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Introduction: Hearing is crucial for a child's development, influencing speech, cognition, and emotional well-being. Early detection of hearing disorders is vital, yet India faces challenges in implementing effective newborn hearing screening (NBHS) programs. This research explores the perspectives of audiologists, focusing on the major and minor challenges faced and current protocols followed across diverse setups in India. Method: A two-phase study involved questionnaire development and data collection from 116 audiologists nationwide. The survey addressed demographics, current practices, challenges faced, and opinions on NBHS improvements. Results: Findings revealed disparities in screening protocols, with 42 variations reported. Challenges included ambient noise control, communication gaps, and lack of interdisciplinary support. Audiologists emphasized the need for sensitizing healthcare professionals, free screening, and increased manpower to enhance NBHS efficacy. Conclusion: The study aligns with global challenges in NBHS program implementation. Rural areas face a shortage of audiologists, emphasizing the necessity to train community health workers. The varied screening protocols and delays in screening timeframe underscore the need for standardized guidelines and increased funding. Audiologists play a pivotal role in NBHS success. To overcome challenges, standardizing protocols, sensitizing healthcare professionals, and promoting community-based screening are crucial. The study emphasizes proactive measures among audiologists, continual research, and collaboration to enhance evidence-based practices and policy improvements in newborn hearing screening. [ABSTRACT FROM AUTHOR]

Delivering specialised care for major burns requires a multidisciplinary health workforce. While health systems ‘hardware’ issues, such as shortages of the healthcare workforce and training gaps in burn care are widely acknowledged, there is limited evidence around the systems ‘software’ aspects, such as interest, power dynamics, and relationships that impact the healthcare workforce performance. This study explored challenges faced by the health workforce in burn care to identify issues affecting their performance. Qualitative in-depth interviews were conducted with a purposively selected sample (n = 31, 18 women and 13 men) of various cadres of the burn care health workforce in Uttar Pradesh, India. Inductive coding and thematic analysis identified three major themes. First, the dynamics within the multidisciplinary team where complex relations, power and normative hierarchy hampered performance. Second, the dynamics between health workers and patients due to the clinical and emotional challenges of dealing with burn injuries and multitasking. Third, dynamics between specialised burn units and broader health systems are narrated in challenges due to inadequate first response and delayed referral from primary care facilities. These findings indicate that burn care health workers in India face multiple challenges that need systemic intervention with a multipronged human resource for health framework. [ABSTRACT FROM AUTHOR]

Introduction: Stereotypes have been a barrier to providing patients a diverse orthopaedic workforce. Our goal was to identify stereotypes and disparities among doctors and their patients regarding the attributes that should determine a competent orthopaedic surgeon. Materials and Methods: A cross-sectional descriptive multicenter study was conducted in India. Tailored questionnaires were administered to patients and orthopaedic postgraduates to determine the attributes they believe patients prefer in their orthopaedic surgeon. Likert data and data on preferred sex of the surgeon were analyzed as categorical data sets using frequency statistics. Participants were asked to rank surgeon attributes and analysis was based on frequency of an item among top 5 surgeon attributes. Results: 304 patients and 91 orthopaedic postgraduates participated in the study. 70.4% and 73% of patients and 27.5% and 29.6% of postgraduates preferred an orthopaedic surgeon with greater physical strength as an outpatient consultant or operating surgeon respectively. 81% of patients had no preference of the sex of their doctor. 56% of postgraduates felt patients would prefer a male operating surgeon, none felt their patient would prefer female orthopaedic surgeon. 92.3% of the female postgraduates felt patients would prefer a male orthopaedic surgeon. Patients most often ranked years of experience, surgical outcomes, time spent with patients, reputation, and physical strength in their top 5 surgeon attributes and sex, religion, and community were given least importance. Conclusion: Diversity among the orthopaedic workforce is necessary to optimize patient care. It is our collective responsibility to educate our patients and trainees and redress the misconceptions and stereotypes that plague our profession. [ABSTRACT FROM AUTHOR]

