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Traditionally the act of public spitting has been a putative "socio-cultural problem" in India. With the growing intensity of COVID-19 pandemic in India, it is of a predominant public health concern as evidence indicates sputum to be the potential reservoir of COVID-19 virus particles which could be easily transmitted. Despite being a significant public health issue, which is also linked to several other communicable diseases most notably tuberculosis (apart from COVID-19), this indiscriminate behavior has not received the due policy attention warranted. National and sub-national government enforcements and community level mass prudence to control this issue have been significantly dismal. Therefore, we aim to propose policy recommendations for short-term and long-term actions to prioritize this issue. The commentary advocates for immediate attention from national level policymakers and public health agencies to collectively respond to this issue and prevent (mitigate) any additional public health sufferings arising from this. Keywords: Public spitting, COVID-19, transmission, policy, India, smokeless tobacco. [ABSTRACT FROM AUTHOR]

Women constitute 70% of the global health workforce but are significantly underrepresented in leadership positions. In India, professional medical associations (PMAs) play a crucial role in shaping policy agenda in the health sector, but very little is known about gender diversity in their leadership. Therefore, we analysed the gender representation of current and past leaderships of Indian PMAs. Data of the current and past national leadership and leadership committees of 46 leading PMAs representing general, specialities, and super-specialities were extracted from their official websites. Gender composition of leadership was analysed using a sequential approach. For Indian Medical Association (IMA), the largest Indian PMA, an analysis of its 32 sub-chapters was also undertaken. The findings revealed that only 9 (19.5%) out of 46 associations are currently led by a woman. Leadership committees of half the associations have less than 20% women, while there were no women in the central committee of nine PMAs. Among past presidents, information was publicly available for 31 associations and all of them have had less than 20% of women presidents till date. Among the 64 individuals currently serving as presidents and secretaries of 32 sub-chapters of IMA, only three (4.6%) are women. Even in associations closely related to women's health, such as obstetrics and gynecology, pediatrics, and neonatology, unequal representation persists, highlighting male dominance. These results demonstrate significant gender disparities in PMA leadership in India, necessitating urgent efforts to promote gender equality. Gender-transformative leadership is crucial to develop gender-sensitive health care policies and practices which can serve as a catalyst for broader societal change., Competing Interests: Three of the authors declare no competing interests. VS is on the Editorial Board of PLOS Global Public Health. VRK is a life member of the Indian Association of Preventive and Social Medicine (IAPSM) and Indian Public Health Association (IPHA) and has voting rights to elect leadership committees in these., (Copyright: © 2024 Singh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In their paper, Tama and colleagues observe that one key challenge in a pilot, multi-component intervention to strengthen health facility regulation was the reaction from health facility owners and providers to regulatory processes. In this commentary, we propose that future research and action on health facility regulation in low- and middle-income countries (LMICs) contexts adopt an explicit focus on addressing the role of interests and interest groups in health systems 'hardware' and 'software.' Research on policy processes in LMICs consist of fewer investigations into the political economy of national or sub-national interest groups, such as physician associations or associations of health facility owners. A growing body of literature explores supply-side and demand-side interest groups, power relations within and between these stakeholders, and their advocacy approaches within LMIC health sector policy processes. We posit that such analyses will also help identify facilitators and challenges to implementation and scale-up of similar reforms to health facility regulation., (© 2023 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)