with the selection of a general practitioner as a preferred healthcare provider. On the other hand, higher levels of education and income were found to have a positive association with the preference for private hospitals. Conversely, these factors were negatively associated with the choice of government hospitals. [ABSTRACT FROM AUTHOR]

Background: It is well documented that the utilization of maternal healthcare services during pregnancy and childbirth plays a significant role in reducing maternal morbidity and mortality. Disruptions in maternal healthcare services during the coronavirus disease 2019 (COVID-19) pandemic have been reported. However, there is a paucity of literature from rural areas, as most of the previous studies are either record-based or conducted in tertiary care centers. This study aimed to determine the proportion of women who received the recommended maternal healthcare services during the COVID-19 pandemic and to study various factors associated with the utilization of services. Material and Methods: In this community-based study, we assessed the utilization of maternal healthcare services among 520 women residing in the Ballabgarh Block of District Faridabad, Haryana, whose antenatal, intrapartum, and postnatal period coincided with the first wave of COVID-19 pandemic. Domiciliary visits were made, and women were interviewed retrospectively regarding maternal healthcare services utilized by them. The antenatal care (ANC) cards were reviewed, and details were corroborated. Results: Full ANC was received by 15.3% of women, and 45% of women had less than four antenatal visits. 30.9% of participants had cesarean delivery. The proportion of cesarean delivery in private facilities was significantly higher than in government facilities [Odds Ratio (OR) (95% Confidence intervals (CI)) =10.04 (5.87-17.19); P < 0.001]. In multivariate logistic regression, gravidity was negatively associated with full ANC [OR (95% CI) =0.43 (0.25-0.74); P = 0.002]. Conclusion: Fewer women received the recommended maternal healthcare services during the COVID-19 pandemic. Detailed assessment of health systems and factors affecting routine healthcare services, during the pandemic, can help improve the readiness and response in the future. [ABSTRACT FROM AUTHOR]

Eye care programs, in developing countries, are often planned using the prevalence of blindness and visual impairment, often estimated from Rapid Assessment of Avoidable Blindness (RAAB) surveys. A limitation of this planning approach is that it ignores the annual overall eye care requirements for a given population. Moreover, targets set are arbitrary, often influenced by capacity rather than need. To address this lacunae, we implemented a novel study design to estimate the annual need for comprehensive eye care in a 1.2 million populations. We conducted a population based longitudinal study in Theni district, Tamil Nadu, India. All permanent residents of all ages were included. We conducted the study in three phases, (i) household level enumeration and enrollment, (ii) basic eye examination (BEE) at household one year post enrollment, and (iii) assessment of eye care utilization and full eye examination (FEE) at central locations. All people aged 40 years and above were invited to the FEE. Those aged <40 years were invited to the FEE if indicated. In the main study, we enrolled 24,327 subjects (58% aged below 40 years and 42% aged 40 years and above). Of those less than 40 years, 72% completed the BEE, of whom 20% were referred for FEE at central location. Of the people aged ≥40 years, 70% underwent FEE. Our study design provides insights for appropriate long term public health intervention planning, resource allocation, effective service delivery, and designing of eye care services for resource limited settings. [ABSTRACT FROM AUTHOR]

The study was conducted in Uttar Pradesh, India to assess the relationship between ICT tools and socio-economic variables of farmers. The ex-post-facto research design and multi-stage random sample technique were used. The data was collected through personal interviews with farmers. The total sample size of the study was 120 farmers. The study data were analyzed with correlation, multiple regression, and path analysis. The coefficient of determination (R2) revealed that 79.90 per cent of the total variation in the utilization of ICT tools by the farmers was explained by the selected independent variables. The path analysis was used to assess the total effect, which was decomposed into direct, indirect, and residual effects. The variable education (0.358) exerted the highest direct effect, while the total indirect effect of extension contact (0.493) was on the utilization of ICT tools by the farmers. The residual effect was 0.201, which means that 20.10 per cent of the variance could not be explained due to exogenous variables. Overall, the study suggests that education and extension contact are crucial factors that affect the utilization of ICT tools by farmers in Uttar Pradesh for agricultural purposes. [ABSTRACT FROM AUTHOR]

Background: The misconceptions about the dental treatment prevailing among the population was considered as one of the important barriers for non- utilization of oral health services. The purpose of the present study was to find out the prevalence of common myths related to oral health and in the treatment aspects among the rural population of Tamilnadu, India. Methods: A cross sectional questionnaire survey was conducted among the outpatients attending a dental college in Tamilnadu. The questionnaire included demographic details and 18 questions related to the traditional beliefs. Result: Out of 371 patients, 70 (18.9%) thought that the extraction of upper teeth will affect their eyesight. 49.1% felt that extraction during rainy season will cause infection. Around 38% believe scaling leads to weakening of the teeth. Chi-square test showed no statistically significant difference exists among the gender and as well as education. Conclusion: The myths related to dentistry still exist which requires further studies based on using appropriate technology to eliminate myths among the community. [ABSTRACT FROM AUTHOR]

Ayushman Bharat yojana have two inter-related components, which are Health and wellness center (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY). Pradhan Mantri Jan Arogya Yojana is the National health protection scheme introduced on 23 September 2018 by the government of India targeting poor, socioeconomically weaker and disadvantaged families. It is a centrally sponsored scheme funded by both the union government and the state. This scheme is offering services to 50 crore re people with world's largest government sponsored healthcare program. The study was initiated to assess the knowledge and utilization of “Pradhan Mantri Jan Arogya YojanaAyushman Bharat” (PMJAY-AB) scheme among the eligible families of selected rural community Lucknow. The objective of the study was to assess the knowledge and utilization of PMJAY-AB scheme among the eligible families of selected rural community in Lucknow and to correlate the knowledge with the utilization of PMJAY-AB scheme. Non experimental descriptive survey research design was used by using convenience sampling technique to collect the data from 150 samples through structured questionnaires. Finding of the study reveals that the majority of people 58 (38.67%) had moderate adequate knowledge, 49 (32.67%) had an inadequate knowledge and, only 43(28.67%) people had an adequate knowledge regarding PMJAY-AB scheme. Utilization rates reveals the majority of people 90.67% are poorly utilization the scheme while 6.67% had average utilization and only 2.67% people are utilizing the full services covered under the PMJAY-AB scheme. Hence the study concludes that the community people needs awareness regarding the Pradhan Mantri Jan ArogyaYojana-Ayushman Bharat” (PMJAYAB) scheme to ensure full coverage. [ABSTRACT FROM AUTHOR]

Background: Pregnancy is the most crucial thing for every mother. Providing appropriate health-care services during pregnancy by skilled health care professionals is important for healthy childbirth and better maternal health outcomes. Despite Antenatal care services being free at the Public Hospital in Sikkim, many pregnant women are reluctant to get ANC services because of many socio-economic and demographic factors. Objectives: The present study aimed to identify various socio-economic and demographic determinants affecting ANC services utilization among rural women of South Sikkim, India. Methods: The community-based cross-sectional study was carried out among 250 reproductive-aged (15-49 years) women residing in South Sikkim, India. The data on various socio-economic and demographic determinants associated with utilization of antenatal care services were collected by adopting a pre-structured schedule interview method by household visits. Results: A total of 73.4% reported that they have utilized the ANC services among women in South Sikkim. Binary logistic regression analysis indicated that several socio-economic and demographic variables of age, age at marriage, age at pregnancy, marital status, family income, education, education of husband, occupation of husband parity and family income were significantly associated with ANC visits (p<0.05), except women's occupation and religion (p>0.05). Conclusion: There is an urgent need to inform pregnant women and their families about the importance of ANC services to enhance effective utilization and improve the overall health status. [ABSTRACT FROM AUTHOR]

