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Smokeless tobacco (SLT) use is widespread across many nations and populations, and India shares more than three-quarters of the global burden of SLT consumption. Tobacco use in India has been largely viewed as a male-dominant behaviour. However, evidence from medical, social and behavioural sciences show significant SLT use among women and young girls. This paper highlights key dimensions of SLT use among women in India including prevalence and determinants, the health effects arising from SLT use and cessation behaviours. The paper concludes by providing recommendations with the aim of setting research priorities and policy agenda to achieve a tobacco-free society. The focus on women and girls is essential to achieve the national targets for tobacco control under the National Health Policy, 2017, and Sustainable Development Goals 3 of ensuring healthy lives and promote well-being for all. [ABSTRACT FROM AUTHOR]

Purpose: To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC) 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously.Methods: A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to "match" the AIOC free-paper with the published paper. In addition, the "purpose," "methods," and "outcome measures" between the two were studied to determine the "match."Results: A total of 58 out of 394 free-papers (14.7%) from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90%) were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50%) followed by glaucoma (24.4%) and cornea (23.8%). Fifteen out of 272 posters (5.5%) were published; orbit/oculoplastics had the highest poster publications (13%). Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%.Conclusion: The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country. [ABSTRACT FROM AUTHOR]

This study analyses the research output of India in epilepsy research during 2002-11 on several parameters including the growth, rank and global publications share, citation impact, share of international collaborative papers, contribution of major collaborative partner countries, contribution of various subject-fields, contribution and impact of most productive institutions and authors, media of communication and characteristics of high cited papers. The Scopus Citation Database has been used to retrieve the data for 10 years (2002-11) by searching the keywords "epilepsy research" in the combined Title, Abstract and Keywords fields. Among the top 20 most productive countries in epilepsy research, India ranks at 11th position (with 1550 papers) with a global publication share of 2.88% and an annual average publication growth rate of 15.31% during 2002-11. Its global publication share has increased over the years, rising from 2.06% in 2002 to 4.65% during 2011. Its citation impact per paper was 2.77 during 2002-11, which decreased from 3.48 during 2002-06 to 2.41 during 2007-11. Its international collaborative publications share was 12.32% during 2002-11, which decreased from 12.45% during 2002-06 to 12.26% during 2007-11. Concludes that India needs to increase both the quantity and quality of research and also the need to share research data and stimulate national and international collaborative research, which will increase both the quantity and quality of research in epilepsy. There is a need to develop a national program on epilepsy as a part of national health plan, besides suggesting the funding agencies to establish a more ambitious funding program into the causes, prevention, cure and care of epilepsy. There is a need to build capacity at all levels of human resources for the management of epilepsy. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of "Written Formative assessments with Peer-Assisted Learning Program" was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016–2019 and 2017–2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination. [ABSTRACT FROM AUTHOR]

Background: The total number of people with HIV (Human Immunodeficiency Virus) infection in India is estimated to be 10% of all global cases. People living with HIV in India often experience discrimination while receiving health care due to inadequate knowledge and fear among health care professionals. Data presented in this paper represents the first phase of a six-year study being conducted at a Medical College in Mumbai, India. Information from this phase of the study will be used to demonstrate the need for an HIV-specific training module for the first year medical students. Methods: A cross-sectional study was conducted among 200 first-year medical students in Mumbai, India to assess knowledge and attitudes as they relate to HIV infection. A self-administered survey was distributed among the medical students at a medical college in Mumbai. The survey sought student responses pertaining to knowledge of HIV risk and transmission, and attitudes towards HIV-infected people. Results: A response rate of 87% was obtained (174 out of 200). Overall, females showed less knowledge pertaining to issues related to human sexuality and HIV transmission when compared to their male peers. Anal intercourse was reported as a risk for HIV transmission by 3% of females as compared to 20% of males (p less than 0.05). Furthermore, 28% of females reported no relationship between the risk of contracting HIV and the type of sexual intercourse compared to 3% of males (p less than 0.05). In general, there were considerable misconceptions regarding the spread and risk of HIV transmission among all medical students. Sixty six percent (66%) of females were comfortable having HIV infected doctors and nurses (co-workers) in clinics and hospitals compared to 36% of males. Forty-four percent (44%) of the medical students preferred not being friends with HIV infected individuals. Sixty-two (62%) percent of the students favored abstinence only messages for prevention of HIV among teenagers. Discussion: Knowledge regarding risk and routes of HIV transmission was lacking among the medical students. Attitudes of the students toward HIV-infected individuals could be best described as ambivalent. However, female students showed more positive attitude towards HIV infected people than their male peers. Conclusions: Based on our findings we recommend the development and integration of a HIV training module in the first year medical curricula in order to address gaps in knowledge and provide training for the development of positive altitudes and tolerance toward HIV infected people. (Contains 2 tables.)