Backround: Occupational Therapy is increasingly becoming popular. The objective of the present study is to develop an insight to the current trends in practice of occupational therapy in India. The target group chosen for the study are budding occupational therapists who have completed their graduation within the last 5 years. Objectives: The study aims to investigate the trends in location of work setups, nature of organization of work, nature of place of employment, current work profile, nature of cases these budding therapists are dealing with currently, the work setup they are employed in and remuneration they are receiving. The trends emerging from the present study would be helpful to understand the current work dynamics and thus prepare the young workforce for future possible opportunities. Study Design: The present study was a survey-based research design. Data was gathered through a questionnaire. Methods: This questionnaire was distributed on an online platform to 695 therapists practicing across India. Care was taken to include only the therapists who had completed their graduation within the last five years i.e., between 2018-22. Data collection was carried out for a period of 8 months from October 2021 to May 2022. RESULTS: The analyses revealed that the profession of Occupational Therapy in the country is dominated by female therapists. The age of the workforce that have responded are in their mid-twenties. Most of them are working in urban or metropolitan setups primarily in Paediatric setups in clinics which are mostly privately owned rehabilitation centres. Conclusion: The present analyses pointed out that there may be a lack of diversification of practice in Occupational Therapy in the country. It also indicated that the freshly graduated out professionals feel that there are a limited remuneration and lack of opportunities in the Government sector, and as a result the current scenario suggests that most of them after being trained turn their head to foreign land for a better opportunity with respect to employment. However, new setups and areas of practice are slowly emerging and opportunities for young budding therapists are increasing back home. [ABSTRACT FROM AUTHOR]

Background: This article presents evaluation findings of the India English Language Programme, an innovative programme aimed at providing Indian nurses with an opportunity to participate in an ethical and mutually beneficial learning programme aimed at supporting migration into the United Kingdom's National Health Service (NHS). The programme provided 249 Indian nurses wishing to migrate to the NHS on an 'earn, learn, and return' basis with funding to support English language learning and accreditation sufficient to apply for Nursing and Midwifery Council (NMC) registration. The Programme provided English language training and pastoral support to candidates, in addition to the availability of remedial training and examination entry for those not meeting NMC proficiency requirements on their first attempt. Methods: Descriptive statistical analysis of programme examination results and cost-effectiveness analysis is presented to demonstrate programme outputs and outcomes. Descriptive economic analysis of programme costings is presented alongside programme results to investigate the value-for-money provided by this programme. Results: A total of 89 nurses were successful in meeting NMC proficiency requirements, representing a pass rate of 40%. Those undertaking OET training and examination(s) were more successful, compared to those undertaking British Council provision, with over half of candidates passing at the required level. This equates to an overall programme cost-per-pass of £4139 and represents a model to support health worker migration, in line with WHO guidelines, delivering individual learning and development, mutual health system gain, and value-for-money. Conclusions: Taking place during the coronavirus pandemic, the programme evidences the effective delivery of online English language training to support health worker migration during a highly disruptive period for global health. This programme demonstrates an ethical and mutually beneficial pathway for English language improvement amongst internationally educated nurses to facilitate migration to and global health learning in the NHS. It provides a template through which healthcare leaders and nurse educators, working in policy and practice environments in the NHS and other English-speaking countries, can design future ethical health worker migration and training programmes to strengthen the global healthcare workforce. [ABSTRACT FROM AUTHOR]

