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INTRODUCTION: Location or distance from healthcare facilities affects the use of health facilities by households. The use of health facilities also have an impact on the socioeconomic conditions. Distance from healthcare facilities significantly affects catastrophic health expenditures. This study aimed to determine the association of physical distance to healthcare facilities with the economic deprivation of households. OBJECTIVE: This study aims to analyze the distance of healthcare facilities from households in different wealth index categories of Odisha. The study argues that the household wealth index is associated with the distance to healthcare facilities. METHODOLOGY: This study is based on six purposively selected districts in Odisha: Rayagada, Kalahandi, Angul, Keonjhar, Khordha, and Kendrapara in India. A cross-sectional household survey was conducted to collect the data. A total of 902 household data points were collected. Data analysis was carried out using SPSS version 25. RESULTS: A difference is observed among households that need to travel more than one hour to reach a private doctor or private hospital: 42.6% of poor households face this challenge, whereas only 25% of wealthy households do. Among those who cannot reach a public hospital in less than an hour, a larger proportion are from poor households (62.6%). The poor and wealthy segments of the population have nearly equal access to NGO-run healthcare facilities in terms of proximity. We observe that poor households are less likely than wealthy households to reach private pharmacists in less than an hour and are more likely to require over an hour to reach them. CONCLUSION: Ensuring healthcare facilities is the minimum requirement within one hour of reach for every household in India. Underreporting of illnesses and diseases is one of the major factors of high mortality in the population. Physical accessibil ity to healthcare facilities can reduce the mortality burden on the population. [ABSTRACT FROM AUTHOR]

Access to reproductive cancer care in India is significantly affected by social determinants of health. Reproductive cancers, including cervical, ovarian, and uterine cancers, constitute a significant health challenge for women in India. This cross-sectional survey aims to comprehensively assess the landscape of reproductive cancer care among women in India, exploring access, awareness, and barriers to timely diagnosis and treatment. This study highlights challenges in delivering care for reproductive cancers among women in India. A cross-sectional survey design was adopted, involving a representative sample of women from four diverse geographical regions, urban and rural settings, and varying socioeconomic backgrounds. Structured interviews were conducted, and questionnaires were used to collect data on participants' awareness of reproductive cancers, utilization of healthcare facilities, and experiences related to access to cancer care. The study adopted a convenient sampling approach and captured data from 509 women diagnosed with reproductive cancer. The collected data were analysed using the SPSS 25 version. Univariate, bivariate and multivariate analyses were performed. The survey identified one-fourth of the respondents as having ovarian cancer, and 23.4% were diagnosed with cervical cancer. One-third of the study respondents were diagnosed with breast cancer, and 18% had other reproductive system cancers. The survey also assesses the prevalence of risk factors contributing to the incidence of reproductive cancers. Socioeconomic status, education level, rural-urban settings, and cultural beliefs influence the healthcare-seeking behavior of the study participants. Insufficient knowledge, the stigma of reproductive health problems, and a lack of family income frequently discourage women from obtaining timely medical treatment. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Access to medicine is a concern in India and other developing countries. In India, Pradhan Mantri Bhartiya Janaushadhi Priyojana (PMBJP) helps to a certain extent in provision of medicines to people experiencing poverty. PMBJP is India's central government scheme hosted by the Department of Pharmaceuticals, which comes under the Ministry of Chemicals and Fertilizers. The scheme was uniformly introduced in all the states of the country to benefit the people at large in 2008. The objective of the scheme is to provide high-quality medication to everyone belonging to different strata of the population, especially underprivileged and impoverished people. The state has high regional inequality where few districts are economically developed while many others are economically backward, and access to medicine remains a challenge. This paper explores the knowledge and awareness of the scheme among PMC owners, grievances, and market competition of PMCs. METHODS: This study adopted a qualitative research method to understand the concerns