Medicinal plant documentation is a wide field of research to identify the chronicle of indigenous knowledge about plant its usage and scientifically validating the valuable species. Several field trips were carried out in Nilgiri hills between September 2021 – January 2022, covering different seasons, in order to know the phenology of the plants, Intensive and extensive field surveys was done in and around villages in Coonoor and Ooty. A total of 42 plant species belonging to 28 families and 31 genera. The majority of the documented plants were climber (13), tree (9), herb (7), shrub (6) and twiner (1). The part of the plant most frequently used was the fruit (22) followed by leaves (13), root (3), tuber (2), rhizome and bark (1). The main uses of the herbal drug have been reported to have several medicinal importance such as anti-diabetic, anti-inflammatory, anti-tumour, gastric ulcer, skin disease, cancer, alzhimer disease, parkinsons, anti-hypertensive, hypolipidemic, antifungal, arthritis, rheumatism, lumbago, anti-asmatic, diuretic, anti-septic, anti- analgesic, antiproliferative, sedative, anti-microbial, antipyretic, anthelmintic. During this survey documentation of medicinal plants seems to be identified to have high medicinal importance. Cayratia pedata, Fragaria nilgerrensis, Syzygium densiflorum and Syzygium grande are some of the very commonly used medicinal plants. There is a need to document the threats which increase biotic interference and climatic change there is an urgent need to create awareness among the local people for the sustainable utilization as well as conservation of these medicinal plants in their original habitat. [ABSTRACT FROM AUTHOR]

Background: India is the second most populated country across the world. Around the world 3, 85,000 babies are born per day. In India the current population are 140 crore. To overcome the growth of population the health care system also delivers the family planning methods in community to stabilize the population. The programmes like Reproductive Child Health Programme, Maternal Child Health Programme and Family Welfare Programme also have taken a recommendation to improve the health of mothers, children and also family members and also they educate about the Family Planning Method. India has adopted the goal of two children norms. In Gujarat there are 6.55 crore population and per 1000 people there are 17.163 births. Aim: The main aim of this study was to assess the effectiveness of education package regarding selected contraceptive methods and to control the growth of population by educating the community peoples at some extent. Objectives: To assess the pre-test and post-test knowledge, attitude and utilization score regarding selected contraceptive methods among postnatal mothers. To evaluate the effectiveness of educational package. To correlate the relationship between knowledge, and attitude. To associate the mean difference before and after the level of knowledge, and attitude. Methodology: The pre-experimental one group pre-test and post-test design was adopted. The 60 postnatal mothers were selected as a sample from various selected PHC of Kheda District by non-probability convenient sampling technique. The written setting permission was taken from the medical officer of PHC for data collection. The prior consent form was also signed by the postnatal mothers for the study. The tool was developed by four sections: Section I: Socio-Demographic Data. Section II: Structured Knowledge Questionnaires. Section III: Likert Attitude Scale. Section IV: Checklist Questionnaires for Utilization. The data were analyzed by using the SPSS Software. The frequency and percentage distribution are used to assess the demographic variables and the mean and standard deviation are used to describe the knowledge, attitude and utilization regarding contraceptive methods. The paired t-test was used to compare pre and post test score, Karl Pearson correlation formula was used to correlate the pre-test level and Chisquare test was used to determine the association between mean differences. Results: Out of 60 samples, 41.7 % (25)belong to age 18-22 years, 100% (60) belong to Hindu religion, 48.3% (29) was not formal educated, 90.0% (54) was housewife, 31.7% (19) belong to 4-6 years duration of marriage, 50.0% (30) have one child, 86.7% (52) have no history of abortion, 75.0% (45) got information related to contraceptive method from Health Personnel. Thepaired t-test value was 15.14, 9.26 and 13.13. Hence, there exists significance effectiveness on level of knowledge, and attitudebefore and after administration of educational package among postnatal mothers. There was positive correlation between knowledge, and attitude (r = 0.65), and found no significant relationship between all the variables regarding selected contraceptive methods after educational package among postnatal mothers. Conclusion: The study concludes that after the intervention, 47% (28) mothers had moderately adequate knowledge, none of them had inadequate knowledge and 53% (32) had adequate knowledge regarding contraceptive method .37% (22) mother had moderately favourable attitude, none of them had unfavourable attitude, and 63% (38) mother had favourable attitude regarding contraceptive method. [ABSTRACT FROM AUTHOR]

Background: This study aimed to generate a pooled national estimate on dental health care services utilization by the adult population in India from any public or private facility in an effort to highlight the demand and usage for oral health care. Methods: In this meta-analysis, PubMed, ScienceDirect, DOAJ, and Google Scholar were searched using a search strategy that combined MeSH headings and keywords (e.g., "Oral Health", "Dental Health Services", utilization, India, etc.) for articles on dental utilization among Indian adults, published between January 2011 and June 2022. Study quality was assessed using the NIH Quality assessment tool, and a random-effects inverse-variance method was used for pulling utilization proportions. Meta-regression and sub-group analyses were conducted to identify the sources of heterogeneity. Heterogeneity is reported as I2. To examine publication bias, the funnel plot, egger's test, and trim-and-fill analysis were performed. Results: From 4012 identified articles, 21 were eligible for inclusion. The pooled dental care utilization amongst Indian adults were found to be 23.96% (confidence interval [CI]: 16.81%– 31.11%, P <0.001,>2=98.93%), and the highest estimate was in South Zone (30.02%, CI: 19.14–40.90, P <0.01,>2=98.63%). Visual inspection of the funnel plot revealed the presence of publication bias (egger's P value 0.02). A mild decrease in utilization estimate was noted through trim and fill analysis (adjusted estimate 17.65%, CI: 8.97–26.33, P =0.03). No significant subgroup effect was found for the variables study zone and conduction years (P value: 0.09 & 0.34 respectively). Conclusion: Future studies should be undertaken to focus on the demand and supply of oral health care services since an evidential gap has been identified due to the uneven distribution of studies available from various regions of India. The heterogeneity can be attributed to the diverse socioeconomic, literacy, and inherent health system performance status. [ABSTRACT FROM AUTHOR]

Utilization rates for government funded maternal and child health facilities are significantly lower among the disadvantaged caste groups in India compared to that of the general caste individuals, particularly when there is lack of awareness about the existing facilities among the targeted beneficiaries. We use propensity score matching method on detailed data from the fourth and current round of the District Level Household Survey to provide robust evidence that not only does awareness improve utilization of essential healthcare facilities but raising awareness can also bridge to a large extent the gap in utilization rates that exists between the advantaged and disadvantaged caste groups. We also find that the Scheduled tribe population which lag significantly behind the general castes as well as the other disadvantaged caste groups such as Scheduled castes and Other backward classes in terms of utilization of these health facilities stand to gain more from awareness. [ABSTRACT FROM AUTHOR]