Background: The Knowledge Network project was launched in 2010 to build evidence on the HIV epidemic by using the data generated by HIV programme implementing organisations in India. This paper describes the implementation of the programme and the strategies adopted to enhance the capacity of individuals to document and publish HIV prevention programme learnings. Further, it discusses the outcomes of the initiative.Methods: A multipronged approach was adopted, where a group of experts were brought together to collaborate with programme implementing organisations, review available data, develop research questions and guide peer-reviewed publications. Further, scientific writing courses were conducted to support individuals from HIV programme implementing organisations as well as educational and government organisations (mentees) to build the documentation capacity of individuals leading programme implementation and current and future researchers. The impact and quality of evidence generated was measured by examining the number of papers published, the number of citations, and the number of papers with at least 10 citations. Additionally, course participants' responses to open-ended questions in the anonymous course evaluation questionnaires are presented as verbatim quotes.Results: Overall, 99 papers on HIV programmatic learnings from India were finalised under the programme, of which 95 have been published. In all, 67 papers were co-authored by mentees. Most papers were published in high-impact factor (1 or more) journals and 72% were cited at least once in the literature. The main themes documented include key populations' HIV risk, HIV risk of general population groups, HIV/STI service delivery models and community mobilisation interventions.Conclusion: The study demonstrates that an integrated approach, involving partnership, capacity-building and mentorship, can maximise the use of available data and build the evidence base on HIV programmatic learnings. The capacity-building model adopted in the programme can be used to build scientific writing and documentation capacity in other public health programmes that are implemented at scale. [ABSTRACT FROM AUTHOR]

India continues to grapple with a significant burden of HIV infections. Despite notable progress in prevention and treatment efforts, multiple challenges, such as high-risk populations, inadequate testing facilities, and limited access to healthcare in remote areas, persist. Though the Government of India offers HIV-1 plasma viral load testing at various medical centers, aiding treatment decisions and monitoring antiretroviral therapy effectiveness, enhancing care for individuals living with HIV under the National AIDS Control Program (NACP), the nation's large population and diverse demographics further complicate its outreach and response. Hence, strategic interventions and alternative methods of testing remain crucial to curbing HIV transmission and improving the quality of life for those affected. Dried blood spot (DBS) sampling has emerged as a convenient and cost-effective alternative for HIV-1 viral load testing, revolutionizing the landscape of diagnostic and monitoring strategies for HIV infection. Though the plasma-based viral load remains the gold standard for monitoring HIV-1, DBS-based HIV-1 viral load testing holds immense promise for improving access to care, particularly in resource-limited settings where traditional plasma-based methods may be logistically challenging. DBS entails the collection of a small volume of blood onto filter paper, followed by drying and storage. This approach offers numerous advantages, including simplified sample collection, transportation, and storage, reducing the need for cold-chain logistics. Recent studies have demonstrated the feasibility and accuracy of DBS-based HIV-1 viral load testing, revealing a strong correlation between DBS and plasma measurements. Its implementation can enhance the early detection of treatment failure, guide therapeutic decisions, and ultimately contribute to better clinical outcomes for HIV-infected individuals. Hence, this review explores the principles, advancements, feasibility, and implications of DBS-based HIV-1 viral load testing. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

Introduction: The healthcare delivery system of Assam faces several challenges to provide affordable, accessible and quality care services. GNRC (Guwahati Neurological Research Center) is the first super-speciality hospital to address many of these gaps by delivering integrated affordable healthcare services to the populations of Assam and other parts of North-eastern India. Description & Discussion: This paper describes the implementation of a care delivery model which provides integrated care delivery services through linking hospitals to primary healthcare services, including preventive, promotive, and curative care, along with delivering easily accessible and affordable care to the people of Assam and other parts of North-eastern India. Conclusion: The proposed model is the first innovative approach from Northeastern India, Assam, to deliver affordable, accessible and patient-centric hospital led community-based preventive, promotive, and primary, secondary, and tertiary hospital-based care. It is anticipated that GNRC's "Affordable Health Mission" will help redesign and integrate the way primary, secondary and tertiary healthcare is delivered to the population of Assam in helping patients manage their own health and reduce the numbers that needs to be admitted to secondary care and tertiary care by improving patients' independence and well-being as well as dramatically reducing the cost to the overall health system. [ABSTRACT FROM AUTHOR]

A well-structured digital database is essential for any national priority project as it can provide real-time data analysis and facilitate quick decision making. In recent times, particularly after the COVID-19 pandemic, invasive fungal infections (IFIs) have emerged as a significant public health challenge in India, affecting vulnerable population, including immunocompromised individuals. The lack of comprehensive and well-structured data on IFIs has hindered efforts to understand their true burden and optimize patient care. To address this critical knowledge gap, the ICMR has undertaken a Pan-India pioneer initiative to develop a network of Advanced Mycology Diagnostic research centres in different geographical zones of the country (ICMR-MycoNet). Under the aegis of this project, a clinical registry on IFIs in the ICUs is initiated. This process paper presents a detailed account of the steps involved in the establishment of a web-based data entering and monitoring platform to capture data electronically, ensuring robust and secure data collection and management. This system not only allows participating ICMR-MycoNet centres to enter patient information directly into the database using standardized Case Report Form (CRF) but also includes data validation checks to ensure the accuracy and completeness of entered data. It is complemented by a real-time, web-based, and adaptable data visualization platform. This registry aims to provide crucial epidemiological insights, promote evidence-based hospital infection control programs, and ultimately improve patient outcomes in the face of this formidable healthcare challenge. [ABSTRACT FROM AUTHOR]

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]

Presents several research papers and studies on medicine presented at the 10th Annual Conference of the Indian Society of Critical Care Medicine in India. Background of the research; Objectives; Study design.

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Although it is well known that vaccines against many infectious diseases confer positive economic externalities via indirect protection, analysts have typically ignored possible herd protection effects in policy analyses of vaccination programs. Despite a growing literature on the economic theory of vaccine externalities and several innovative mathematical modeling approaches, there have been almost no empirical applications. The first objective of the paper is to develop a transparent, accessible economic framework for assessing the private and social economic benefits of vaccination. We also describe how stated preference studies (for example, contingent valuation and choice modeling) can be useful sources of economic data for this analytic framework. We demonstrate socially optimal policies using a graphical approach, starting with a standard textbook depiction of Pigouvian subsidies applied to herd protection from vaccination programs. We also describe nonstandard depictions that highlight some counterintuitive implications of herd protection that we feel are not commonly understood in the applied policy literature. We illustrate the approach using economic and epidemiological data from two neighborhoods in Kolkata, India. We use recently published epidemiological data on the indirect effects of cholera vaccination in Matlab, Bangladesh (Ali et al., 2005) for fitting a simple mathematical model of how protection changes with vaccine coverage. We use new data on costs and private demand for cholera vaccines in Kolkata, India, and approximate the optimal Pigouvian subsidy. We find that if the optimal subsidy is unknown, selling vaccines at full marginal cost may, under some circumstances, be a preferable second-best option to providing them for free. (Contains 14 footnotes, 2 tables, and 8 figures.)