of pharmacists and PMCs. An interview schedule was used to assess the situation. The research revolves around subjects such as proprietorship, motivational aspects, monetary provision, faith, satisfaction, perceived benefits, and challenges of the stakeholders. Therefore, openended, in-depth interviews were best suited for the study. PMC pharmacists were the only participants in the study. The data collection took place in January and February 2023. RESULTS: The results are presented under three themes pertaining to the PMC business: awareness, grievances, and market competition. The study revealed that the ownership of the PMCs was of two types in the state of Odisha, India: one was an old PMC that started between 2008 and 2015, and the other type was a new PHC that started after 2015. In 2015, radical changes were brought into the scheme. The popularity of the scheme among private pharmacists became a phenomenon after 2015; earlier, it was under the control of the government and the District Red Cross (DRC). The scheme was made open for all independent private pharmacists in 2015. The risk of expired stocks constantly loomed over the PMC business. PMC owners discussed expired drug management mechanisms. Market competition was very much in favor of the PMC owners, as thei r products were much cheaper than the branded market products. However, they reel under small earnings due to the low price of their products. CONCLUSION: Disseminating information about the PMBJP scheme is currently limited to existing pharmacists. The scheme could be promoted to recent graduates with D. Pharma or B to expand its reach. Pharma degrees, encouraging them to become independent PMC pharmacists. Additionally, enhancing mechanisms for managing expired drugs would make the PMC business more appealing. Reforms are also needed for older PMCs (established between 2008 and 2015) to prevent conflicts with authorities and other schemes. While PMCs benefit from lower product prices, they must increase sales volume to achieve satisfactory income, which should be considered to improve the financial outcomes for PMC owners. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The complex relationship between cancer care and poverty was examined in this paper. The study identified the association of various demographic factors with cancer care. The study also analyses the family's role and the support network in cancer care. METHODOLOGY: The study employed a mixed-method approach to understand cancer care in Jharkhand, India comprehensively. The study was conducted as a cross-sectional survey with 204 reproductive cancer patients. A structured interview schedule covered the socio-demographic variables and cancer care facilities. The study also used case study methods with three eligible adults who underwent or were currently undergoing cancer treatment. Descriptive statistics were used to summarise the study findings. The narratives of each case study construct a comprehensive understanding of each patient's journey with cancer care. The study has received ethical approval from the Institutional Review Board (IRB) and the cancer hospital. RESULTS: The survey results show that 47% of the respondents access treatment. Only 12.7% of respondents had taken the HPV vaccine, and 44.6% got physiotherapy during the treatment. Forty-four percent of respondents accessed counselling services from health services providers. Respondents' characteristics, such as age and gender, were strongly associated with access to counselling services. Education and family income were statistically associated with access to cancer care treatment. Only 7.4% of respondents arranged transport for treatment, and 11.8% arranged logistics and various treatment therapy for cancer care. Cancer patients from Jharkhand frequently face discrimination in receiving health care due to their economic condition. The case study perceived the differences in wealth, social class and family role in cancer care. As a result, cancer patients often feel hopeless and isolated, leading to depression and anxiety. CONCLUSION AND IMPLICATION: Poverty plays a negative role in providing and accessing cancer care in the state of Jharkhand. The role of family and society is essential for a cancer survivor. Psychological support from the family gives hope to life of the cancer patients. In addressing the complex relationship between financial burden and cancer care, both government agencies and the social structures must implement comprehensive strategies. [ABSTRACT FROM AUTHOR]