Most Indian tribes have limited access to healthcare facilities and rely heavily on traditional healing practices. This narrative review aimed to identify the disparities in the implementation of healthcare services and in accessing and availing these services by the indigenous population in India. We also have tried to throw light on the plausibility in strengthening the efficiency and efficacy of the public health system, by utilizing the available resources to its maximum potential, so that there will be a measurable outcome in the health status of these populations in India, coherently with the relevant sustainable development goals (SDG). The evidence from published literatures supports the fact that the disparity exists in the health status of indigenous populations in India as compared to the general populations. It emphasizes the need to address the key determinants such as the lack of knowledge, traditional healing practices and poor utilization of healthcare services provided to them. Various factors such as accessibility to healthcare resources, traditional healing practices, lack of awareness regarding healthcare services and schemes provided by the government, insufficient data regarding their issues and challenges and cultural and language barriers worsen the health status of indigenous people. However, our review reiterates that a well-structured and sustainable policy with reframed infrastructure and administration of healthcare system might bring a positive change in the health status of indigenous population in India., Competing Interests: Declarations Ethics Approval This is a narrative review, and hence, no ethics approval was required. Consent to Participate Not applicable. Consent for Publication Not applicable. Conflict of Interest The authors declare no competing interests., (© 2023. The Author(s).)

Background: Adolescence is a critical phase in the life of woman. At this stage, she would stand at the beginning of adulthood. This stage is in midway between childhood and womanhood and it is the most eventful for mental, emotional, social and psychological health and well-being. The life-cycle approach for holistic development of a child remains unaddressed if adolescent girls are excluded from the nutritional and developmental programmes. Aims/Objectives: To study the awareness, utilization and perception of ICDS scheme by adolescent girls in coastal Karnataka. Methodology: A community based cross sectional study was conducted among 66 adolescent girls in the field practice area of a tertiary care Hospital in South India. Results: All the adolescent girls were registered. But only 2 beneficiaries were given services in rotation basis for the period of 6 months. Among the study subjects, larger proportion were aware of Supplementary Nutrition SN (97%) followed by Iron & Folic Acid supplementation IFA (43.9%) and Nutrition & Health Education NHED (25.8%). Majority were utilizing SN (97%) followed by IFA supplementation (30.3%) and NHED (25.8%). SN food of good quality (60.9%) followed by average quality (37.5%) and of adequate quantity (93.8%). It was also found that 92.4% adolescent girls were satisfied with SN. Conclusions: It is vital to register all the adolescent girls, and ensure that they all avail the ICDS services regularly to improve the nutritional status. There is a necessity to improve the quality and quantity of food provided as per the hope of mothers to ensure better utilization. [ABSTRACT FROM AUTHOR]

Context: In India, the use of social security schemes by the rural population has not been evaluated with much consideration. The awareness of these social security programs plays a vital role in their use. Aims: This research was conducted to evaluate the awareness among the rural population regarding government-initiated social security schemes and to provide recommendations based on the results of the study. Settings and Design: A community-based cross-sectional study was conducted in a rural health care center. Methods and Material: A sample of 250 individuals in the rural health care center of a dental college was subjected to a questionnaire regarding the awareness of the government-launched social security schemes—Sukanya Samridhi Yojana, Pradhan Mantri Suraksha Bima Yojana, Atal Pension Yojana, Pradhan Mantri Jeevan Jyoti Bima Yojana, Ayushman Bharat Yojana, and Pradhan Mantri Kisan Samman Nidhi Yojana. Statistical Analysis Used: The study data were analyzed by Epi InfoTM 7 software package. Descriptive statistics were assessed and differences between the two groups were compared using the Chi-square test and the P value of < 0.05 was considered to be significant. Results: In the present study, 212 rural people were aware of any one of the recently initiated social security schemes, and the awareness level of these social security schemes was higher in those with age more than 30 years, males, literates, and classes 3 and 4 economic groups of population. Conclusions: The rural population's knowledge of the government's social security schemes is strong, and it is affected by people's age, gender, literacy level, and socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Disability certification is an essential requirement to avail of the various disability benefits including disability pension, family pension, insurance, income tax rebate, travel concession etc. The lack of awareness among persons with mental illness and their caregivers is a major barrier in availing such benefits. Aim of the study: To assess the socio-demographic and clinical variables along with the pattern of utilization of disability certificates for disability benefits by the persons with disability (PwD) having a mental illness. Materials and Methods: Consecutive patients who obtained disability certificates due to mental illness in the last 5.5 years were contacted and their responses were recorded on a semi-structured questionnaire telephonically. Result: Over a period of 5.5 years 123 certificates were issued to individuals of which 100 were contacted. Out of the 123 cases, 11 could not be contacted, one patient didn't collect the certificate to date, 6 patients expired after obtaining the certificate and 5 didn't come for reassessment. Out of the 100 cases who participated in the study, 91 persons (91%) mentioned that these certificates were useful for them. Regarding the disability-related benefits, 51% had received a disability pension, 43% used it for travel concession and the rest (1% to 9%) used it for getting income tax rebates, insurance and family pension. While exploring and interviewing for additional benefits other than those available currently by the Government of India, 13% wanted to get free medicines, 17% wanted increased job opportunities and 2% wanted to have a smooth procedure for availing benefits. Of those contacted, 19% also disseminated the information about the disability certification and the related benefits to other needy persons. Conclusion: The utilization of disability certificates by those with mental illness is largely limited mostly to availing pension or travel concession. [ABSTRACT FROM AUTHOR]

Background: Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India. Methods: The study included 72,262 individuals (45 years and older) from the cross-sectional 2017–2018 Longitudinal Ageing Study in India (LASI) Wave 1. Results: The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07–1.34), having pain (AOR: 1.48, 95% CI: 1.29–1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35–1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12–1.50), male sex (AOR: 0.76, 95% CI: 0.68–0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60–0.87), urban residence (AOR: 0.71, 95% CI: 0.57–0.88), diabetes (AOR: 0.66, 95% CI: 0.55–0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37–0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30–0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01–1.35), sleep problems (AOR: 1.28, 95% CI: 1.08–1.51), having pain (AOR: 1.82, 95% CI: 1.55–2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22–1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33–0.51), hypertension (AOR: 0.82, 95% CI: 0.71–0.95), diabetes (AOR: 0.50, 95% CI: 0.39–0.65), urban residence (AOR: 0.25, 95% CI: 0.19–0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58–0.85). Conclusion: A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified. [ABSTRACT FROM AUTHOR]

Background: Despite the government's continuous efforts for improving healthcare services in the country, utilization of healthcare services is still a serious concern in India. Adequate, affordable, and accessible healthcare services could effectively reduce morbidity. Objectives: This study was performed to examine the pattern of healthcare services utilization among households of Assam along with factors determining utilization of healthcare services. Methods: This study was based on primary data collected from 771 randomly selected households from four districts of Assam. Structured questionnaire was used to collect information on socioeconomic, demographic, morbidity details, and utilization pattern. Binary logistic regression analysis was used to understand the factors determining utilization of healthcare services. Results: There were 829 reported illness cases in the study area during the reference period, of which 87.67% cases were treated at medical institutions, 4.94% cases were selftreated and for 7.35% cases no medical treatment have been sought. In both rural and urban areas private healthcare facilities are the most preferred healthcare provider. Majority (41.32%) households were very satisfied with the service provided by private health facilities. Logistic regression analysis revealed that occupation and age of the household head; household's monthly income, size of the household, distance to the nearest health facility and insurance status were the main factors influencing utilization of healthcare services. Conclusion: The study revealed that low-income households in rural areas utilized private health services. Though households from rural areas have easy access to public health facilities than private health facilities, lower income households were forced to seek treatment from private sector by paying higher charges. Due to poor quality services in public sector, likelihood of visiting private health facility is increased. There is need to improve public health infrastructure along with quality of healthcare services in rural areas, only physical access to health institution may no ensure proper utilization. [ABSTRACT FROM AUTHOR]