Background: Indo-US Masters in Emergency Medicine (MEM) certification courses are rigorous three-year emergency medicine (EM) training courses that operate as a partnership between affiliate hospitals or universities in the United States with established EM training programs and local partner sites in India. Throughout their 15 years of operation, these global training partnerships have contributed to the EM workforce in India. Our objective in this study was to describe Indo-US MEM program graduates, their work environments, and their contribution to the growth of academic EM and to the coronavirus disease 2019 (COVID-19) response. Methods: An electronic survey was created by US and Indian MEM course stakeholders and distributed to 714 US-affiliated MEM program graduates. The survey questions investigated where graduates were working, their work environments and involvement in teaching and research, and their involvement in the COVID-19 response. We consolidated the results into three domains: work environment and clinical contribution; academic contribution; and contribution to the COVID-19 response. Results: The survey response rate was 46.9% (335 responses). Most graduates reported working within India (210, 62.7%) and in an emergency department (ED) setting (304, 91.0%). The most common reason for practicing outside of India was difficulty with formal MEM certificate recognition within India (97, 79.5%). Over half of graduates reported dedicating over 25% of their work hours to teaching others about EM (223, 66.6%), about half reported presenting research projects at conferences on the regional, national, or international level (168, 50.5%), and almost all graduates were engaged in treating COVID-19 patients during the pandemic (333, 99.4%). Most graduates agreed or strongly agreed that they were satisfied with their overall MEM training (296, 88.4%) and confident in their ability to practice EM (306, 91.6%). Conclusion: Indo-US MEM graduates have made a notable contribution to EM in India through clinical service delivery, teaching, and research, even more essential in the context of the COVID-19 pandemic. The roles of these graduates should be acknowledged and can contribute further to expandEM specialty and systems development across India. [ABSTRACT FROM AUTHOR]

Background: Poverty is directly linked to public health care delivery in many ways and dimensions. Every aspect of the human sphere is preplanned, but a health crisis is the only emergency which pushes humanity into severe economic stress. Therefore, every nation aims to safeguard its citizens from a health crisis. In this aspect, India needs to improve its public health infrastructure in order to protect its citizens and save them from poverty. Objectives: (1) To assess the current pitfalls in public critical health care delivery, (2) to analyze whether the health care delivery matches the requirements of its population in every state, (3) to produce solutions and guidelines to overcome the stress in this priority area. Materials and methods: Data regarding the critical care workforce, which includes critical care doctors and nurses, were taken from official websites and other sources. Critical care infrastructure data were retrieved from the Internet sources. Data were validated by consulting state government sources and cross-checked for bias elimination. The data were analyzed using the "Statistical Package for Social Sciences" software version 20, and were presented using descriptive statistics. Results: There is a 1:10 percentage of deficit in the case of critical care workforce and infrastructure when compared with its need analysis. Critical care medicine specialists are in 1:75 when compared to other specialties. Conclusion: Overall, the public sector critical care needs a total boost through out of box solutions. According to the Stockholm International Peace Research Institute (SIPRI), India spent the third most on defense in the world in 2021. India spent 76.6 billion dollars on its military in 2021, up 33% from 2012 and 0.9% from 2020. However, since India is considered a fast-growing economy, there is still a huge disparity in critical care. Without resetting critical health care, India cannot grow in welfare indices even if it is among the top gross domestic product (GDP) countries. [ABSTRACT FROM AUTHOR]

The article focuses on the low representation of female orthopedic surgeons in India and how this gender gap can be addressed. The authors conducted a study to find possible causes for the low number of female orthopedic surgeons, by examining the perceptions of orthopedics as a specialty among undergraduate medical students.