In this paper, I have described the healthcare problem (maldistribution of doctors) in India. Later, I have introduced the concept of artificial intelligence (AI) and I have described AI technology with various examples, how it is rapidly changing the healthcare scenario across the world. I have also described the various advantages of artificial intelligence technology. At the end of the paper, I have raised some serious concerns regarding complete replacement of human based healthcare technology with artificial intelligence technology. I concluded that there is not the slightest question that AI will influence the future. People must be innovative, insightful, and context-aware for AI to work. This is because humans will continue to contribute value that cannot be reproduced by robots. [ABSTRACT FROM AUTHOR]

The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacitybuilding measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country. [ABSTRACT FROM AUTHOR]

The dream of universal health care demands a much larger and wider approach, engaging not just the public but also the private sector. This paper has attempted mapping the present public-private partnership scenario in India using the WHO health system functions framework, giving an insight into the nature and extent ofchallenge of the present dominant model. A systematic review methodology was adopted to identify published literature on private-public partnership in India. From an initial pool of 785 articles were identifi ed. Finally a total of 29 published articles meeting the inclusion criteria were included. The descriptive framework of Health system functions by WHO (2000), were used to analyze the data. All papers which were considered for the study were segregated based on the 4 prime health system functions: Financing; Management of non-fi nancial inputs; Health service delivery and Oversight. The literature review reveals that more than half of the papers (51.72%) selected for the study were focused on health service delivery functions and quite thin literature were available for other 3 functions, which includes fi nancing, management of non-fi nancial inputs and oversight functions as per WHO. This fi nding raise an important question if the genesis of most of the public-private partnerships is out of the inability of the public sector in reaching out to a particular target group by virtue of its geographical position or diffi culty in working with high risk groups. Considering the limitations of the present model of engagement of private and public sectors, it demands for an alternative model of engagement where the mutual strength that exists with each one of the partners, could be harnessed and complemented. An alternate model is to engage in tri-partite partnership (TPP) between the government, non-government and the corporates. [ABSTRACT FROM AUTHOR]

Evidence-informed policymaking integrates the best available evidence on programme outcomes to guide decisions at all stages of the policy process and its importance becomes more pronounced in resource-constrained settings. In this paper, we have reviewed the use of systematic review evidence in framing National Health Programme (NHP) guidelines in India. We searched official websites of the different NHPs, linked to the main website of the Ministry of Health and Family Welfare (MoHFW), in December 2020 and January 2021. NHP guideline documents with systematic review evidence were identified and information on the use of this evidence was extracted. We classified the identified systematic review evidence according to its use in the guideline documents and analysed the data to provide information on the different factors and patterns linked to the use of systematic review evidence in these documents. Systematic reviews were mostly visible in guideline documents addressing maternal and newborn health, communicable diseases and immunization. These systematic reviews were cited in the guidelines to justify the need for action, to justify recommendations for action and opportunities for local adaptation, and to highlight implementation challenges and justify implementation strategies. Guideline documents addressing implementation cited systematic reviews about the problems and policy options more often than citing systematic reviews about implementation. Systematic reviews were linked directly to support statements in few guideline documents, and sometimes the reviews were not appropriately cited. Most of the systematic reviews providing information on the nature and scale of the policy problem included Indian data. It was seen that since 2014, India has been increasingly using systematic review evidence for public health policymaking, particularly for some of its high-priority NHPs. This complements the increasing investment in research synthesis centres and procedures to support evidence-informed decision making, demonstrating the continued evolution of India's evidence policy system. [ABSTRACT FROM AUTHOR]

Background: Building on a distinguished history of community medicine training, public health programs have been expanding in India in recent years. The COVID-19 pandemic has brought additional attention to the importance of public health programs and the need for a strong workforce. This paper aims to assess the current capacity for public health education and training in India and provide recommendations for improved approaches to meet current and future public health needs. Methods: We conducted a desk review of public health training programs via extensive internet searches, literature reviews, and expert faculty consultations. Among those programs, we purposively selected faculty members to participate in in-depth interviews. We developed summary statistics based on the desk review. For qualitative analysis, we utilized a combination of deductive and inductive coding to identify key themes and systematically reviewed the strengths and weaknesses of each theme. Results: The desk review captured 59 institutions offering public health training across India. The majority of training programs were graduate level degrees including Master of Public Health and Master of Science degrees. Key factors impacting these programs included collaborations, mentorship, curriculum standardization, tuition and funding, and student demand for public health education and careers. Collaborations and mentorship were highly valued but varied in quality across institutions. Curricula lacked standardization but also contained substantial flexibility and innovation as a result. Public sector programs were perceived to be affordable though fees and stipends varied across institutions. Further development of career opportunities in public health is needed. Conclusion: Public health education and training in India have a strong foothold. There are numerous opportunities for continued expansion and strengthening of this field, to support a robust multi-disciplinary public health workforce that will contribute towards achieving the sustainable development goals. [ABSTRACT FROM AUTHOR]