Background: Maternal health services refer to the promotive, preventive, curative and rehabilitative care of mothers. Antenatal care is the care of women during pregnancy the main aim of care is to achieve at the end a healthy baby from healthy mother. Antenatal mothers should be educated regarding regular antenatal checkups, diet, personal hygiene, adequate rest, sleep, exercise, immunization, warning signs of pregnancy and child care. Methods: Descriptive study to assess the knowledge, barriers of non- utilization regarding Maternal Health services. The data was collected using structured knowledge questionnaire and utilization and barriers to non-utilization checklist from 60 postnatal mothers up to 3 months after delivery. Result: The study result showed that women 78.34% had average knowledge and 21.66% had good knowledge regarding maternal health services. Social barriers for non-utilization were family pressure, shyness, poor transportation and illiteracy. Economic barriers for non-utilization were health expenditure perceived as waste, unemployment, low socio economic status and large family size respectively. Cultural barriers for non-utilization were lack of formal education and religious practices respectively, family members disapproved superstition. There was no significant association between knowledge, utilization and barrier on non-utilization of maternal health services and selected demographic variables. Conclusion: The study concluded that postnatal mothers had average knowledge and there is need to create awareness on maternal health services launched by the government of India. Low socioeconomic condition, early marriage and pregnancy, inappropriate antenatal health check-up, and cultural taboos were significant factors affecting the satisfactory utilization of services among mothers. Hence, there is a need to emphasize on utilization and eradicate barriers related to non-utilization of maternal health services. [ABSTRACT FROM AUTHOR]

The present paper discusses about the applications of protected cultivation for crop activities, and technology utilization in India. The crop production, management, plant propagation are applied at protected cultivation in sustainable agriculture. The advancement of technology is boosted in protected cultivation that transforms sustainable agriculture into modern agriculture. The various agricultural crops are practiced naturally after research progress in protected cultivation. The various sophisticated technologies like scientific farming, vertical farming, vertical farming with hydroponics, organic farming, micro-irrigation, organic fertigation, chemical fertigation, IPM, IDM, INM, farm machines & tools, aquaponic, micro green farming, in-situ crop preservation, azolla production and seed production are utilized in crop activity and academic & research. The modern technologies are constituted in protected cultivation that transforms modern agriculture into smart agriculture. It will promote land, water, waste land conservation. It would reform nutrient content of the soil, forbids soil erosion and soil pollution. It will provide employment opportunities, agricultural business, food security and rural development in India. [ABSTRACT FROM AUTHOR]

Background and Aims: Antenatal oral care has been given least priority on a global scale. The study assesses self-perception of oral health knowledge and related behaviors among antenatal mothers. Method: A cross-sectional study was done among 400 pregnant women attending antenatal care clinic of a tertiary care center in Kerala, India. Details regarding knowledge, attitude, and practice were obtained, after getting an informed consent. The dental caries experience and gingival status were measured. To test the significance (p ≤ 0.05) between variables, Chi-square test was used. Results: Poor oral health knowledge was observed among 75.5% of the pregnant mothers. Oral health problems were reported by 63.2% of them. Low priority for oral health (59.4%) and fear for fetal safety (17.5%) were the reasons for delaying dental services. Oral examination showed that more than half of the study subjects had a high prevalence of dental caries (67.5%) and low gingival bleeding status (26.2%). The study highlights that more than half of the study population (60.8%) were influenced by the elderly in the family to avoid certain food items. A better oral health knowledge was observed among the upper middle class (OR - 2.8) who had visited dentists within the last six months (OR - 3.6) and child bearing mothers (OR- 0.46) (p ≤ 0.05). [ABSTRACT FROM AUTHOR]

Background: To understand the awareness and utilization of assistive technology in students at schools for the blind in Delhi. Methods: A cross sectional study was conducted among 250 students selected randomly from 10 blind schools in Delhi. Binocular distance presenting and pinhole vision acuity were assessed using Snellen "E" chart and a multiple pinhole occluder. Students were also interviewed using a questionnaire about 42 assistive devices to understand their awareness and use. Results: Male participants were 72.8%. Of the total, 27.6% students had best corrected visual acuity <6/18 to 1/60, and the rest had <1/60 vision. The awareness about tactile and sound-based technology was good among students: Braille books (98%), Braille slate and stylus (99.2%), handheld audio recorders (77.6%) and screen readers (77.2%). Good awareness was reported for abacus (88.8%), walking long canes (94.4%) and smart cane (89.6%), audible balls (96%), Braille chess (82.8%) and talking watch (98%). Among the students with <6/18 to 1/60 vision, the awareness of visual based technology ranged from 0.8% (typoscope) to 43.6% (video magnifiers). Braille technology was used for reading by 96.4% (books) and for writing by 96.8% (Braille slate and stylus) irrespective of visual status. Other devices were poorly used ranging from nil (typoscope) to 55% (screen readers). The use of math and science learning devices was poor (<20%). Walking canes were used by 59% of students whereas 87.2% students used audible ball for games. Conclusion: The results showed that majority of students used tactile based technology irrespective of visual status. Students with visual disability need assistive technology for a wide range of activities including academic learning. Students in schools for the blind who have binocular best corrected vision acuity of 1/60 or better should be encouraged to use visual based assistive technology instead of tactile based. Students with binocular best corrected vision acuity less than1/60 should be encouraged to use other available tactile and sound-based assistive technologies as well as Braille books and Braille slate and stylus for their academic activities including maths and sciences. Teachers should be trained in the use of various assistive technologies for reading, writing, maths, sciences, sports, mobility and activities of daily living. [ABSTRACT FROM AUTHOR]

Introduction: For effective formulation of oral health policies it is important to understand the magnitude of oral health/diseases in a community keeping in mind various factors that influence utilization of dental services. Objective: To estimate geographic distribution of dental problems and factors affecting utilization of dental services from secondary data of patients visiting a private dental institute in Kasaragod District, North Kerala. Methods: Data from 2498 patients was extracted and categorized according to age, gender, chief complaints, delay (time gap) in utilization of dental services and area of residence. Distance from area of residences and to the dental institute was calculated for individual patients categorized according to gram panchayats, block panchayats and municipalities. The distance was mapped according to block panchayat. The data was analyzed using chi-square test for age group, gender and time taken to utilize dental services. Results: Majority of patients belonged to age group of 21 - 30 years and males were more than females. Dental caries was common dental problem followed by dental pain in all block panchayats and municipalities. Patients reported from distances as far as 50 km. There was a significantly higher utilization of dental services by males in all age groups except females in the age group of 31 - 50 years (P = 0.001) and only 13.7 percent utilized dental services within one week of dental problem with more males than females (P = 0.04) Conclusion: Males utilized dental services more than females and majority were in age group of 21 - 30 years. About 85.5 percent of patients reported from within a radius of 30 km. Data from private sectors can be used to describe the dispersion of dental problems in a community, thereby providing more comprehensive view of magnitude of dental problems. [ABSTRACT FROM AUTHOR]

