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Introduction: Out-of-pocket (OOP) expenditure influences the access to the healthcare of the marginalized and vulnerable population including under-five children (U5C). The aim of the study is to estimate the OOP expenditure and its predictors in Bhubaneswar, a region of eastern India., Methods: A cross-sectional study was conducted using a semi-structured interview schedule in 20 urban slums of Bhubaneswar. The survey was carried out by using the National Sample Survey Office (NSSO) health consumption schedule 25.0 in which mothers of U5C with illness (n = 530) were interviewed. For data analysis, the nonparametric Wilcoxon rank-sum test and Kruskal-Wallis test were used as tests of significance., Results: The study revealed that the mean OOP expenditure for outpatient department (OPD) care was ₹375.9 (₹219.48). The mean approximated expenditure was ₹1669.8 (₹1131.9) for inpatient department (IPD) care. In OPD care, doctors' fee and medicine cost constituted 65.01% and 50.46% of OOP expenditure, respectively. In IPD care, medicine cost and doctors' fee contributed to 36.62% and 30.54% of OOP expenditure, respectively. The major significant predictors that contributed to increased OOP were gender and delay in approaching the source of treatment in OPD, whereas in IPD no such predictors were observed., Conclusions: This study prominently sheds light on the issue of accessibility and affordability of health services without a comprehensive health insurance scheme for U5C illness among the vulnerable urban slum dwellers to achieve universal health coverage., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Background: Internet is the world's largest network of information and communication services. The internet is widely used in medicine and had a significant impact on research, training, and patient care., Objectives: (1) To assess internet use to obtain health information for patient care among physicians of a medical college hospital. (2) To investigate the utilization of the internet during their daily practice and to know the reasons for its use and nonuse., Materials and Methods: A hospital-based cross-sectional study was conducted for a period of 2 months of May and June 2015 in a Medical College Hospital of Eastern India. A convenient sample of 200 physicians was included in the study. Data regarding access of internet in workplace, time spent on the internet for medical and nonmedical purposes, opinions regarding use of the internet to update medical knowledge, obstacles that affect its use, etc., were collected. The data were analyzed using SPSS software version 20., Results: It was seen that 47% doctors use laptop for accessing internet, followed by mobiles (34%). E-mail was the main purpose (41%) of internet use, followed by research (32.5%). Majority told that e-mail was the main purpose of last internet use (46.5%), followed by browsing medical resources (23%), research (15.5%), and patient care (12.5%). 97.5% agreed that they had ever browsed internet for patient care and 85.5% doctors agreed that they had obtained relevant information. 26.5% told that they need training for accessing free full-text electronic journals and 25% need training to access the sources for best clinical evidence for patient care. Other training needs were literature search (18%), downloading textbooks and other resources (15.5%), and searching internet sites for medical information (10%)., Conclusion: Providing training for improvement of searching skills for obtaining up-to-date medical information, and evidence-based medicine from internet will improve their practice of medicine., Competing Interests: There are no conflicts of interest.

Background: Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of the availability of contraceptive services., Objectives: (1) To study the sociodemographic profile of abortion seekers. (2) To study the reasons for procuring abortions by married women of reproductive age group., Materials and Methods: It was a cross-sectional community-based study. All the married women of reproductive age group (15-49 years) with a history of induced abortion were selected as the subjects., Results: The most common reason for seeking an abortion was poverty (39.4%), followed by girl child and husband's insistence, which accounted for 17.2% each. More complications were noted in women undergoing an abortion in places other than government hospitals and also who did it in the second trimester., Conclusions: To reduce maternal deaths from unsafe abortion, several broad activities require strengthening such as decreasing unwanted pregnancies, increasing geographic accessibility and affordability, upgrading facilities that offers medical termination of pregnancy (MTP) services, increasing awareness among the reproductive age about the legal and safe abortion facilities, the consequences of unsafe abortion, ensuring appropriate referral facilities, increasing access to safe abortion services and increasing the quality of abortion care, including postabortion care., Competing Interests: There are no conflicts of interest.