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. [ABSTRACT FROM AUTHOR]

More than supply the demand for health care usually determines the design of public health services. This is more so when technological developments, including that of information and communication technologies, pierce through the process of utilization of any service by the public. Although prior research papers have focused on the factors that impact on the adoption of information technology, there are limited empirical research works that simultaneously capture technology factors (TAM, TAM2) and end-user development specifc factors (perceived technology usage and intention to recommend) helping healthcare professionals to adopt Health Management Information System (HMIS) software in the healthcare environment. To fill this gap, the present paper used the Technology Acceptance Model (TAM), the extended TAM model (TAM2) and identified the important determinants of user acceptance perceived risk and trust. This is specifcally undertaken in order to describe ESIChealthcare professionals behavioral intention to adopt HMIS software services. The study was conducted in the Employees' State Insurance Corporation (ESIC) main hospital and dispensaries in the Tirunelveli sub-region. The required data were collected from 171 ESIC healthcare professionals in the Tirunelveli sub-region. A Structural Equation Model (SEM) approach was used. Convergence anddivergence with earlier findings were found, confrming that Perceived Usefulness (PU), Perceived Ease of Use (PEOU), social infuence, facilitating conditions and training hadsignificant infuence on the intention of healthcare professionals to adopt HMIS software. The study provideda basis for further refnement of technology adoption model. Improvingperceived usefulness factor (perceived long-term usefulness) may turn healthcare professionals towards adoption of HMIS. [ABSTRACT FROM AUTHOR]

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them. [ABSTRACT FROM AUTHOR]

Anemia is one of the most pressing public health issues in the world with iron deficiency a major public health issue worldwide. The highest prevalence of anemia is in developing countries. The complete blood count is a blood test used to diagnose the prevalence of anemia. While earlier studies have framed the problem of diagnosis as a binary classification problem, this paper frames it as a multi class (three classes) classification problem with mild, moderate and severe classes. The three classes for the anemia classification (mild, moderate, severe) are so chosen as the world health organization (WHO) guidelines formalize this categorization based on the Haemoglobin (HGB) values of the chosen sample of patients in the Complete Blood Count (CBC) patient data set. Complete blood count test data was collected in an outpatient clinical setting in India. We used Feature selection with Majority voting to identify the key attributes in the input patient data set. In addition, since the original data set was imbalanced we used Synthetic Minority Oversampling Technique (SMOTE) to balance the data set. Four data sets including the original data set were used to perform the data experiments. Six standard machine learning algorithms were utilised to test our four data sets, performing multi class classification. Benchmarking these algorithms was performed and tabulated using both10 fold cross validation and hold out methods. The experimental results indicated that multilayer perceptron network was predominantly giving good recall values across mild and moderate class which are early and middle stages of the disease. With a good prediction model at early stages, medical intervention can provide preventive measure from further deterioration into severe stage or recommend the use of supplements to overcome this problem. [ABSTRACT FROM AUTHOR]

In recent years, community health governance structures have been established in many low and middle-income countries (LMICs) as part of decentralization policies aimed at strengthening primary healthcare systems. So far, most studies on these local structures either focus on measuring their impact on health outcome or on identifying the factors that affect their performance. In this paper we offer an alternative contribution that draws on a sociological interpretation of community health governance to improve understanding of how the government's policy vision and instrumentation translate to interactions that take place within local spaces at field level. We study 13 Village Health Sanitation and Nutrition Committees (VHSNCs) in Karnataka, India, from 2016 to 2018 focusing on sanitation, nutrition and hygiene which remain impediments to improving primary healthcare amongst poor and marginalized communities. Three local governance mechanisms of horizontal coordination, demand for accountability and self-help help to explain improvements that have taken place at village level and contribute to the creation of a new theory of community health governance as evolving phenomenon that requires a constant process of learning from the field to strengthen policymaking. [ABSTRACT FROM AUTHOR]

While considerable existing literature has focused on the lack of sanitation services in informal settlements, this paper argues for the need for well-maintained sanitation services in city public spaces. Specifically, the paper describes the impact of a lack of sanitation facilities in public spaces and its linkages to waste picker women’s sense of safety and security. Drawing on the experiences of waste picker women residing in an informal settlement in Pune, it focuses on women’s everyday improvisations and negotiations to cope with the unavailability or inaccessibility of sanitation facilities while they traverse the city, picking and segregating waste, and the impact on their income, health and psychological well-being. The findings show that the policy discourse on sanitation needs to be expanded beyond a focus on informal settlements to include a public sanitation component. [ABSTRACT FROM AUTHOR]

Background: In the last two decades, cesarean section (CS) deliveries in India have increased by six-fold and created economic hardship for families and households. Although several schemes and policies under the National Health Mission (NHM) have reduced the inequality in the use of maternal care services in India, the distributive effect of public health subsidies on CS deliveries remains unclear. In this context, this paper examines the usage patterns of CS delivery and estimates the share of public health subsidies on CS deliveries among mothers by different background characteristics in India.Data: Data from the fourth round of the National Family Health Survey (NFHS-4) was used for the study. Out-of-pocket (OOP) payment for CS delivery was used as a dependent variable and was analyzed by level of care that is, primary (PHC, UHC, other) and secondary (government/municipal, rural hospital). Descriptive statistics, binary logistic regression, benefit incidence analysis, concentration curve and concentration index were used for the analysis.Results: A strong economic gradient was observed in the utilization of CS delivery from public health facilities. Among mothers using any public health facility, 23% from the richest quintile did not pay for CS delivery compared to 13% from the poorest quintile. The use of the public subsidy among mothers using any type of public health facility for CS delivery was pro-rich in nature; 9% in the poorest quintile, 16.1% in the poorer, 24.5% in the middle, 27.5% among richer and 23% in the richest quintile. The pattern of utilization and distribution of public subsidy was similar across the primary and secondary health facilities but the magnitude varied. The findings from the benefit-incidence analysis are supported by those obtained from the inequality analysis. The concentration index of CS was 0.124 for public health centers and 0.291 for private health centers. The extent of inequality in the use of CS delivery in public health centers was highest in the state of Mizoram (0.436), followed by Assam (0.336), and the lowest in Tamil Nadu (0.060), followed by Kerala (0.066).Conclusion: The utilization of CS services from public health centers in India is pro-rich. Periodically monitoring and evaluating of the cash incentive schemes for CS delivery and generating awareness among the poor would increase the use of CS delivery services in public health centers and reduce the inequality in CS delivery in India. [ABSTRACT FROM AUTHOR]