Objective: To assess the status of utilization of Maternal Health Care (MHC) services in slums of an industrialized city and elucidating the various determinants influencing the utilization. Materials and methods: A Cross-sectional study using multi stage sampling methodology was conducted in slums of an industrialized city. The study participants were the women who had given a live birth in the last one year before 4 weeks of the study starts. Total one hundred eighty families were interviewed & analysed. Results: The utilization of MHC services was poor as compared to national averages in urban slums. There was no association between age of mother, birth order, educational and occupational status of head of family with utilization of services while education and employment of mother, category and type of family, distance and time to reach health facility, were significantly associated. Conclusion: The reduction of maternal mortality and morbidity mostly depends on the utilization of MHC services. The findings of this study have important implications for improving utilization of maternal health care services. [ABSTRACT FROM AUTHOR]

Background: Slum population in India is increasing with urbanization and even after various efforts of Government and NGOs, slum dwellers remains deprived of basic services for quality of life. Getting health services by elderly slum dwellers is also a challenging task. Objective: The aim of this study was to find out the major barrier perceived by elderly slum dwellers in utilization of Health services. Methodology: 125 elderly aged 60 and above were randomly selected from Jawahar Nagar Urban slum of Jaipur, Rajasthan. Structured interview schedules were developed, field tested and used to interview elderly slum dwellers. Result: 84% of the elderly respondents were aware of the nearby government health facilities; data indicates that unaware elderly did not access any public health care facility. unawareness is a barrier in accessibility of health services. 78.26 percent elderly were aware about the free treatment facility available at government health centers but unaware elderly have not accessed any public health care facility. It was found that maximum waiting time of more than 60 minutes was for those who visited public hospital. 77.6% elderly did not have free health care card mostly due to unawareness. Other barriers to access of health care were Behavior of service providers (88.3%), Distance from home (64.7%), Transport facility (82.4%), Amenities at the health facility (88.3%) and Convenience for attendants (88.3%).Conclusions: Major barrier identified by elderly slum dwellers in utilization of Health services are Availability of service provider, cost, timeliness, ease of access, behavior of service provider and coverage through insurance or beneficiary schemes [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was conducted to find out the realistic about the user's utilization and satisfaction level of Central library of Sikkim Manipal Institute of Medical Sciences (SMIMS), Gangtok, Sikkim, India. The user's satisfaction of a library totally depends upon the utilization of library resources and services. Methodology: For the required queries a questionnaire was prepared for the present study and it was distributed among 120 SMIMS students randomly. Findings: The study exposed that students use the library for browsing e-resources and borrow books as per their need. From the students responses it was clear that users give preferences on accessing e-resources than printed material. Research Limitations: The present study is limited only for the students of the particular medical institution. The students were selected from different disciplines i.e. medical science, nursing and physiotherapy. Though faculties also use the library along with the students of this institution yet the research survey was limited for the students only. Practical Implications: Users were satisfied by using the library services like e-resources accessing, printing & photocopying service, DDS service, SMS alert service etc. Above these services the respondents recommended for digitization of the central library for the better utilization of library services as new information and communication technology are developing day by day so it should be implemented for best practices. Originality: This is the original study as it is absolutely based on primary data from student's survey. Some additional data are also collected personally from the library staff to know the better utilization of library services. [ABSTRACT FROM AUTHOR]

Introduction: It is estimated that 68% of the World’s population shall live in urban areas by 2050; India will have added 416 million to the urban population. With rapid increase in population, the healthcare needs also increase. In 2016, 63% of the deaths were due to non-communicable diseases and 26% due to communicable diseases. India is a country with high level of morbidity. Communicable diseases contribute to the morbidity more than the non-communicable diseases. Despite the increasing public and private expenditure on healthcare, utilization of health services still remain low. The utilization of public health services in India range from 10-30%. Aim and Objective: To study the Patterns and Determinants of Utilization of Healthcare. Materials and Method: A cross-sectional study was conducted among 256 attendees of a health camp conducted in urban field practice area, using a predesigned and pretested questionnaire. Data entered into Microsoft excel and analysed using SPSS 20. Results: The overall population of the area was 7634, 2256 were attended the camp giving a 30% utilisation. Out of 256 patients 40.6% were males and 59.4% were females. 25.7% Respiratory, 12.9% musculoskeletal and 11.7% gastrointestinal problems were common. It was found that the behavioural determinants of subjects utilising healthcare facilities both in public and private sector showed that free services was observed as main factor for approaching public healthcare against reliability. Whereas less waiting time was the principal factor compared to cleanliness for visiting private healthcare. Conclusion: In the study population, Respiratory problems were found to be highest, private healthcare facility was preferred. [ABSTRACT FROM AUTHOR]

Primary healthcare is a vital strategy which remains the backbone of health service delivery. As on March 31st 2017, there were a total of 25, 650 primary health centres(PHC) functioning in the country. Though the number of PHC’s had increased, the utilization is declining over the years as people seek private health sectors due to various reasons. Objective: To assess the awareness and utilization of primary health care services provided by Thirumazhisai PHC. Methodology: A Community based cross-sectional study was conducted among people residing in Thirumazhisai. The Sample size of 233 was calculated. The study population was selected by simple random sampling technique. A pre-designed, pre-tested semi-structured questionnaire was used to collect data. Data entered in MS excel and analyzed using proportion. Results: Among 233 people, 183 (78.8%) people knew about PHC services. Regarding utilization of services, 165(70.8%) were availing services provided by PHC. The reasons given for non utilization of services were long waiting time (51.4%), dissatisfaction of Doctor-Patient relationship(17.7%), non-availability of essential medicines (14.7%), PHC not clean (8.8%), and PHC does not have all required services (7.4%). Conclusion: In resource-constrained developing countries like India, all efforts should be undertaken to bring about the maximum efficiency of health care delivery. Role of primary healthcare is essential in the progress towards achieving universal health coverage (UHC). [ABSTRACT FROM AUTHOR]

Throughout the globe, researcher’s debates on the significance of socio-economic factors in influencing the choice of seeking care at health facilities. India’s health care system is characterized by multiple systems of medicine, mixed ownership patterns and different delivery structures. Recent surveys, nationwide, show that dependence on private sector for outpatient and inpatient services has significantly increased among the population. The changing trend can be contributed to rising income levels, demographic and cultural shifts and changing disease patterns. This paper examines the significance of socio-economic variables of patients in selecting and utilizing inpatient services at tertiary level health facilities of West Bengal. Information about the socio-economic status of the population is vital for demographers, health administrators, social workers and policy makers for planning and financing of health programs. The study findings reveal that inpatients age, education, residence, family income, availability of health insurance schemes show a significant effect on the utilization of a health care facility. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the utilization pattern of anti‐epileptic drugs (AEDs) in Indian paediatric patients and compare it with the global usage data. Methods: Paediatric patients (≤18 years) with a confirmed diagnosis of epilepsy and prescribed with at least one AED were included in the study from a child neurology clinic in Pune, Maharashtra, India. The data pertaining to the type of epilepsy, and drug therapy was obtained retrospectively. The prescribing pattern of AEDs was identified and compared with the drug utilization pattern of the Asian and European countries from a systemic literature review. Key findings: Out of the 343 paediatric patients enrolled in the study, 55.6% were males. Thirty‐four per cent of the patients were under the age group of 2–6 years. More than half (60.5%) of the patients were diagnosed with generalized seizures, with tonic–clonic seizures (48%) being the most common among them. Out of the 37.9% of patients diagnosed with partial epilepsy, simple partial seizure was the most common type. The most commonly prescribed drug was sodium valproate for both generalized and partial seizures. Levetiracetam was found to be the preferred newer AED for management of generalized epilepsy. Similar prescribing pattern was seen in Asian countries where sodium valproate was the most preferred AED followed by levetiracetam and oxcarbazepine. Sodium valproate was also highly prescribed in European countries while levetiracetam and oxcarbazepine were underused. Two hundred and seven patients (60%) were managed on monotherapy. Conclusions: Older generation AEDs are still used in majority of patients as mono and dual therapy. Among the newer generation AEDs, there is an increase in the utilization of levetiracetam. Prescription of AEDs in our study goes in line with Asian countries but differs with the European counterparts due to various reasons. [ABSTRACT FROM AUTHOR]