Introduction: Liver cirrhosis is the consequence of hepato-cellular injury that leads to both fibrosis and nodular regeneration in the liver. It is the most common cause of portal hypertension and its morbidity and mortality is higher in our country. Objective: To compare the efficacy of different doses of carvedilol and propranolol for treatment of portal hypertension in patients of liver cirrhosis. This randomized clinical trial was conducted in the North Medical Ward, King Edward Medical University, Mayo Hospital, Lahore for 6 months i.e. March 2013 to August 2013. Methods: After ethical approval of the study, 100 confirmed cases of liver cirrhosis with portal hypertension of ages 16 to 85 years with either gender were selected for this study by non-probability purposive sampling. These cases were randomly named as group A (I), A (II) & B (I), B (II). In group A (I) & (II) patients were given propanolol (20mg), Cavedilol (6.25mg) and group B (I) & (II) patients were given propranolol (40mg), carvedilol (12.5mg). Portal hypertension was labeled as portal flow velocity >12cm H O/sec on Doppler 2 ultrasonography. Portal flow velocity (PFV) was measured before and 90 minutes after administration of trial drugs and >20% decrease in portal flow velocity from baseline was considered as efficacy. Results: The mean age of the patients in group A was 48±14.4 years and in group B was 54 ±12.4 years. In group A (I), the mean portal flow velocity at baseline was 22.16±4.28 cm H O/sec and after treatment at 90 2 minutes mean portal velocity was 18.12±4.14 cm H O/sec. In group A (II), the mean portal flow velocity at 2 baseline was 25.16±4.2 and after treatment at 90 minute mean portal velocity was 13.16±2.42. In group B (I), the mean portal flow velocity at baseline was 25.56±3.54 and after treatment at 90 minutes it was 13.96±3.5.In group B (II), the mean portal flow velocity at baseline was 28.44±4.13 and In group B (I) after treatment at 90 minute mean portal velocity was 10.36±2.49. Conclusion: High dose carvedilol was more effective than propranolol as well as low dose of carvedilol in reduction of PFV. [ABSTRACT FROM AUTHOR]

Background: Substantial out-of-pocket (OOP) expenditures push a large portion of the population below the poverty line, especially those residing in rural areas having low incomes. Individuals from economically disadvantaged states in India incur higher healthcare costs for hospitalization in public health centers than do those from more developed states. Economically poorer households in states such as Bihar and Odisha face significantly higher OOP expenditures for hospitalization in public health centers than do those in economically developed states such as Tamil Nadu., Objective: This study aims to compare households by using the wealth index and demographic factors concerning OOP expenditures on medicines for acute and chronic illnesses in Odisha, India., Methodology: A cross-sectional household survey was adopted to conduct the research. Access to medicines focused on OOP expenditures in Odisha is being studied by purposively selecting six districts: Rayagada, Kalahandi, Angul, Keonjhar, Khordha, and Kendrapara. A total of 902 households were surveyed. A stratified random sampling procedure was adopted to select the locations and households. The survey took place from October 2021 to February 2022. The sampled respondents were investigated for acute and chronic illnesses. The software SPSS version 25 was used to analyze the data. The details of the expenditures for the past four weeks were compared with those of medicines and healthcare expenses. Households were categorized into wealthy, middle, and poor classes. The prevalence of acute and chronic illnesses was analyzed in light of the share of medicine expenditures to total household expenditures., Results: Out of 902 surveyed households, 173 (19.2%) spent out-of-pocket (OOP) money on medicines due to acute and chronic illnesses. Among the studied population, 23.7% were affected by acute illness, whereas 10.9% suffered from chronic illness. Wealthy households constituted most of the OOP expenditure (81 wealthy households), whereas 33 poor households also contributed to the OOP expenditure. According to the unadjusted odds ratio (UOR) analysis, wealthy households were 0.25 times less likely to spend more than 50% of their total monthly household budget on medicine than poor households (UOR = 0.25, 95% CI = 0.09-0.65). Similarly, ST households were 0.18 times less likely to spend more than 50% of their money on medicine from their budgets than SC households (UOR = 0.18, 95% CI = 0.04-0.72)., Conclusion: The present study again reveals that capital regions (metropolitan regions) are well protected against OOP expenditures on medicines, but tribal areas are still underserved. The odds ratio reveals a critical positive association between high OOP and poor economic status in households in Odisha. That association must be minimized or nullified for equitable economic and social development., Competing Interests: Declarations. Ethics approval and consent to participate: Yes, an ethical approval from the University of Hyderabad, Institutional Ethics Committee was obtained before the study was conducted. The ethical approval was done in accordance with the Declaration of Helsinki. Informed consent to participate was obtained from all of the participants in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)