Over 70 per cent of India's surface water is polluted by human excreta and other waste and less than 35 per cent of urban wastewater is treated. This poses a severe risk to public and environmental health. Urban waterbody rejuvenation in India often focuses on aesthetic improvements rather than addressing its systemic interdependencies with sanitation. This paper establishes these systemic links through a mixed-methods study using water-quality testing and stakeholder interviews in the city of Bengaluru, India. A conceptual system dynamics model of technical, social, institutional and environmental factors is developed. Results show that sewage leaks into lakes via stormwater drains are a major pollution pathway, among others. Three system levers for positive change have been identified: coordination of government entities, adequate faecal sludge management and strong citizen involvement. Citywide inclusive sanitation (CWIS) is proposed as an approach to provide leverage and solve the intertwined issues of public and environmental health. [ABSTRACT FROM AUTHOR]

Background: Patient education is an essential component of improving public health as it empowers individuals with the knowledge and skills necessary for making informed decisions about their health and well-being. Primary care physicians play a crucial role in patients' education as they are the first contact between the patients and the healthcare system. However, they may not get adequate time to prepare educational material for their patients. An artificial intelligence-based writer like ChatGPT can help write the material for physicians. Aim: This study aimed to ascertain the capability of ChatGPT for generating patients' educational materials for common public health issues in India. Materials and Methods: This observational study was conducted on the internet using the free research version of ChatGPT, a conversational artificial intelligence that can generate human-like text output. We conversed with the program with the question - "prepare a patients' education material for X in India." In the X, we used the following words or phrases -- "air pollution," "malnutrition," "maternal and child health," "mental health," "noncommunicable diseases," "road traffic accidents," "tuberculosis," and "water-borne diseases." The textual response in the conversation was collected and stored for further analysis. The text was analyzed for readability, grammatical errors, and text similarity. Result: We generated a total of eight educational documents with a median of 26 (Q1-Q3: 21.5-34) sentences with a median of 349 (Q1-Q3: 329-450.5) words. The median Flesch Reading Ease Score was 48.2 (Q1-Q3: 39-50.65). It indicates that the text can be understood by a college student. The text was grammatically correct with very few (seven errors in 3415 words) errors. The text was very clear in the majority (8 out of 9) of documents with a median score of 85 (Q1-Q3: 82.5-85) in 100. The overall text similarity index was 18% (Q1-Q3: 7.5-26). Conclusion: The research version of the ChatGPT (January 30, 2023 version) is capable of generating patients' educational materials for common public health issues in India with a difficulty level ideal for college students with high grammatical accuracy. However, the text similarity should be checked before using it. Primary care physicians can take the help of ChatGPT for generating text for materials used for patients' education. [ABSTRACT FROM AUTHOR]

Background: Developing public health educational programs that provide workers prepared to adequately respond to health system challenges is an historical dilemma. In India, the focus on public health education has been mounting in recent years. The COVID-19 pandemic is a harbinger of the increasing complexities surrounding public health challenges and the overdue need to progress public health education around the world. This paper aims to explore strengths and challenges of public health educational institutions in India, and elucidate unique opportunities to emerge as a global leader in reform.Methods: To capture the landscape of public health training in India, we initiated a web-based desk review of available offerings and categorized by key descriptors and program qualities. We then undertook a series of in-depth interviews with representatives from a purposively sample of institutions and performed a qualitative SWOT analysis.Results: We found that public health education exists in many formats in India. Although Master of Public Health (MPH) and similar programs are still the most common type of public health training outside of community medicine programs, other postgraduate pathways exist including diplomas, PhDs, certificates and executive trainings. The strengths of public health education institutions include research capacities, financial accessibility, and innovation, yet there is a need to improve collaborations and harmonize training with well-defined career pathways. Growing attention to the sector, improved technologies and community engagement all hold exciting potential for public health education, while externally held misconceptions can threaten institutional efficacy and potential.Conclusions: The timely need for and attention to public health education in India present a critical juncture for meaningful reform. India may also be well-situated to contextualize and scale the types of trainings needed to address complex challenges and serve as a model for other countries and the world. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism is an emerging public health concern, which need to be of due significance. Inspite of iodine supplementation started three decades ago, hypothyroidism is still a problem to be tackled. Apart from iodine deficiency, the contributing factors of hypothyroidism have to explored. Aim: To identify the contributing factors of hypothyroidism in adults. Materials and Methods: A systematic literature search was done using PubMed, MEDLINE, Embase, Google Scholar and the internet search from 2000 to 2018. The key words used were hypothyroidism, thyroid disorders, underactive thyroid, contributing factors, causes and associative factors. All the articles were analysed and the data were extracted using eligibility (inclusion and exclusion criteria) criteria. A total of 14 articles, which are either review articles or systematic reviews, in English language, and are fully retrievable were analysed and a systematic review was performed. Among the reviews, nine were review analysis and five were systematic reviews. The risk of bias assessment was done at the study level and data synthesis was done based on the criteria satisfied by the checklist. Results: The present analysis has included studies related to contributing factors of hypothyroidism. The analysis revealed the following contributing factors of hypothyroidism. Too little or too much iodine (43%), excess fluoride (7%), female gender (14%), presence Thyroid Per Oxidise (TPO) antibodies (36%), smoking status (14%), age above 70 years (21%), unregulated use of pesticides (14%), contaminated drinking water (14%), certain medicines (29%), use of plastic bottles contain Bisphenol A (BPA) and paper cups insulated with plastics (7%) and exposure to goitrogens (7%). Conclusion: Hypothyroidism is a leading emerging health problem in India. The prevalence is 11-15%. Despite the fact iodine fortification since 1983, hypothyroidism is a major public health to be tackled. In the current review five studies from India were included. Most of the studies showed the iodine as the contributing factor either in too much level or too little level. [ABSTRACT FROM AUTHOR]