Background: India has 8.6% elderly population which is going to increase to 12% by 2025. Government of India is providing for the elderly through various social security and welfare schemes as well as legislations. But various studies, mostly in rural areas have shown that the awareness regarding these schemes was poor and incomplete. Utilization of schemes by the beneficiaries was even poorer. Very few studies have assessed the same in urban areas. Aims & Objectives: To assess the awareness and utilization of geriatric welfare schemes and factors associated with them among urban elderly. Material & Methods: The study was conducted in urban field practice area of Dept of Community Medicine, SMS&R, Greater Noida. 402 elderly living in slums of Bhangel, Noida, were interviewed using semi structured questionnaire assuming 50% awareness levels in the urban area with 10% relative precision and 95% confidence interval. Results: Awareness regarding any one scheme was 31.6%, of whom only one fourth subjects knew about more than one scheme. Among those who knew about the schemes, only 40% were utilizing them. The awareness as well as utilization was found to be significantly associated with religion, caste and educational status of the subject. Conclusion: The study shows poor awareness and even poorer utilization of geriatric welfare schemes among elderly people of urban slums. Further studies are required for judging the influencing factors. [ABSTRACT FROM AUTHOR]

India's northeast region comprises eight states, which, together, is home to 3.8 per cent of the country's population. The quality of healthcare and manpower availability remains a cause for concern in the region, affecting the overall health-seeking behaviour of the people. This study attempts to understand the determinants of utilization of healthcare services in Northeast India. Healthcare and morbidity data for this study are based on a Northeast India sample from the National Sample Survey Organization's (NSSO's) health consumption data (2014). Probit, multinomial and mixed conditional logit models were employed in the study. In Northeast India, uneducated, higher-aged, Schedule Castes/Schedule Tribes (SCs/STs), Muslims, rural people and district people are served less by medical institutions and because of poor road connectivity they either remain untreated or seek care at underequipped primary healthcare services, while their counterparts utilize private facilities mostly for outpatient care and either public hospital or private facilities for inpatient care. There is also a tendency to substitute alternative healthcare when the cost of an inpatient healthcare service rises. To protect the interest of marginalized people and achieve the target of accessible, affordable and quality healthcare, the government needs to strengthen the primary healthcare in rural areas and improve the quality of healthcare in urban areas without increasing the cost of treatment. [ABSTRACT FROM AUTHOR]

Background: Demographic transition increased the proportion of elderly in India. Elderly persons experience increased economic dependency for their day-to-day existence. The Government of India provides monetary benefit through social welfare schemes. Health outcomes of the elderly improve when they are economically independent. We aimed to assess the awareness and utilization of social welfare schemes among elderly persons in an urban resettlement colony of Delhi. Materials and Methods: This was a community-based cross-sectional study conducted from February to May 2018. Two specially recruited interviewers administered the self-developed semi-structured interview schedule. It consisted of sociodemographic data, awareness, and utilization of various schemes. Results: A total of 931 [416 (37.4%) males and 515 (55.3%) females] participants completed the interview. Of the total, 809 (86.9%) participants were aware of at least one social welfare scheme. Participants utilizing any of the social welfare schemes were 393 (42.2%). Females utilized the social welfare schemes almost twice as compared to males (AOR = 1.7, 95% CI: 1.1–2.6). Participants aged 75 years and above had four times higher utilization of social welfare schemes compared to 60–64 years age group (AOR = 3.9, 95% CI: 2.4–6.4). Conclusion: Although the awareness of social welfare schemes among elderly persons was good, their utilization has scope for significant improvement. Focus is needed on elderly males and among the younger elderly persons. [ABSTRACT FROM AUTHOR]

Background: Major illness requiring hospitalization in poor family makes the family poorer with further tragic outcomes. In that view, Rashtriya Swasthya Bima Yojna (RSBY) by GOI and Mukhyamantri Amrutam (MA) Yojna by Gujarat Government were launched for Below Poverty Line families. Aims & Objectives: To assess knowledge and utilization regarding these two schemes amongst the registered families. Material & Methods: A community-based survey was carried out in a block of Gandhinagar using 30 clusters sampling. Sample size was calculated taking RSBY utilization rate 2.0%. Results: 98.4% had RSBY card & 83.7% had MA card. Common reasons for not having card were either "card not issued/people did not go to collect card" or "were unaware about the schemes/card". Only 1.5% families had valid RSBY cards. Knowledge regarding both the schemes (when & where to use, benefit amount etc.) was very poor (20- 25%). RSBY & MA utilization among valid card holders for last 1 year was 1.2% & 0.2% per enrolled member respectively in last 1 year. In both RSBY & MA, 30 - 40% beneficiaries had out of pocket expenditure, mainly towards transport & food. Few had towards medicines and/or investigations. However, most were satisfied with the services. Conclusion: Looking to the poor knowledge, it is important to carry out IEC activities to make people aware about the schemes which will help increase the utilization. [ABSTRACT FROM AUTHOR]

The Government of India has decided to revive alternate systems of medicine (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy -- AYUSH) on a mission mode. However, this endeavour is barely supported by any nationally representative assessment of the demand for these alternate systems of medicine. This assumes additional significance in light of persistently low levels of public spending on the conventional health system. This article does an exploratory analysis of the 68th round (2011-2012) of the National Sample Survey data to generate evidence on the demand for AYUSH services and patterns in utilization, if any. It finds that although AYUSH had a fairly consistent presence in policy pronouncements, its utilization is low, with substantial variations across states in terms of usage, availability and perceived efficacy of AYUSH. Inadequate awareness about the system and inef- ficacy of treatment emerge as the two biggest reasons for not using these services. There exist rural- urban and class differences in utilization, medium of delivery and determinants of AYUSH use in India. [ABSTRACT FROM AUTHOR]