Background: Doctors exhibit significant high stress levels due to an increasing overburdened healthcare system and increased high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the current pandemic. Stress among doctors has been linked with adverse physical and psychological health. Previous research indicates that perceived stress levels are correlated with emotional intelligence (EI) and with the coping strategies employed by doctors. Aims and Objectives: (1) To establish the relationship between perceived stress and emotional intelligence. (2) To evaluate the mediating role of adaptive and maladaptive coping strategies in relationship between EI and perceived stress among doctors during the current pandemic. Materials and Methods: This was a cross-sectional study involving 600 doctors working in dedicated COVID section of reputed medical college from March 2021 to June 2021 recruited for the study. Participants were recruited on-campus through web-based questioners, composed of three validated questionnaires namely Perceived Stress Scale, Brief Coping Orientation to Problems Experienced Inventory, and the Schutte Self-Report Emotional Intelligence Test and socio demographic form. Descriptive statistics were used to test the study hypotheses. Results: Higher EI was associated with lower perceived stress, and this association was partially mediated by both adaptive and maladaptive coping responses. Higher EI was associated with greater use of adaptive coping and lower use of maladaptive coping, and these, in turn, were negatively and positively, respectively, associated with perceived stress. Conclusion: The findings suggest that interventions aimed at increasing emotional intelligence and adaptive coping strategies may help to reduce perceived stress. [ABSTRACT FROM AUTHOR]

Objective To implement rehabilitation services in a rural area of Raigad district, Maharashtra, India. Methods We piloted a rehabilitation service delivery model through the Mahatma Gandhi Mission Institute of Health Sciences, in five villages. The institute performed participatory rural appraisal and focus group discussions with stakeholders to identify general issues in village life that could affect delivery. To integrate rehabilitation service delivery into the existing primary care system, a team from the institute developed a strategic plan through multidisciplinary clinical meetings. A rehabilitation team conducted a door-to-door survey and referred people needing rehabilitation services to the outreach visits the team was making to the primary health centre twice a week. If needed, patients could be referred to a university teaching hospital for tertiary-level care. Findings The rural appraisal identified lack of awareness, inadequate workforce and infrastructure as key issues for rehabilitation services delivery. In response, we conducted awareness campaigns and formed a rehabilitation team consisting of personnel and students from the institute. Between 2018 and 2021, the team provided care to 1800 patients, of which half (900 patients) had musculoskeletal disorders. After rehabilitation, 360 (40%) of these 900 patients performed daily-living activities and continued to work with reduced pain within 2-3 days after rehabilitation. The team provided antenatal care to 1629 pregnant women with musculoskeletal pain or stress urinary incontinence. Conclusion Provision of rehabilitation services built awareness about physiotherapy, developed a rehabilitation care pathway and established a need for regular services. Using existing resources of the institute and involving students rendered the model sustainable. [ABSTRACT FROM AUTHOR]

Introduction: Entry of women into urology has not kept pace with that in other surgical branches with only 1% of Urological Society of India (USI) members being female. The objective of this study was to explore the personal and professional challenges, practice barriers, and level of satisfaction among female urologists/urology trainees in India. Methods: A strictly confidential and anonymous 26-item questionnaire with respect to professional and personal challenges, workplace discrimination, and family satisfaction was circulated as a Google form through email and WhatsApp to all the female members of the USI (full and associate) and trainees (n = 48) based on identification from the USI directory. Results: Thirty-three out of 48 female urologists responded (68%). Among the respondents (n = 33), majority had <5 years of experience (60.6%), of which 30.3% were residents, which reflected a recent surge in women joining urology. Majority (57.7%) chose to subspecialize, commonly in "female urology". Many (72.7%) were encouraged to take this subspecialty. Gender discrimination at workplace was reported by 54.5%, commonly by patients and consultants. 68% of respondents had conceived either before or during residency, leading to additional domestic responsibilities. 9.1% suffered a pregnancy-related complication, which they believed was a direct consequence of their work environment. These obstacles led to 30.3% of women reporting that their personal life had compromised their careers. Professional dissatisfaction was reported by 60.1% of women, with common causes being less operative time than male counterparts and lack of mentorship. Despite these challenges given a chance, 78.7% would choose urology again, and 66.7% would encourage their daughter to pursue a career in urology. Conclusion: Professional and personal challenges as perceived by women responding to our survey include gender discrimination in training and work, lack of mentorship, pregnancy-related compilations, and compromised career due to family responsibilities. Despite these, most would choose this specialty again. [ABSTRACT FROM AUTHOR]