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Introduction: Addressing social determinants of health (SDH) from a global health security perspective is important especially in low and middle income countries. Socioeconomic status, cultural, political and behavioural factors influence health and disease of the people. This paper seeks to describe how government programmes and other initiatives are expected to play an important role in addressing SDH and thereby improving health of the people. The analysis addresses both health and social policy issues. Context and Aim: The study assumes importance in view of India moving towards strengthening health and social security of its people through several policy-driven initiatives. Methods: This analysis classifies the 100 plus programmes launched by the Government of India into health, education, nutrition, social security, etc., and compares available indicators (2000–2018) Findings: The initiatives of the Government of India are expected to improve health and social security of its people, with focus on addressing health as well as social inequity. One of the programmes (Swachh Bharat Mission – clean India mission) has helped in avoiding 300,000 child deaths. Official survey results are not available for all indicators. Innovative contribution to policy, practice and/or research: Analysis of Government of India's policy-driven programmes and other initiatives with focus on livelihood improvement indicate that they are contributing to ensure health and social security; and are worth replicating in similar settings. [ABSTRACT FROM AUTHOR]

Background: Reduction of multidimensional poverty and tuberculosis are priority development agenda worldwide. The SDGs aims to eradicate poverty in all forms (SDG 1.2) and to end tuberculosis (SDG 3.3.2) by 2030. While poverty is increasingly being measured across multiple domains, reduction of tuberculosis has been an integral part of public health programmes. Though literature suggests a higher prevalence of tuberculosis among the economically poor, no attempt has been made to understand the association between multidimensional poverty and tuberculosis in India. The objective of this paper is to examine the association of multidimensional poverty and tuberculosis in India.Methods: The unit data from the National Family Health Survey-4, conducted in 2015-16 covering 628,900 households and 2,869,043 individuals across 36 states and union territories of India was used in the analysis. The survey collected information on the self-reported tuberculosis infection of each member of a sample household at the time of the survey. Multidimensional poverty was measured in the domains of education, health, and standard of living, with a set of 10 indicators. The prevalence of tuberculosis was estimated among the multidimensional poor and non-poor populations across the states of India. A binary logistic regression model was used to understand the association of tuberculosis and multidimensional poverty.Results: Results suggest that about 29.3% population of India was multidimensional poor and that the multidimensional poverty index was 0.128. The prevalence of tuberculosis among the multidimensional poor was 480 (95% CI: 464-496) per 100,000 population compared to 250 (95% CI: 238-262) among the multidimensional non-poor. The prevalence of tuberculosis among the multidimensional poor was the highest in the state of Kerala (1590) and the lowest in the state of Himachal Pradesh (220). Our findings suggest a significantly higher prevalence of tuberculosis among the multidimensional poor compared to the multidimensional non-poor in most of the states in India. The odds of having tuberculosis among the multidimensional poor were 1.82 times higher (95% CI, 1.73-1.90) compared to the non-poor. Age, sex, smoking, crowded living conditions, caste, religion, and place of residence are significant socio-demographic risk factors of tuberculosis.Conclusion: The prevalence of tuberculosis is significantly higher among the multidimensional poor compared to the multidimensional non-poor in India. [ABSTRACT FROM AUTHOR]

The sudden upsurge in the newly emerging COVID-19 variants acted as a catalyst for India to scale up the viral Genomic surveillance in order to understand the nature and trends of the newer variants of concern and strengthen public health interventions across the country. The Government of India has proposed the Indian SARS-CoV-2 Genomics Consortium to expand the whole-genome sequencing (WGS) of this virus. However, in a vast country like India introduction and implementation of any new strategies amidst the already existing barriers due to COVID-19 will be a herculean task. This paper talks about how the primary care physicians can play a vital role in successful implementation of the above strategy in addition to the surveillance systems in India. [ABSTRACT FROM AUTHOR]

Implementing the nurturing care framework (NCF) for early childhood development (ECD) is essentially multisectoral, requiring coordination amongst all sectors and harmoniously integrating it within the existing contact opportunities in the health sector. This paper discusses the relative strengths, persisting gaps, challenges, and the way forward to implement nurturing care for ECD through the public health system. The vast network of frontline health workers and health facilities; community, home, and center-based service delivery; health and wellness centers located close to the communities have the potential to promote nurturing care. Persisting gaps include limited capacities of health workers in the nurturing care domains, lack of community engagement for ECD, weak referral linkages, inability to reach the most vulnerable children, missed opportunities for early identification of children at risk, and early intervention for children developmental delays and difficulties. Moving forward, incorporating nurturing care components into essential services packages, enhancing competencies of health workers, engaging with parents, establishing a mechanism for tracking children at risk, and developmental surveillance by trained service providers can provide the much-needed impetus to ECD. [ABSTRACT FROM AUTHOR]