In this article, an attempt has been made to examine the factors associated with the utilization of health care services among the urban households in India based on NSS case-level data of 42nd (1986-1987) and 60th round (2004-2005). The result of multivariate logistic regression analysis reveals that the education level of household head is not only an important positive predictor in the utilization of health services in general but is also found as a negative predictor to determine the utilization of public facilities in particular (National Sample Survey, 1998). It is also found that the weaker social class like scheduled caste (SC) is less likely to use curative health care facilities but the chances of using public facilities are much higher compared to non-SC households (National Sample Survey, 2006). It is found that the influence of household income for accessing health care services has been sharpened over the period. The study also reveals that the utilization of public health facilities is much higher in low-income states but the rate of improvement of public health care utilization is much higher in case of outpatient care services. The size of town has shown a significant impact on the utilization of health services. The chances of using public facilities have increased in small- and medium-sized town compared to metro cities. The level of intra-household disparities in access to health facilities with respect to age and gender has increased in urban India. Significant gender disparities are found in case of public health service utilization both for inpatient and outpatient care services in urban India. [ABSTRACT FROM AUTHOR]

Background: Antenatal care (ANC) is one of the basic components where it can provide pregnant women with an expansive scope of well-being, health promotion, and preventive health services. However, still 830 women die every day from preventable pregnancy-related causes, and 99% of these deaths occur in developing countries, out of which 20% of these deaths were from India. Objectives: The objective of this study is to explore the factors influencing the utilization of reproductive health services among mothers and to find the association between various factors and utilization of reproductive health services. Methods: A community-based cross-sectional study was conducted during January–June 2017 among 160 mothers who had an infant aged <6 months in Mawkyrwat Block, South West Khasi Hills District in Meghalaya. Respondents were selected through simple random sampling, and semi-structured questionnaire was used for data collection. Data were analyzed using SPSS 16. Results: Mothers attending four or more antenatal checkups were 10.6%, where 53.5% of the mothers registered their first ANC checkups only by the second trimester and 57.5% preferred home delivery. Nearly 52.9% of the mothers were staying more than 5 km away from the health-care facilities. The usage of family planning methods was very low, i. e., 96.9% of the mothers are not using any of the family planning methods. Conclusion: Study finding reveals that the utilization of health-care services was low. Area-specific approaches such as health camps and mobile clinics might result in improved utilization of reproductive health services. [ABSTRACT FROM AUTHOR]

Introduction: Blood Transfusions are used for various medical conditions to replace lost components of the blood. One may need a blood transfusion due to several reasons including blood lost during major surgery, childbirth, a severe accident and in severe cases of anemia. Since there is no substitute for blood and its products blood should be utilized thoughtfully and optimum utilization should be ensured. Methods: A retrospective study was carried out in a tertiary care hospital for a period of one month to study the utilization of the blood. The parameters studied included detailed study of the components of blood utilized and not utilized. Classification of blood components utilized was done age-wise, gender-wise and department-wise. Also, percentage of discard of blood components from blood bank as well from the components being returned was noted. Results: The total units of blood collected in the month of February & March were 853 and 791 units respectively. The components maximally utilized were leucocytes reduced red cell component. The component, which showed maximum wastage, was Random donor platelet. Maximum blood was utilized within the age group 41-64. Male patients required more of blood units than females. The reason for maximum wastage was found to be "Expired Sample". The maximum return seen was of red blood cells. The average time taken for return was 113 minutes. Conclusion: This study implies the need for efficient blood banking so that blood components can be utilized resourcefully and minimal wastage can be ensured. [ABSTRACT FROM AUTHOR]

Introduction: Despite various health programs and policies in the country, maternal health care service utilization by eligible women remains sub-optimal esp. in disadvantaged subsets of population. Aim and Objectives: The present study was conducted with an aim to assess the utilization of maternal health care services (ANC and PNC) and the factors influencing maternal health care utilization in urban slums of Lucknow. Materials and Methods: Study design- Cross Sectional. Study Area- Urban slums of Lucknow. Study Unit-Women who had delivered in the past one year. Study Period-July, 2014 to March, 2015. Sampling Technique - Simple random sampling. Sample Size-968 participants. Study Technique- Personal Interviews using a pre-tested, pre-structured questionnaire. Results: The study observed that utilization of maternal health care services was sub-optimal, few indicators being abysmally low like PNC visits (5%). Socio-demographic factors like education of women, religion and parity was found to be significantly associated with Maternal health care utilization. Discussion: Current study re-emphasized that utilization of maternal health care services is affected by multiple socio-demographic factors like maternal education, religion and parity of women. Education increases awareness about health, availability and accessibility of services and help develop the confidence while religious faith also decides the utilization of services. Conclusion: The better utilization of the maternal health services can be achieved by overall socio-economic development including focus on women empowerment and education, focus on religious norms and faiths in the health policies. Recommendations: Policies and programs focusing on education of community especially women and girls and incorporation of opinions of religious bodies could be an appropriate strategy. [ABSTRACT FROM AUTHOR]

Background: Punjab is becoming cancer capital of India due to increasing cancer rates especially in Malwa belt. Keeping in view the alarming increase in cancer incidence in this region, 1881 Reverse Osmosis plants have been installed in 16 districts of Punjab by the Government since 2010, but People are not utilizing this community RO water fully. Although 180 crores of rupees have been spent on installation of these RO plants by the government, but little attempts have been made to ascertain the extent of utilization of this water by the people and the Knowledge, Attitude and practices of the people residing in rural areas regarding community RO water. Aim of the study to assess the utilization and awareness of community RO water by the households in the study area. Results: There is only 50% utilization of community RO water as per this study. Most common responses elicited for not using community RO water was the unavailability of any family member for fetching this water (32%). Some other reasons observed were affordability (18%), accessibility due to distance of RO plant (15%) and dislike for taste of water (17%) though most of the households were aware of the risks of using contaminated water. Conclusions: though utilization of community RO water has increased as compared to past records still it is not as much as expected, since it has been 5 years since the installation of RO plants. Government heads to intensify its efforts in making people aware and solving the problems encountered in using community RO water. [ABSTRACT FROM AUTHOR]

On an average, 10% Indians are covered under different types of health insurance schemes, mostly inadequate. This low coverage might be because of lack of awareness about health insurance or might be because of lack of financial literacy. The aim of the present study was to investigate the awareness, and utilization of health insurance in the selected population of State of Sikkim. A cross-sectional descriptive study was carried out in north eastern region (NER) of India, which is considered as one of the backward regions of the country. Sample unit was revisiting Central Referral Hospital Manipal, Gangtok Sikkim. The study was conducted among 1500 Out-patients revisiting the various outpatient departments of the hospital. Finding was significant for awareness of health insurance; enrolment for the scheme; reason for non-enrolment. 49.9% of the non-enrollees were not aware of the health insurance schemes. 25.1% of the participants have utilized the services more than five times in a year. An important finding of the current study is that education and economic class seldom influence peoples' enrolment in health insurance schemes. The study supports this statement as 89.6% of literates were from non-enrollees group and 77.7% were from lower middle class and upper lower income groups. This indicates the need for financial education for people and their families to take up better financial investment decision and increase their health security. Enhancing the financial literacy and to create awareness and benefits of health insurance among the people of the selected region is important. It is suggested that the issues related financial literacy can be taken up by insurance companies or the organizers by conducting more and more awareness programs in identified regions of low and moderate enrolment across the country. [ABSTRACT FROM AUTHOR]