Background: Nurses are the backbone of health care systems worldwide. In India the assessment of existing knowledge of nursing workforce and the utilization of skills is not evaluated and properly used to ensure good quality in health care. Method: Using the Delphi technique a survey was developed and sent to nurses. Self- rating method (on a likert scale) were used in order to operationalize the personal skills. Results: Almost half (48%) of the participants have a Bachelor degree. Out of this 27.2% qualified for a higher education (e.g. Master in related subject). Most nurses (56% in sample were females) are permanent employed working as staff nurse or nursing officers in the public sector. Among the participants 20% have sufficient teaching experience between 1 to 3 years. Self-rating of skills was high in almost all topics. Conclusion: Having attained higher education most of the participants remain working as staff nurses. The good self-rating of participants underlines their ability to take over much higher positions and responsibilities. Moreover, teaching experience is hardly acknowledged by institutions since teaching staff is usually recruited from outside. The study suggests that a majority of the population has an interest to work in rural area .Better work conditions are needed in order to gain workforce in this areas. Skills should effectively utilized in areas of administration, management, research and education, with a proper distribution to rural and urban areas in order to ensure a good health care system in India. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy (OT) practice in India is yet to be regulated at the national level. This presents a significant challenge to the OT community in India as it would be difficult for them to defend themselves if other professionals violate the scope of practice (SOP) boundaries. Objectives: The aim is to explore the views of occupational therapists (OTs) related to the issue of SOP boundary violation in OT practice in India. Study Design: An online survey research design was chosen to conduct this study. A 10-item electronic survey (9 with response options and one open ended) was developed based on the research question. Methods: An online survey link generated through SurveyMonkey was E-mailed to 760 OTs in India, identified through convenient sampling. The survey link was also shared on four WhatsApp Messenger groups (TNAIOTA Official Group, OTist Group, Clinic OT, and IPOTPDG1) with many Indian OTs (snowball sampling). Data were collected from January 29, to February 29, 2020. Results: The number of responses received was 126. One hundred and nine (87%) respondents believed that other professionals encroach OT's SOP boundaries knowingly or unknowingly. This belief is strong among all OTs across the nation, regardless of gender and practice experience. Conclusions: Many OTs in India believe that individuals belonging to other professions step into the domain of OT knowingly or unknowingly. Enacting an OT practice legislation, establishing a regulatory body at the national level and increasing them at state levels, endorsing an official SOP document, educating stakeholders, and engaging in awareness promotion initiatives would help mitigate the issue to a great extent. Ongoing and strategic efforts by the OT community in India are warranted. [ABSTRACT FROM AUTHOR]

Background: A large number of government primary health-care facilities (GPHCFs) in India do not have access to the regular electricity supply. Objectives: To assess the status and change in electricity access, sources, and reliability at primary health centers (PHCs) in India; and to understand the effect of regular electricity supply on health services provision and on workforce availability and retention. Materials and Methods: Secondary analysis of data from the lastest two rounds of district-level household survey (DLHS) in India, conducted in 2007-2008 and 2012-2013. Results: Data of 8619 PHCs from DLHS-3 and 8540 PHCs from DLHS-4 were analyzed. The proportion of PHCs with access to electricity increased from 87% to 91%. However, regular electricity supply was available at only 50% of PHCs in 2012-2013, which was an increase from 36% such PHCs in 2007-2008. PHCs with regular electricity supply provided services to 50% more beneficiaries (deliveries and vaccination) than PHCs without regular or no electricity (P ≤ 0.001). Increased access to regular electricity was associated with improved availability and retention of health staff (P = 0.001). Conclusion: Government policies should aim to ensure access to regular electricity-supply-beyond just connection from grid-at all GPHCFs, including health sub-centers, PHCs, and community health centers. Indicators on electricity access at GPHCFs could be standardized and integrated into regular health and facility-related surveys as well as in the existing dashboards for real-time data collection. Health policy interventions should be informed by regular data collection and analysis. Improving access to regular electricity supply at GPHCFs can contribute to achieve the goals of National Health Policy of India. This will also help to advance universal health coverage in the country. There are lessons from this study, for other low and middle income countries, on improving health service provision at government health care facilities. [ABSTRACT FROM AUTHOR]