The present pilot study was conducted to investigate the effectiveness and efficiency gains in collect outpatient health information from primary health centres and health sub centres through mobile applications for detecting disease outbreaks in near-real-time. The researchers were also interested in evaluating the difficulties in implementing mobile health technology with health workers of lesser technical experience in electronically submitting patient data. "Evaluating a Real Time Biosurveillance Program: A pilot project" was conducted in Thiruppathur block of Sivaganga district in southern rural Tamil Nadu in India from July 2008 to July 2010. During the first year, the researchers and technicians interacted with the health workers to develop the technology. Thereafter, digital data submission using the mHealthSurvey, from the 28 rural health care centres, began in June 2009. The digitized data was analysed for unusual patterns using the TCWI (T-Cube Web Interface). Adverse events detected through TCWI were disseminated via SMS, Email, and Web with the Sahana Alerting Broker web-based software. Averages of 217 health records were collected each day for detection of adverse epidemiological events. A major advantage of the mobile phone patient data collection method was the improved timeliness for real-time detection of any disease outbreak. Besides the delays of digitizing data because of the parallel routine labor intensive paper work, the health workers in Tamil Nadu were able to submit reliable patient health data using mobile phone, which makes it a friendly, efficient, and cost effective tool of data collection. [ABSTRACT FROM AUTHOR]

Purpose Recently, the Indian government launched health insurance schemes for the poor both to protect them from high health spending and to improve access to high-quality health services. This article aims to review the potentials of health insurance interventions in order to improve access to quality care in India based on experiences of community health insurance schemes. Data sources PubMed, Ovid MEDLINE (R), All EBM Reviews, CSA Sociological Abstracts, CSA Social Service Abstracts, EconLit, Science Direct, the ISI Web of Knowledge, Social Science Research Network and databases of research centers were searched up to September 2010. An Internet search was executed. Study selection One thousand hundred and thirty-three papers were assessed for inclusion and exclusion criteria. Twenty-five papers were selected providing information on eight schemes. Data extraction A realist review was performed using Hirschman's exit-voice theory: mechanisms to improve exit strategies (financial assets and infrastructure) and strengthen patient's long voice route (quality management) and short voice route (patient pressure). Results of data synthesis All schemes use a mix of measures to improve exit strategies and the long voice route. Most mechanisms are not effective in reality. Schemes that focus on the patients’ bargaining position at the patient-provider interface seem to improve access to quality care. Conclusion Top-down health insurance interventions with focus on exit strategies will not work out fully in the Indian context. Government must actively facilitate the potential of CHI schemes to emancipate the target group so that they may transform from mere passive beneficiaries into active participants in their health. [ABSTRACT FROM PUBLISHER]

Background: The occurrence of workplace hazards, occupational diseases, and deaths contribute significantly to the increase in the global burden of diseases. The Municipal Solid Waste (MSW) workers experience occupational stressors throughout the process of waste management that affects their well-being and results in high rates of occupational health problems. It is vital to understand the workplace practices and occupational morbidities of the MSW workers to ensure their safety and well-being. In this context, the study aimed to explore the occupational health and safety practices at the place of work among the MSW workers in Karimnagar and Hyderabad in Telangana, India. Methodology: A cross-sectional study was conducted in two cities of Telangana. A total of 394 MSW workers were surveyed. The number of MSW workers in Karimnagar and Hyderabad were 152 and 194, respectively. A pre-tested questionnaire was administered to the MSW workers to study the occupational morbidities and workplace safety practices. Focused group discussions were conducted among the MSW workers in both cities. In-depth interviews of sanitary supervisors in Karimnagar were conducted. Semi-structured questionnaires and interview guides were used with questions on sociodemographic characteristics, health status, work environment, protection strategy, and healthcare utilization. MS Excel and NVivo-12 were used for data analysis. Results: Musculoskeletal problem was the major reported morbidity among the MSW workers (76.6%). Injuries were reported more among the MSW workers in Hyderabad (39.7%) along with a fear of being hit by vehicles while working on the main roads. About 88.7% of the MSW workers had less than secondary education. There was a wage difference between the contract and permanent MSW workers. There was a lack of provision of personal protective equipment and poor working conditions, overall. Lack of basic amenities such as the provision of drinking water and toilets apart from inadequate social security and healthcare facilities was reported. Conclusion: This paper highlights the unsatisfactory working environment and high-occupational morbidities among the MSW workers in Telangana. There was a lack of basic amenities at the workplace making it difficult for the MSW workers. A comprehensive approach which focuses on the health and safety with social security for the MSW workers is required. [ABSTRACT FROM AUTHOR]

Urban sanitation in India faces many challenges. Nearly 60 million people in urban areas lack access to improved sanitation arrangements, and more than two-thirds of wastewater is let out untreated into the environment, polluting land and water bodies. To respond to these environmental and public health challenges, urban India will need to address the full cycle of sanitation, i.e. universal access to toilets, with safe collection, conveyance and treatment of human excreta. This paper outlines these concerns, and highlights the need for focusing on access to water and the full cycle of sanitation for the urban poor, as fundamental to addressing the sanitation challenge. Priorities for policy and financing for urban sanitation in India are discussed, and the paper concludes with an examination of key policy initiatives in the last decade, assessing the extent to which these priorities are gaining attention. [ABSTRACT FROM AUTHOR]