Background: Antenatal and post natal care are important component of maternal mortality rate. Antenatal facilities provided to mothers form the base of their future outcome. The services provided to mothers are still poor in India. A proper and effective program implementation is depending on understanding of basic factors that affect maternal and child health services utilization. Considering all these facts, it is important to study the maternal health service utilization pattern among the beneficiaries living in urban area of Jabalpur and factors responsible for their under utilization. Material & Methods: A prospective study was carried out in urban area of Jabalpur district of Madhya Pradesh. Cluster sampling technique was used to select 396 Antenatal females in the 36 different clusters. Information about socio demographic factors and ANC services utilization was recorded. Results: This study showed that 50.50% of women were registered within 12 weeks of pregnancy, 58.80% women received four or more antenatal visits, 23.99% women consumed hundred and more Iron Folic Acid (IFA) tablets and 96.21% received 2 doses of Tetanus Toxoid (TT) injections. Only 22.72% women had complete ANC service utilization. Conclusion: Utilization of Antenatal Care (ANC) services was poor in the urban areas of Jabalpur district even though the physical accessibility was adequate. ANC services utilization is significantly associated with level of education of mother, education of husband, occupation of mother, type of family and time of registration of pregnancy. [ABSTRACT FROM AUTHOR]

Background: The utilization of restorative dental care is very scarce in rural India. Association between level of education and health of a person has been well-documented in many countries and time periods with a range of potential factors shaping the connection between both.Objectives: This cross-sectional survey was conducted to evaluate an association between the level of education (educational qualification) and utilization of restorative dental care among rural women associated with self-help groups.Materials and Methods: A semi-structured questionnaire was administrated to 660 rural women associated with self-help group by trained research assistants. The 604 completed questionnaires were received and reviewed. The education levels were divided into three groups: Group 1 - illiterates (17.2%), Group 2 - school educated (69.4%), and Group 3 - college educated (13.4%). Chi-square test was applied to evaluate the utilization of dental services by rural women, and logistic regression was applied to evaluate the influence of their educational qualifications on utilization.Results: A total of 604 properly filled questionnaires out of 660 (91.51% response rate) were included in the analysis. Only 56.9% of the sampled rural women indicated that they have visited dentists earlier. The maximum number of individuals who have never visited the dentist belonged to illiterate group (55.7%), and the association was statistically significant (0.004) when compared with educated individuals.Conclusion: The results of this study concluded that the level of education has a significant influence on the utilization of dental care. [ABSTRACT FROM AUTHOR]

Globally, India is the leading producer of fruits. Fruits after consumption leave a peel which is a nuisance to the environment as a solid waste. In this article, commonly available large volume-fruit peels (FP) (viz. banana, orange, citrus, lemon and jackfruit) were investigated for surface, physical and chemical characteristics with a view to propose their valorization in detail. Each FP was characterized by proximate and ultimate analysis, porosity, particle density, bulk density, point of zero charge (pHpzc), surface pH, surface charges, water absorption capacity, BET surface area, scanning electron microscopy, Fourier transform infrared spectroscopy and TGA/derivative of thermogravimetric. The BET surface area of FP is very less, between 0.60 and 1.2 m2/g. ThepHpzcand surface pH values of orange peel (OP), citrus peel (CP), lemon peel (LP) and jackfruit peels (JFP) are in the range of 3-4. The pHpzc value and surface pH of banana peel (BP) is closer to 7. The order of surface acidity is OP > LP > CP > JFP > BP. From TG curves it is clear that FPs are stable below 150°C. The results will be useful for rational design, when FP is used as a substrate for bioactive compounds, phenolic antioxidants, organic acids, enzymes, biofertilizer, production of energy and as adsorbents. [ABSTRACT FROM AUTHOR]

Objective: To assess the utilization regarding Integrated Child Development Services (ICDS) among women. Study design: Descriptive survey. Materials and method: A sample size of 100 women from Ernakulam district, Kerala. Statistical analysis used: Frequency and percentage to describe sample characteristics and utilization of ICDS services. Results: Out of 100 women, 84 % were utilizing any one of the ICDS services and 16% were not utilizing any ICDS services. Conclusion: Accurate information and encouragement from health personnel will further help to improve the utilization regarding ICDS services. Keymessages: An integrated package of services will help in the holistic development of the child. [ABSTRACT FROM AUTHOR]

Background: In Gujarat, India, a state led public private partnership scheme to promote facility birth named Chiranjeevi Yojana (CY) was implemented in 2005. Institutional birth is provided free of cost at accredited private health facilities to women from socially disadvantaged groups (eligible women). CY has contributed in increasing facility birth and providing substantially subsidized (but not totally free) birth care; however, the retention of mothers in this scheme in subsequent child birth is unknown. Therefore, we conducted a study aimed to determine the effect of previous utilization of the scheme and previous out of pocket expenditure on subsequent child birth among multiparous eligible women in Gujarat.Methods: This was a retrospective cohort study of multiparous eligible women (after excluding abortions and births at public facility). A structured questionnaire was administered by trained research assistant to those with recent delivery between Jan and Jul 2013. Outcome of interest was CY utilization in subsequent child birth (Jan-Jul 2013). Explanatory variables included socio-demographic characteristics (including category of eligibility), pregnancy related characteristics in previous child birth, before Jan 2013, (including CY utilization, out of pocket expenditure) and type of child birth in subsequent birth. A poisson regression model was used to assess the association of factors with CY utilization in subsequent child birth.Results: Of 997 multiparous eligible women, 289 (29%) utilized and 708 (71%) did not utilize CY in their previous child birth. Of those who utilized CY (n = 289), 182 (63%) subsequently utilized CY and 33 (11%) gave birth at home; whereas those who did not utilize CY (n = 708) had four times higher risk (40% vs. 11%) of subsequent child birth at home. In multivariable models, previous utilization of the scheme was significantly associated with subsequent utilization (adjusted Relative Risk (aRR): 2.7; 95% CI: 2.2-3.3), however previous out of pocket expenditure was not found to be associated with retention in the CY scheme.Conclusion: Women with previous CY utilization were largely retained; therefore, steps to increase uptake of CY are expected to increase retention of mothers within CY in their subsequent child birth. To understand the reasons for subsequent child birth at home despite previous CY utilization and previous zero/minimal out of pocket expenditure, future research in the form of systematic qualitative enquiry is recommended. [ABSTRACT FROM AUTHOR]

Background: Urban Social Health Activists (USHAs) are the grass root health care workers of urban areas. There are 290 USHAs distributed in various Urban Health Centers (UHCs) of Rajkot city. Objectives: To compare the (i) effectiveness of the training received by the USHAs on their knowledge and counseling skills (ii) knowledge and counseling skills of USHAs on the awareness and utilization of Maternal and Child Health (MCH) care services by their beneficiaries. Methods: This cross-sectional study involved 32 USHAs and 416 beneficiaries served by the same USHAs. 32 USHAs serving in the same field practice area for more than two years were randomly selected. The beneficiaries were those mothers who had a child between 1-2 years age, and who had availed their antenatal and postnatal services in the same area. A scoring system was used to assess the knowledge and counseling skills of the USHAs and the knowledge and utilization of services by their beneficiaries. Results: The utilization of health services was significantly more in the beneficiaries who were serviced by USHAs having comparatively better knowledge (72.7% vs. 35.3%) and counseling skills (62.2% vs. 30.6%). The median score for knowledge (41 vs. 30) and counseling skills (20 vs. 16) of the USHAs was found to be more (P < 0.05) in those who had undertaken induction training. Conclusions: Induction training helped the USHAs to improve their knowledge and counseling skills. Utilization of MCH services was more in those areas served by USHAs having better knowledge and counseling skills. [ABSTRACT FROM AUTHOR]