Introduction: Mining industry has grown sharply to satisfy demands of metal and minerals for rising infrastructure. Mining is hazardous, although it is among major occupations in India involving large work force. This study was conducted to assess sociodemographic profile of sandstone mine workers in Jodhpur and to identify their major social issues. Material and Methods: A cross-sectional study was conducted among mine workers of Jodhpur, Rajasthan. Data on socioeconomic status, and occupation of each family member were collected. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 23.0. A value of P < 0.05 was considered as statistically significant. Results: A total of 1604 workers were enrolled in study. More than three fourth (78.7%) of them were male. Their age ranged between 14 and 82 years with a mean age of 37.62 ± 12.30 years. Mean age of female workers was significantly higher than of male workers. Average years of working for males were significantly higher than females. Majority were illiterate, proportion being higher in females. Approximately 13% mine workers married before legal age. Approximately 2.68% children under 14 years of age were involved in income generation activity. Conclusion: More than three fourth of workers were male. Mean age of female workers was significantly higher than males. Illiteracy, child marriage, and child labor were present among mine workers. Strengths and Limitations: Robust dataset, complete enumeration, large sample size. [ABSTRACT FROM AUTHOR]

Context: Almost 1/5th of the adolescent population suffers from mental morbidity. In older adolescents, clinical challenges are accompanied by unique psychosocial and developmental needs. Recent legislations in India - the Mental Health Care Act, 2017 and the Juvenile Justice Act, 2015 - mandate specific arrangements and provisions for evaluation and treatment of children and adolescents. A separate inpatient Adolescent Psychiatry Center (APC) was started at National Institute of Mental Health and Neurosciences, Bangalore, in 2016. Aims: (a) The aim of this study is to present the need for, development, infrastructure and workforce at APC; (b) to describe clinical profile of adolescents admitted to APC and (c) to identify clinical and psychosocial challenges in the management of older adolescents. Setting and Design: The paper covers consecutive inpatient admissions over the first 7 months of APC. Materials and Methods: Data were gathered from a review of hospital records, staff meetings, and case files. Statistical Analysis: Qualitative data, such as clinical management challenges, are summarized under major emergent themes. Quantitative data are summarized as means with standard deviations and frequencies with percentages. Results: Males, from urban, nuclear family background constituted the majority admissions. Family stressors and risk behaviors were prevalent. Unique clinical challenges included - risk behaviors, issues related to autonomy, conflict with family and conflict with the legal system. Conclusions: Older adolescents need to be treated in an environment appropriate to their age and developmental stage. Restructuring of spaces, routines, and creative inputs to interventions strategies must be made for healing environments for youngsters. APC could be a model for the development of other similar centers. [ABSTRACT FROM AUTHOR]

In 2004, a Mental Health Pilot Project was implemented in Gujarat State, India, for the rehabilitation of persons with mental disorders in community settings, along the lines of the CBR model. The state government, in collaboration with the Royal Netherlands Embassy, selected the Blind People's Association (BPA) to design and implement the programme. Working closely with NGOs and local communities, this private-public partnership established referral links with government hospitals to provide medicines and counselling to affected persons. At the end of 18 months, 1206 people (diagnosed with schizophrenia, mania, depression and epilepsy) had accessed psychiatric services on a regular basis, and 272 people had recovered and resumed their earlier occupations. As a result of the pilot project, it may be concluded that rehabilitation of people with mental illness is possible outside of hospital settings. [ABSTRACT FROM AUTHOR]