The outbreak of novel and recent coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has made an emergency throughout the world. In India, the outspread of the pandemic was observed on 3 March 2020, and after that exponential growth in the cases was observed in the country. Owing to the widespread transmission, high population density, high testing capacity and ineffective treatment, a continuous rise in cases was observed due to the pandemic in India. In this paper, we have discussed the trend and spread of COVID-19 spread in India with time, history of initial confirmed cases, the impact of phased manner lockdown, age- and gender-wise trend of cases and comparison of cases with the other most affected countries. The study uses exploratory data analysis to describe the current situation of COVID-19 cases in India till 16 August 2020, with the help of data from the Ministry of Health and Family Welfare, Government of India (GOI) and the World Health Organization (WHO). As of August 16, the total number of confirmed cases in India crossed 2.5 million marks with over 50,000 causalities. With more patients recovering and being discharged from hospitals and home isolation (in case of mild and moderate cases), the total recoveries have crossed the 1.8 million mark with a recovery rate of more than 70% and case fatality rate of 1.94% which is maintained below the global average and is on a continuous positive slide. The study also enlightens the preventive and stringent measures taken by India to combat the COVID-19 situation along with the future prospects. The GOI is following its proactive and preemptive approach for management, prevention and containment of COVID-19 in collaboration with the WHO. [ABSTRACT FROM AUTHOR]

Non-communicable diseases are already acknowledged as a double burden, and now childhood obesity is putting extra strain on our health system. The current paper aimed to analyze the ongoing health and related programmes/policies in India, and we discussed the existing opportunities in the programmes to address the issue of childhood obesity in India. We searched the "MEDLINE," "PsycINFO," "Scopus," "Web of Science," and "Google Scholar" databases using the following keywords: ("overweight") and ("obesity"), ("childhood obesity"), ("nutritional programmes in India"), ("Health policies in India"), ("malnourished children in India") in combination with each other and in truncated form. All the relevant articles and policy documents (MOHFW, INDIA) available in the public domain were included to support the argument for this narrative review. We found that we have programme gaps like guidelines issues by Food Safety Standards Authority of India to tackle childhood obesity and it has not been strictly implemented due to multiple reasons. School health programme has an opportunity to address the issue of childhood obesity, but at the ground level the outcomes are not very promising. The National Nutrition Mission have only focussed on undernutrition and anemia problem, ignoring the overweight/childhood obesity. Primary care physicians are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke is dealing with health promotion and prevention, early diagnosis, and management of all ages, except children. Diet provided in Integrated Child Development Scheme is calculated based on calories, not by the quality which is a concern to us. The breastfeeding promotion programme named Mothers Absolute Affection programme has not been implemented with letter and spirit. Other than health programmes, we assume that Ministry of Urban Planning, Foreign Direct Investment policy, Advertisement Council of India and many more sector/policy/programme are indirectly responsible for the increasing burden of childhood obesity in India. Lack of awareness and wrong perception also responsible for the development of childhood obesity. We have multiple National Health Programmes and Policies to address the childhood malnutrition, but are focussing the undernutrition component only, ignoring overnutrition problem in the children, which is emerging as quadruple burden to our health system. Appropriate actions and inclusion of suggestions provided in this study for the improvement of the programmes at the practical level needs to be considered by the policy makers to halt the ever-rising trend of childhood obesity and primary care physicians should play a leadership role. [ABSTRACT FROM AUTHOR]

The emergence of coronavirus disease-2019 (COVID-19) has caused unprecedented challenge to manage the bodies of the dead. The disposal of the dead becomes a challenge as there is a shortage of coffins, and crematoriums are overwhelmed. A recent correspondence published in the Journal of Public Health highlighted the importance of performing the last rites in a time of COVID-19 pandemic. This paper argues that the bodies of those who have died because of COVID-19 should be treated with respect and dignity. [ABSTRACT FROM AUTHOR]

Health sector reforms were introduced in several states of India in 1991. The rationale was to increase choice and competition, to improve quality and access to health care Such demand-led incentives were integral to macro-economic stabilization programs world-wide during the 1990s. For a majority of the population of India, health care costs linked to commercialisation of health services were forcing households into serious debt. Using primary data on patterns of utilisation of health services (2002), this paper reports from a systematically collected empirical evidence base, to explore the preliminary impact of changes to the health sector from 1991 to 2000 in West Bengal (WB), Tamil Nadu (TN), and the hospital sector of Andhra Pradesh (AP). The overall aim is to provide historical context to the experience of reforms for poor and vulnerable groups and to understand current discourses on the health system in India, focused on "managed care" through a universal health insurance programme. We explore linkages between the past and present on disinvestment in public provision and its long-term consequences for equity of access to health care in the three states, and elsewhere in the country. [ABSTRACT FROM AUTHOR]

Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home. [ABSTRACT FROM AUTHOR]

Global health diplomacy has gained significant importance and undoubtedly remained high on the agendas of many nations, regional and global platforms amid the coronavirus disease 2019 (COVID-19) pandemic. Many countries have realized the importance of the health sector and the value of a healthy workforce. However, there is little control on issues related to trade that impact on human health due to the dominance of profit-oriented business lobbies. A balance, however, needs to be struck between economic profits and a healthy global population. This paper aimed to highlight the importance of building capacity in global health diplomacy, especially during the COVID-19 pandemic so that health personnel may effectively negotiate on the multisectoral stage to secure the resources they need. The recent proposal to waive off certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement for the prevention, containment and treatment of COVID-19 by India and South Africa at the World Trade Organization (WTO) presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access at the international level so that both developed and developing nations may enjoy improved health outcomes related to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]